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14 Oct 15:12

How One of America's Most Overweight Cities Lost a Million Pounds

by Ian Birrell

So interesting...

Parkin Parkin / Mosaic

When Velveth Monterroso arrived in the U.S. from her hometown in Guatemala, she weighed exactly 140 pounds. But after a decade of living in Oklahoma, she was more than 70 pounds heavier and fighting diabetes at the age of 34. This friendly woman, a mother of two children, is a living embodiment of the obesity culture cursing the world’s wealthiest country. “In Guatemala it is rare to see people who are very overweight, but it could not be more different here,” she said. “I saw this when I came here.”

As soon as she arrived in the U.S. she started piling on pounds—an average of seven each year. In Guatemala, she ate lots of vegetables because meat was expensive. But working from 8 o'clock in the morning until 11 at night as a cook in an Oklahoma City diner, she would skip breakfast and lunch while snacking all day on bits of burger and pizza. Driving home, she would often resort to fast food because she was hungry and exhausted after a 15-hour day slaving over a hot grill. If she and her husband Diego—also a cook—made it back without stopping, they would often gorge on whatever was available rather than wait to cook a decent meal.

Her lifestyle was no healthier when she stopped working after having her second child eight months ago. She was tired and her family encouraged her to drink lots of atole—a heavily sweetened corn-based drink popular in central America—to aid the breastfeeding of her new daughter, Susie. Sugar levels in her body soared, and on top of her obesity she became pre-diabetic.

Velveth’s life was changed—and probably ultimately saved—when she took Susie for a medical check-up and was enrolled in a program to curb obesity. Now she eats fast food just once a week, cooks more vegetables, has cut down the number of tortillas consumed at meals and exercises daily by walking up and down stairs for 20 minutes. Although still overweight, in just four months she has lost 16 of those pounds gained in America. “All my friends are impressed,” she told me with a smile. “I feel like I have so much more energy now. I can do the shopping and laundry, bathe the baby, and I’m not nearly so tired as before.”

Velveth is one beneficiary of a remarkable attempt to tackle obesity: Oklahoma City has declared war on fat. First the mayor—realizing he had become clinically obese just as his hometown was identified by a magazine as one of America’s most overweight cities—challenged his citizens to collectively lose a million pounds. But hitting that target was just the start: This veteran Republican politician then took on the car culture that shaped his nation and asked citizens to back a tax rise to fund a redesign of the state capital around people.

This unleashed an incredible range of initiatives, including the creation of parks, sidewalks, bike lanes, and landscaped walking trails across the city. Every school is getting a gym. With the new emphasis on exercise, city officials spent $100 million creating the world’s finest rowing and kayaking centre in a Midwest town with no tradition of the sport beforehand. Overweight people are targeted at home and at work to alter their lifestyles, while data are used to discover the districts with the worst health outcomes so that resources can be poured in to change behavior.

The experiment is unusual in terms of its ambition, breadth and cost, all of which take it beyond anything being attempted by other American cities in the fight against fat. The battle is being done with, rather than against, the fast-food industry and soda manufacturers, relying largely on persuasion instead of coercion through soda bans and sugar taxes. The city has been dubbed “a laboratory for healthy living.” Yet what makes the experiment quite so extraordinary is that it is being attempted in Oklahoma.

The city is one of the nation’s most spread-out urban environments, covering 620 square miles, which means its 600,000 residents rely on cars; there are so many freeways they quip that “you can get a speeding ticket at rush hour.” Not only did the city not have a single bike lane, also it reputedly had the highest density of fast-food outlets in America, with 40 McDonald’s restaurants alone. It sits in a state seen as cowboy country filled with ultra-conservative Okies, symbolized by The Grapes of Wrath, John Steinbeck’s definitive 1930s novel about poor farmers driven away by drought and hardship. The economy collapsed again in the 1980s amid the energy crisis, with bank closures and another generation drifting away; then came the terrible 1995 bombing that killed 168 people.

Churches began setting up running clubs, schools discussing diet, companies holding contests to lose weight.

The man behind the transformation is Mick Cornett, a former television sportscaster who became mayor in 2004. Three years later he was flicking through a fitness magazine when he noticed his city had been given the unwanted accolade of having the worst eating habits in the U.S. and was prominent on a list of the nation’s most obese populations. This coincided with his own reluctant acceptance, after checking his personal details on a government website, that at almost 220 pounds he was obese.

“This list of obesity affected me as mayor, and when I then got on the scales it affected me personally. I have always exercised and I remember thinking that I did not eat between meals, yet I was eating 3,000 calories a day. As mayor people are always wanting to meet with you, so it was not unusual to have a business breakfast, then a lunch with someone, then a function dinner. And in between there can be events with snacks and cookies.”

Cornett’s response was to start losing weight by watching what he ate; today he is almost 40 pounds lighter. But he also began to think about the issue, wondering why America was ignoring such a massive problem. His eventual conclusion was that this was because no one had any real solutions to the crisis. At the same time, the mayor began to look afresh at the culture and infrastructure of his city, realizing how the extent of reliance on cars had alienated human beings from enjoying and using their own urban environments.

His first step was to challenge citizens to join him on a diet. Using his flair for publicity after 20 years in television, he announced that he wanted Oklahoma City to lose one million pounds. He made the annoucement standing in front of the elephant enclosure at the local zoo on New Year’s Eve, aware of the media focus on diets in the days after the festive excess. He persuaded a health-care magnate to fund an information website called This City Is Going On A Diet—and was relieved over the following days as local papers backed his campaign and the national media praised it.

Churches began setting up running clubs, schools discussing diet, companies holding contests to lose weight; chefs in restaurants competed to offer healthy meals. More importantly for the mayor, people across the city began discussing a crisis spiraling out of control. Almost one-third of adult Oklahomans are obese, while the state ranks among the worst in fruit consumption and has one of the lowest life expectancies in America. Diabetes rates nearly doubled in a decade. Perhaps most alarmingly, more than one in five children aged 10 to 17 suffer from obesity and almost one-third of pre-school infants are overweight.

Ashley Weedn, the medical director of a specialist child-obesity clinic that opened three years ago in Oklahoma City, told me they were seeing ‘incredible’ cases of four-year-olds with high cholesterol and children consuming five times the daily sugar allowance in soft drinks alone. “We are even coming across kids with joint problems usually associated with much older people because of the strain on their legs, which we are seeing as early as six. This can involve surgery because of the pressure on bones leading to abnormal growth, which can lead to misshapen limbs.”

Despite some flak from doctors, Cornett decided from the start to work with the food and drink industry. So the soda sector sponsors health programs to fight obesity, and the mayor even posed with the boss of Taco Bell in one of the chain’s outlets to publicize a low-fat menu; indeed, he keeps one of the company’s promotional cut-outs in his office and proudly showed it to me when we met. “Even when I lost weight I would go to a fast-food place, although I might have a bean burrito without sour cream,” he told me. “I could not stop people going to them, but I could try to make them more discerning with their orders. You can’t totally change people’s habits.”

In January 2012 the city hit the mayor’s million-pound target—47,000 people had signed up, losing on average more than 20 pounds apiece. An admirable achievement, with the campaign proving a clever way to raise awareness. But for all the publicity, Cornett’s ambitions had grown way beyond that original simple stunt: Now he wanted to remake his huge metropolis by remolding it around people in place of cars. Or as he explained it, “putting the community back in the community.” Yet although these days hailed as an urban visionary, he readily admits there was no “grand plan” at the outset.

Oklahoma City has been a sprawling place since the day it was founded with a land grab in 1889, when thousands of settlers raced from a gunshot to stake out their land. Like most U.S. cities, it is criss-crossed with thunderous multi-lane freeways and developed around the car. Pedestrians and cyclists were largely ignored, with few pavements and no bike lanes. When Cornett began the first of his record-breaking four terms as mayor in 2004 the city was still emerging from the economic collapse of the 1980s; he was lucky to inherit the legacy of a predecessor who understood the need to create a nicer living environment to attract families and professionals, and who did so by building a new canal and sports arenas.

He was partly spurred into action by another of those lists loved by magazines, when his hometown was labelled worst for walking in the country. Cornett contacted a planning expert named Jeff Speck, who conducted a survey of the city that concluded it had twice as many car lanes as needed. The result was the dismantling of its one-way system, seen as encouraging faster driving, along with the start of a project to install hundreds of miles of pavements, parks, trees, bike lanes, sports facilities, and on-street parking to create a “steel barrier” between those thundering freeways and pedestrians.

“Obesity is the underlying cause of almost every chronic condition we have in Oklahoma.”

The scale is impressive. The city’s downtown is being rebuilt, while next up is the creation of a 70-acre central park, since studies show people exercise more if close to green spaces. “The American health-care crisis is an urban design problem,” argues Speck, author of a book called Walkable City. “The lack of attention to such issues has been a huge black hole. Data shows that physical health and obesity are tied much more to physical exercise than to diet. But what makes Oklahoma unique is their willingness to invest so generously, for which they must be commended.”

Cornett estimates about $3 billion has come from public funds, with up to five times that sum spent by the private sector riding his city’s renaissance. There was, for example, just one struggling hotel downtown at the turn of the century; today there are 15, and it was difficult to find a room at short notice. Remarkably, residents voted to pay for this redevelopment with a 1 cent rise on the local sales tax, which raises about $100 million a year; other funds have been taken from tobacco settlements and rising income from property taxes as firms and people are attracted back. Oklahoma City currently has among the lowest unemployment in the country, which blows away the dusty Grapes of Wrath clichés.

The most unexpected part of the makeover can be found a few minutes’ walk from the city’s entertainment district of Bricktown, where one of the world’s finest rowing facilities has been created in the heart of the Midwest. This is a city that even the mayor’s chief of staff says was a “horrible” place when growing up. Yet what was once a dried-up river in a dilapidated ditch best avoided by decent folks at night is now a sparkling 3-mile stretch of water, fringed with lush landscaping, futuristic-looking boathouses, bike lanes and floodlights.

According to Shaun Caven, a 47-year-old Scotsman who led the gold-medal-winning British canoe and kayak team at the 2008 Olympics before moving to be head coach at the Oklahoma City Boathouse, this will be the best set-up in the world upon the completion of its $45m white-water course. There are even altitude-training facilities in one of those high-tech boathouses. “People thought I was mad when I moved here—they said there’s no water, since the impression is of a bone-dry landscape,” said Caven. “But I liked the fact there was no history and the chance to start something from nothing.”

The river feels a long way from rowing’s upper-crust heritage: People on paddleboards and school parties on dragon boats share the water with U.S. Olympic teams in training under the searing sun. Efforts are made to attract people from across society: 50 firms have joined a corporate rowing league, while eight local high schools have their own boats. Among those I met there was Bob Checorski, a 76-year-old sweating from his exertions after rowing an impressive 11,000 meters, who told me he began six years ago after losing his free gym membership at work. “I do it for relaxation rather than racing—although I did win a silver medal in a doubles race soon after joining, with a guy who’d had open-heart surgery,” he said. “Now I just go out and enjoy myself.”

But plush sports facilities, nice parks and pleasant sidewalks can only go so far in fighting a culture of rampant obesity; many people need encouragement, help and even prodding to alter lethal lifestyles. And Oklahoma has some of the highest mortality rates in the U.S. So six years ago the city started poring over all available data to find its least healthy zip codes, discovering that some disadvantaged parts suffer five times as many deaths from strokes and cardiovascular conditions as wealthier areas. This led to the redirection of funds to places most in need.

Many experts compare this struggle to the anti-smoking movement.

“Obesity is the underlying cause of almost every chronic condition we have in Oklahoma,” said Alicia Meadows, the director of Planning and Development at Oklahoma City-County Health Department. “If you direct significant resources into areas of greatest health inequalities, we think you make the biggest difference.” They have an eight-strong team of outreach staff going to markets, sports events and even calling door-to-door in areas where data indicate people are in need of the most help. “We make it clear we don’t want to see their papers; we know many are undocumented. But their health impacts on the city’s health.”

These outreach officials come from the same communities they seek to change. One is a mother-of-two from an impoverished Mexican background, who told me she used to know nothing about nutrition; now she has lost 70 pounds and taken up kickboxing. I watched Dontae Sewell, another convert, lead a “Total Wellness” class in a library, making self-deprecating jokes about scoffing burgers at barbeques as he explained the etiquette of healthy eating. “If your friends love you, they still gonna visit even if you just serve them vegetables,” he declared.

The lesson was good-spirited, with lots of banter and little homilies alongside advice on when, what, and where to eat. The class of 22 women and one man, mostly overweight and some clearly obese, had lost 200 pounds between them in five weeks. “We want to see our grandkids,” one middle-aged mother told me afterwards. Sewell, with a chunky silver cross around his neck, asked how many of the class ate at the table; just four raised their hands. Then he asked how many fast-food outlets they passed on their way home from work. “Two dozen,” replied one woman. “Too many,” said another, laughing. “Don’t be too hard on yourselves,” said Sewell. “It’s about small changes and creating new habits.” Afterwards he confessed only about one-third stuck long term to their lifestyle changes.

The city has also built specialist “Wellness Campuses” in its worst-afflicted areas, the first in a low-income, largely African-American area to the north-east of the city. The slick new building—filled with medical clinics, communal meeting rooms and kitchens for cooking demonstrations—sits in verdant grounds dotted with walking and bike trails. Patients at the private–public partnership can see specialists in everything from nutrition to domestic violence, taking home prescriptions for food boxes and soon even for running shoes and vests. The local soccer team is building its training ground beside the campus to encourage participation in sport.

There is no doubt Oklahoma City and its fat-fighting mayor deserve credit for their war against obesity, an inspiration to a country in which over two-thirds of the adult population are overweight and which has such a strong car culture. At the very least they have made their hometown a more pleasant place to live—so important given the struggle between cities for jobs and young professionals. Yet the key question is whether even such valiant and wide-ranging efforts can dent such a huge health problem, one needlessly killing so many people on the planet. After all, one Lancet study looking into three decades of global obesity found that not one of the 188 nations studied had managed to turn the tide on this crisis, which grows worse by the day.

There are signs of success, although Cornett is not making big claims. “All I will say is that my impression is we are going in the right direction.” He is skeptical about data on obesity, but health indicators seem to back him. In the lowest-income areas, which have the highest rates of diabetes and blood pressure problems along with the worst outcomes, they have cut key indicators by between 2 and 10 percent in five years. Although Oklahoma men live almost six years less than the national average, the city has seen a 3 percent fall in mortality rates. Yet for all this, the rise in obesity has slowed—down from 6 percent a year to 1 percent—but it is sadly still increasing.

No wonder many experts compare this struggle to the anti-smoking movement, which took several decades of campaigning, education and regulation to change societal behavior. This was underlined to me the night before leaving Oklahoma City as I ate in a restaurant recommended by Cornett’s office. After a superb plate of pasta, I was offered dessert and chose a “roasted-pecan ice-cream ball ... smothered in chocolate sauce.” The waiter said that was a good choice, then asked if I wanted it “volleyball, softball, or baseball sized.” I went for the smallest; it was delicious and absurdly filling. But a posh restaurant offering volleyball-sized portions of ice cream? As Cornett says, it is hard to change habits in the battle against obesity.

This article appears courtesy of Mosaic.

05 Oct 17:57

The Better The Credit Score, the Longer-Lasting The Relationship

by Svati Kirsten Narula

This is a strategy I haven't tried.

Mark Blinch / Reuters

Those pondering the longevity of their relationships can rely on something other than the opinions of friends—they can look at their credit scores.

A new working paper published by the U.S. Federal Reserve Board finds that the higher someone’s credit score is, the higher his or her chances of a lasting relationship will be.

A trio of economists parsed data from the Fed’s consumer-credit panel to identify the credit scores of couples in committed relationships. People tend to form committed relationships with people whose credit scores are in the same range, the study found. And couples with high credit scores tend to stay together longer.

The credit scores were measured by Equifax, and indicate individuals’ creditworthiness on a scale from 280 to 850. The economists were able to track the relationships and credit scores on a quarterly basis. They identified “committed relationships” by noticing when two individuals who previously had not shared addresses began to do so, and continued living together for at least a year. The researchers said they applied a few other unspecified restrictions to ensure that most of the couples identified were indeed committed partners—though they note that they couldn’t distinguish between married and non-married or “cohabiting” ones, nor did they much care about this distinction.

“We are interested in the implications of credit scores and the associated match quality in a general swath of committed relationships, not just the couples who are legally married,” the researchers wrote, adding that cohabiting couples increasingly “share many household economic and financial responsibilities in a way similar to married couples.”

More From Quartz

For every additional 100 points or so in a couple’s average credit score at the beginning of their relationship, their odds of separating during the second year of the relationship drop by 30 percent, the researchers found. Also, if the difference between a couple’s individual credit scores is greater than 66 points at the start of the relationship, the couple is 24 percent more likely to split up within the second, third, or fourth year of the relationship. The study also noted that a pair’s credit scores are likely to converge slightly over the course of a relationship.

The link between credit scores and relationship longevity probably has to do with creditworthiness being a proxy for “an individual’s general trustworthiness and commitment to non-debt obligations,” the study notes. Those characteristics affect all sorts of things involved in sharing a household—who takes out the trash, for example, and who’s more likely to forget a birthday or anniversary.

Interviews of more than 50 people by The New York Times in 2012 revealed similar views; some had discussed credit scores on first dates, and others had found dates on websites such as And a Citigroup survey conducted in 2015 found that 78 percent of Americans would rather have a financially-savvy partner than a physically attractive one.

01 Oct 14:08

The Rise of Buffy Studies

by Katharine Schwab

ILU, Buffy.

CW / Andrey Kuzmin / Shutterstock / Paul Spella / The Atlantic

When Joss Whedon’s classic show Buffy the Vampire Slayer went off the air in 2003, its cult status was still very much nascent. Cue the novels, comics, video games, and spinoffs, not to mention fan sites, fan fiction, conventions, and inclusion on scores of “Best TV Shows of All Time” lists. But while it remains good fun to watch a seemingly ditzy teenager and her friends fight the forces of darkness with super-strength, magic, and witty banter, the show’s seven seasons have also become the subject of critical inquiry from a more intellectually rigorous fanbase: academics.

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Buffy, along with critically acclaimed series like The X-Files and Twin Peaks, came before The Sopranos and the beginning of the Golden Age of Television, but helped pave the way for scholars to treat television shows like The Wire, Mad Men, and Breaking Bad as sprawling works of art to be dissected and analyzed alongside the greatest works of literature. Academics have found Whedon’s cult classic to be particularly multi-dimensional—trading heavily on allegory, myth, and cultural references—while combining an inventive narrative structure with dynamic characters and social commentary.

As a result, hundreds of scholarly books and articles have been written about Buffy’s deeper themes, and an entire academic journal and conference series—appropriately called Slayage—is devoted to using the show and other Whedon works to discuss subjects such as philosophy and cultural theory. Buffy as an allegorical spectacle of postmodern life? Check. Buffy as a progressive, feminist challenge to gender hierarchy? Check. Buffy as a philosophical examination of subjectivity and truth? Why not?

Douglas Kellner, a professor at UCLA, has written that popular television does a particularly good job of expressing the subconscious fears and fantasies of a society, and that Buffy is an especially useful example. The show’s fantastical elements, he said, provide “access to social problems and issues and hopes and anxieties that are often not articulated in more ‘realist’ cultural forms,” like cop shows or sitcoms. But even popular dramas with similar surface-level conceits like Teen Wolf and Vampire Diaries, which focus mostly on soap-opera romance and teen issues, lack Buffy’s allegorical elements, which elevate the show and make it fascinating for scholars to study.

In Buffy, monsters act as physical stand-ins for societal differences and threats: Vampires symbolize sexual predators, werewolves represent bodily forces out of control, and witches tap into tropes about how female power and sexuality is seen as threatening. By fighting the “Big Bad,” Buffy and her friends fight the monsters everyone faces—oppressive authority figures, meaningless rules, confining social norms, sexual awakening, loneliness, redemption—in other words, the terrors of growing up and finding one’s way in the world.

Buffy scholars have taken dozens of different approaches to understanding the television show or using it to further work in other disciplines. In the decade since it went off the air, a Stanford University population ecologist used mathematical formulas to determine potential vampire demographics in Sunnydale, the fictional California town where the show is set. A strategist at the Center for Strategic and International Studies, the prominent Washington, D.C. think tank, compared Buffy’s war against the forces of evil to the U.S.’s war on terror and named a new paradigm in biological warfare after the fictional vampire slayer. An English-language historian and linguist published a lexicon of ‘Buffyspeak,’ the insider name for the particular slang and expressions used in the show (Examples include: “Love makes you do the wacky,” “What’s with the grim?” and “She’s the Do-That Girl”).

“Whedon seems to be an almost inexhaustible source,” said David Lavery, an English professor at Middle Tennessee State University who teaches courses on Mad Men, Doctor Who, and Lost as well as Buffy, and co-founded the Whedon Studies Association, an academic organization devoted to analyzing the works of the eponymous writer, producer, and director. “There’s the complexity, intertextuality, authenticity of his stories that makes them so rich for study. If he keeps making stuff for the next 10 years, I think Whedon studies will be going on for quite a long time.”

By fighting the “Big Bad,” Buffy and her friends fight the monsters everyone faces.

Even though it helped set the stage for prestige shows like Mad Men to be studied in an academic context, Buffy lacks some of the same gravitas those series do. The New Yorker critic Emily Nussbaum has lamented that Buffy doesn’t look the way “worthy” television should look, which has made it difficult for her to convince friends and peers of its quality. (In early seasons, she noted, “the werewolf costume looked like it was my great-aunt Ida’s coat.”) Still, Buffy’s sometimes Dr. Who-esque campiness itself has merited critical essays. Meanwhile, other scholars have unpacked the complex relationship Joss Whedon has to his universes, examining him as an auteur on par with show creators such as Vince Gilligan, Matthew Weiner, and Shonda Rhimes.

Beyond Buffy, the field of popular-culture studies is rising in universities across the country. Students are critiquing Madonna, Jay-Z, and Harry Potter, as well as The Sopranos, The Wire, and Lost. These scholars—many of whom are fans of the works they study—sometimes brush up against an academic culture that looks down upon their texts of choice, despite television’s formal and thematic similarities to other well-established areas of study.

But throughout history, yesterday’s lowbrow is often tomorrow’s cultural classic. Rhonda Wilcox, who also co-founded the Whedon Studies Association, frequently compares the episodic format of television to 19th century serialization of novels, like those of Charles Dickens. Dickens, as well as Shakespeare, was considered “pop culture” and thus unworthy of study by close-minded academics who maintained that epic poetry was the most legitimate text. Literary studies and film studies as they’re known today both underwent similar battles for legitimacy that television studies is currently facing. “I think that we’re slowly getting people to recognize that television studies needs to be taken seriously. It’s a general prejudice because it’s fun,” Wilcox says.

Perhaps unsurprisingly, Whedon himself supports the rise of the discipline. In an interview with The New York Times in 2003, he said, “I think it’s always important for academics to study popular culture, even if the thing they are studying is idiotic. If it’s successful or made a dent in culture, then it is worthy of study to find out why.”

04 Sep 14:40

The Next Great TV Show (If Someone Will Make It)

by Christopher Orr


20th Century Fox

Fifteen years ago, when I finished reading Patrick O’Brian’s magisterial 20-novel Aubrey-Maturin series for the first time, I remember thinking, damn you, Horatio Hornblower. C.S. Forester’s renowned nautical protagonist was at the time enjoying the starring role in the British TV series Hornblower, and given the close similarities to O’Brian’s oeuvre—both concern the Royal Navy during the Napoleonic era—it seemed unlikely bordering on inconceivable that anyone would try to adapt the latter for television.

That was, of course, at a time when it almost went without saying that a project of such scope and pedigree would have to be British. But the televisual times have since changed immeasurably for the better on this side of the Atlantic, and now it’s easy to envision O’Brian’s books—which The Times Book Review has hailed as “the best historical novels ever written”—being adapted by any number of networks: HBO, obviously, but also AMC, FX, Netflix, USA … the list grows longer by the month.

Which is a very good thing, because if someone would merely get around to undertaking them, the Aubrey-Maturin novels could easily provide material for exquisite television, offering the action and world-building scale of Game of Thrones, the social anthropology (and Anglo-historical appeal) of Downton Abbey, and two central characters reminiscent of (though far more deeply etched than) Rust Cohle and Marty Hart in the first season of True Detective. Someone really needs to make this happen.

I was reminded of this when I rewatched Peter Weir’s 2003 big-screen O’Brian adaptation, Master and Commander: The Far Side of the World, on a recent transatlantic flight. It is a fine film (I reviewed it here), but it scarcely attempts to scratch the surface of its principal characters, let alone the rich supporting populations who orbit them.

Those principal characters are Captain Jack Aubrey—brave, gregarious, impetuous, not infrequently subject to romantic indiscretion—and his ship’s surgeon, Stephen Maturin, an accomplished but introverted scholar and naturalist. (He’s also gradually revealed to be a high-level spy, as well as an uncommonly gifted duelist and assassin.) The two meet-ugly at a concert in Minorca on April 1, 1800—Maturin is infuriated by Aubrey’s tapping to the beat “a half measure ahead”—but quickly become fast friends in part thanks to their shared love of music. Together they form what Christopher Hitchens described as “one of the subtlest and richest and most paradoxical male relationships since Holmes and Watson.”

In Weir’s film, Aubrey and Maturin were played, respectively, by Russell Crowe and Paul Bettany. And while both actors offered solid performances, neither was particularly well-suited to his role: Crowe is too dark for Aubrey, and Bettany not dark (or small) enough for Maturin. Properly cast—a pairing such as that of Chris Hemsworth and Daniel Brühl in Ron Howard’s underrated Rush would be closer to the mark—both are potentially career-defining roles, Maturin in particular.

Though you wouldn’t know it from Weir’s film, which took place entirely at sea, O’Brian provides solid female roles, too, in Aubrey and Maturin’s contrasting love interests, Sophie Williams and, especially, Diana Villiers. (It’s no coincidence that the author to whom O’Brian is most frequently compared—more than Melville or Conrad or Forester—is Jane Austen.) Outwards from this core are found an absurdly generous constellation of supporting characters: Tom Pullings, Barrett Bonden, Preserved Killick, Padeen (if he wasn’t an inspiration for George R.R. Martin’s Hodor, the resemblance is a remarkable coincidence), Sam Panda, Mrs. Broad, Clarissa Oakes, Heneage Dundas, Capitaine Christy-Pallière, the poor, doomed Lord Clonfert, and on and on.

There would be some narrative issues to untangle in adapting O’Brian’s work for television—chief among them the long, alternating storylines at sea and on land—but material this rich and vast could be sewn together in innumerable ways. And while it would inevitably be an expensive production, Hornblower showed that a similar feat could be pulled off way back in 1998. (Moreover, if financing can be arranged for an excellent but decidedly eccentric literary adaptation such as Jonathan Strange & Mr. Norrell—well worth checking out, incidentally, for those who haven’t—surely it could be found for a series with the relative commercial appeal of Aubrey & Maturin.)

So if you happen to know a network executive (or, better yet, are one yourself), please raise the idea with all available alacrity. The possibility of historic television, in both senses of the word, awaits. Until then, we will make do with O’Brian’s novels—which, if it is not already apparent, I recommend wholeheartedly to anyone who has not already had the good fortune to encounter them.

This article was originally published at

19 Aug 17:20

How Friendship Fights Depression

by Julie Beck

Ah, good old feelings-sprinkler. Anyway, yay friendship.

Paulo Otavio / Flickr

“As everyone knows, depressed people are some of the most boring people in the world,” Mindy Kaling writes in her book Is Everyone Hanging Out Without Me? “I know this because when I was depressed, people fled. Except my best friends.”

In a section titled “Best Friend Rights and Responsibilities,” she vows, “If you’re depressed, I will be there for you … I will be there for you during your horrible break-up, or getting fired from your job, or if you’re just having a bad couple of months or year. I will hate it and find you really tedious, but I promise I won’t abandon you.”

Having a relationship with someone who’s depressed can be difficult. It’s hard to hear a friend say negative things about herself; it’s hard to know how to help. These are among the more noble reasons people might have—or they may just not want to be brought down themselves by spending time with someone who’s depressed.

There’s an idea out there that you can “catch” depression, that it’s contagious. (One self-help book unequivocally declares in its title that Depression Is Contagious.) Some research supports this idea—one study found that depressive symptoms tended to appear in clusters in social networks, and another found depressive thought patterns spread between college roommates (though positive thinking spread as well).

But a new study published in Proceedings of the Royal Society B challenges that notion. Depression doesn’t spread, it found, but a healthy mood does. The researchers looked at data from more than 2,000 high-school students who took a survey of depression symptoms, and who also reported who their friends were, over a period of six to 12 months. Kids who initially scored as clinically depressed did not “infect” their friends, but if they had enough friends who had what the study called a “healthy mood” (in that they didn’t meet the criteria for depression), that doubled their chances of recovering from their depression. And for people who weren’t depressed in the first place, having enough mentally healthy friends halved their chances of developing depression.

That’s a pretty large effect, and supports previous research saying that high-quality social relationships lower people’s risk of depression.

Thomas House, one of the study authors and a senior lecturer in applied mathematics at the University of Manchester, says he believes this model has an advantage over the studies that find clusters. When you find clusters of friends who are depressed, it’s possible there’s a third factor at play—maybe “they're all heavily drinking or they’re all doing something else that makes them more predisposed to depression,” House says. “Our method wasn't susceptible to that because we looked at direct changes of state. We were pretty much directly observing this process of your friend influencing you. And the nice conclusion that we got was that your friends can protect you from depression and help you recover from it.”

That’s if mentally healthy people are there for their depressed friends, which could be easier said than done. Even if you can’t actually catch depression, that’s not to say spending time with a depressed friend doesn’t take its toll. As the cartoonist Allie Brosh, of the site Hyperbole and a Half, wrote in her astute comic about depression, “It's weird for people who still have feelings to be around depressed people. They try to help you have feelings again so things can go back to normal, and it's frustrating for them when that doesn't happen.”

“We’re not saying you have no negative effect on your friends’ mood but just that it’s not enough to push them into really full clinical depression,” House says.

And people suffering from depression may be inclined to withdraw anyway, to retreat and ruminate alone. That can be exacerbated by their friends’ misguided attempts to cheer them up.

“People want to help,” Brosh writes. “So they try harder to make you feel hopeful and positive about the situation … The positivity starts coming out in a spray—a giant, desperate happiness sprinkler pointed directly at your face. And it keeps going like that until you're having this weird argument where you're trying to convince the person that you are far too hopeless for hope just so they'll give up on their optimism crusade and let you go back to feeling bored and lonely by yourself.”

One theory of social support and depression suggests that whether relationships have a positive effect depends on whether the person feels like the relationship is meeting their basic psychological needs—autonomy, competence, and relatedness. This article gives the example of friends helping a depressed person with chores and errands. That could make the person feel better, but only if he sees it as an expression of love, rather than something that’s taking away his control over his own life.

We don’t know the details of the friendships in this new study—exactly what they talked about around the cafeteria table, what gestures were made, which were appreciated. But nonetheless, it seems that just being there was enough to have ripples.

This article was originally published at

30 Jul 12:50

The Worst Part About Recovering From a Concussion

by Sean McCoy

I took forever to get over my concussion, I also experienced ongoing headaches, depression and my doctor ended up giving me some Celebrex for what he thought might be whiplash. Sometimes I think I'm still affected, I feel quite different to before the injury.

Shaun Best / Reuters

Long after the pitch was thrown, after the screens dimmed and the books snapped shut, I reached the most despairing days of my concussion. The beginning had been fairly easy—as easy, that is, as getting concussed can ever be. The initial diagnosis was optimistic, symptoms were consistent with mild traumatic brain injury, and I assured my friends and family I’d be back to normal in a matter of weeks, if not days.

After all, the knock was nothing terrible: a low 80s heater to the dome from a D3 freshman. I was wearing a helmet. It was a sunny California afternoon. We all thought I’d be fine. I went to my evening politics seminar after practice and don’t remember feeling hazy or otherwise out of sorts. But the next day I started experiencing symptoms. And then, my symptoms started getting worse.

I soon learned that my confidence had been misplaced, and that despite the recent cultural shift toward focusing on brain injuries among professional athletes, modern medicine still has a long way to go before concussions are truly understood. It was this lack of understanding that was, for me, much more frustrating than the felt reality of my injury. The Centers for Disease Control estimates 1.7 million people in the United States suffer some form of traumatic brain injury every year—more than double the number of heart attacks that strike Americans each year. About 75 percent of those brain injuries are considered concussions or other forms of mild injury. And 80 to 90 percent of people will recover from a concussion within a seven to 10 day period, according to the National Institutes of Health. The other 10 to 20 percent are people like me, languidly drifting toward recovery at a more uncertain pace—like an amoeba in a petri dish.

All this highlights one of the great paradoxes of modern medicine: Some of the most common ailments remain some of the least understood.

* * *

Due to a host of reasons, doctors and medical professionals still struggle to answer seemingly basic questions about concussions. “For the vast majority of concussions that are treated in the E.R. and in the trainer’s room, there is currently no prognostic test available,” said Robert Siman, a researcher and professor of neurosurgery at the University of Pennsylvania.

This is partly because the very diagnosis and monitoring of a concussion are based on an amalgam of imperfect tests, none of which fully examines the underlying pathophysiological nature of the injury. New research assessing the severity of concussions through blood testing may eventually help unlock new methods for understanding such injuries, but further trial is still required. For now, when a person is suspected of having sustained a mild traumatic brain injury, they undergo a series of cognitive and symptom-based assessments. How is your memory? Are you experiencing headaches? Nausea? Dizziness? Loss or lack of balance? Sensitivity to light or sound? Patients are often asked to fill out a scorecard ranking the severity of their symptoms, and as symptoms vanish, they return to normal activity.

“We always look at mind, body, and spirit,” said R. Robert Franks, an osteopathic family physician and spokesperson for the American Osteopathic Association. “It’s an all-encompassing pathology, and you have to look at the complete patient with this, you have to look balance, you have to look vision, you have to look cognition, you have to look at neck pain for whiplash type injury, you have to look at anxiety, depression … you have to look at sleep. We focus so much on headache and dizziness, and those other symptoms kind of go by the wayside, but the athlete is not ready to go until we have all of those in check.”

In more serious cases of brain injury, imaging from a C.T. scan or an M.R.I. can reveal specifics, like an intracranial bleed, which takes longer to heal. But in the majority of patients suffering from concussions, it can be difficult if not impossible to say whether they will be part of the 80 to 90 percent that recovers quickly, or the latter 10 to 20 percent that needs more time. For the most part, doctors end up cobbling together an understanding of a person’s injury through subjective reports, brain imaging, and other tests. “So you can see a number of different things,” said Alison Cernich, the director of the National Center for Medical Rehabilitation Research at the NIH, “not just through cognitive testing and not just through asking the person, but by looking at some of the other symptoms.”

Symptom-scoring became the primary means for doctors to assess me as the weeks of my concussion wandered on. Every other day I filled out a questionnaire ranking my various ailments on a scale of 1 to 6. This process proved problematic: What is a 4, really? Individuals have different pain thresholds and rankings; and those individual rankings are easily subject to shift. At the beginning of my concussion I recall putting down 1s and 2s. But as the days wore on I realized I had been swayed by my own optimism. Now I really was a 2, back then I should have been a 4! I would suddenly realize that I felt better, but I didn’t have the numeric wherewithal to express my progress because I had skewed my initial ranking. Not only is such a scale nebulous and subjective, it relies on the perception of someone with a head injury. Even today, fully healed, a 1-to-6 scale would prove difficult for me to navigate. But imagine trying to fill out the scorecard while concussed. Imagine, while brain-addled, trying to give doctors, or anyone for that matter, a clear picture of your mind and body. And then imagine that picture serving an important role in your overall diagnosis.

I don’t want to give the impression that I was monitored solely on self-reported symptoms. Doctors regularly checked my eyes and memory. I had a C.T. scan taken, which came back clean. Doctors often asked me to perform balance, dexterity, and mobility tests, and they monitored my vitals and reflexes. I rode a stationary bike to see if activity exacerbated my symptoms. But I was not treated the same way a professional athlete might be treated. Which meant I wasn’t seen by specialists like Franks, who is also the director of the Rothman Concussion Institute and the co-medical director of the Jefferson Comprehensive Concussion Center. Franks is the team physician for U.S. Wrestling and consults for the Philadelphia Phillies, as well.

“Right now I think the biggest help for us with concussion is that we now have objective and subjective signs,” said Franks. “And you know, when I first started this it really was all about what the patient told us.” According to Franks, the measurement of balance is a direct reflection of certain elements of brain function. Advances in computer-based neuropsychological testing—a process that compares pre- and post-impact scores to assess cognitive ability—help, too. “We can also now objectively look at cognition, the way the brain is working,” he said.  

But a passage from The Consensus Statement on Concussion in Sport, a document that doctors and trainers rely on to treat concussions, says that while neuropsychological tests can offer “important data” for clinicians to consider, they “should not solely be used to diagnose concussion.” The guidelines also caution against widespread adoption of such tests, citing “insufficient evidence” for such a recommendation.

The problem is that we can’t see all of the inner-workings of the brain. As the neurosurgeon Siman told me, “concussion produces a sort of wide array of non-specific symptoms, non-specific in the sense that none of them are specific to concussion.” Just because a patient is experiencing headaches, mood swings, and trouble sleeping, doesn’t mean the patient is concussed. And just because a person is reporting symptoms, doesn’t mean those symptoms are accurate. Athletes, especially those competing for their paycheck, have all sorts of incentives to underreport symptoms to get back on the field. Similar pressure to misreport applies to students afraid of falling behind in class (or afraid of taking finals), as well as individuals whose jobs could be in jeopardy. “Our other big challenge continues to be those who don’t report symptoms to us,” Franks said.

All of this is to say that doctors depend a great deal on symptom analysis and some of those symptoms require subjective reporting. This causes frustration from the perspective of scientific rigor, a frustration that has led many researchers, like Siman, to look for alternative means of evaluation. Siman’s work has largely involved tracking a protein fragment, SNTF, in the bloodstream. He recently completed a study using blood samples from Swedish professional ice hockey players, where he found that the existence of elevated levels of SNTF in the blood correlated with the players’ recoveries from concussions. This type of study, and others like it that track certain biomarkers, could potentially change the foundation of how we understand concussions. “SNTF is something whose production is actually tied to the underlying pathophysiology that causes problems after a concussions” said Siman. In other words, the presence of this protein fragment could help show how severe a person’s injuries are.

Siman likes to refer to his research as an effort to find the “Troponin blood test for brain damage.” If someone is suspected of having had a heart attack, one of the most important diagnostic measures is to test for the protein Troponin in the blood. Troponin, usually only found in cardiac muscle cells, spills into the blood when those cells die. “A finding of an elevated level of Troponin in the blood is one of the key diagnostics routinely used for the diagnosis of heart attack.” said Siman. “So we’ve been looking for a brain injury counterpart to that.” Just as doctors track Troponin to diagnose a heart attack, Siman hopes a different protein can be found and tracked as a reliable diagnostic for concussions.

Other researchers are laboring to find similar objective, pathophysiological indicators of concussions. In addition to biomarkers in the blood, researchers have been experimenting with alternative imaging techniques. But for now, neither approach is recommended outside of research settings, according to The Consensus Statement on Concussion in Sport. Several doctors told me that developing biomarkers for assessing patients with concussions could be an important step forward—especially among those who are reluctant to acknowledge they’re still suffering from injury.

“[We] have a hard time often convincing parents, coaches, athletes, that yes, you’re still seeing residual concussion symptoms here,” Franks said. But the existence of a reliable biomarker could change the nature of that conversation. It would provide damning evidence that a player is still concussed. “I think that [a biomarker] is going to be the wave of the future, we just don’t have one that we’re 100 percent, you know, ready for yet,” he said.

Until then, doctors continue to rely on what Siman calls, “indirect measures of brain function,” to determine the extent and severity of a concussion. And for those of us without special assistance from professional athletic trainers, that makes the lousy experience of a concussion all the more muddled. This is without even going into what we still don’t know about treating concussions, an area sometimes no more mature than our ability to diagnose.

In the weeks after I thought I healed, I labored through headaches that Advil only dulled, but never took away. I was unsure whether my discomfort came from some lingering cognitive dissonance, or perhaps whiplash, as one doctor suggested may be the case. I recalled bygone scorecards of my days stranded in a sea of 1s and 2s, and wondered: Am I better now? Was I still concussed then? I flinched involuntarily when a door slammed shut, or when a shard of sunlight caught me from from behind the blinds. Often I retreated to my room—construction paper muffling the windows—and lay on my back, spinning a baseball into the air and lulling myself with the rhythmic smack of tightened leather on my palm. It was all I could do to keep my mind off the uncertainty of a lengthening recovery.

This article was originally published at

29 Jul 12:00

The Soul of the Metallica Lover

by Olga Khazan

Mostly shared for the headline.

Jorge Adorno / Reuters

For anyone who has ever caught some treacly adult contemporary on the radio and wondered “Who on earth likes this stuff?” while twisting the dial, a new study might have an answer. A bunch of softies, that’s who.

In the paper, published recently in the online journal PLoS One, Cambridge psychologist David Greenberg theorized that music tastes are determined in part by peoples’ tendency to fall into one of two rough personality categories: empathizers or systemizers. Empathizers are people who are very attuned to others’ emotions and mental states. Systemizers are more focused on patterns that govern the natural and physical worlds.

Over the course of multiple experiments that included 4,000 participants, listeners took personality questionnaires and then listened to and rated 50 pieces of music.

Greenberg found that people who scored high on empathy tended to prefer music that was mellow (like soft rock and R&B), unpretentious (country and folk), and contemporary (Euro pop and electronica.) What they didn’t like, meanwhile, was “intense” music, which he classified as things like punk and heavy metal. People who scored high on systemizing, meanwhile, had just the opposite preferences—they kick back to Slayer and could do without Courtney Barnett.

Type “e” are empathizers; type “s” are systemizers; type “b” are in between. (PLOS)

To get even more specific, the music empathizers liked tended to be softer, more depressing, and have more emotional depth. Systemizers, meanwhile, grooved to things that were high-energy, animated, and complex. Empathizers liked strings; systemizers liked distorted, loud, and “percussive.”

Preferences for various music qualities, by personality type. (PLOS)

They also came up with some, uh, playlists for people who find themselves solidly in either the empathizer or systemizer category.

High on empathy:

  • “Hallelujah” – Jeff Buckley
  • “Come Away With Me” – Norah Jones
  • “All of Me” – Billie Holliday
  • “Crazy Little Thing Called Love” – Queen

High on systemizing:

  • Concerto in C – Antonio Vivaldi
  • Etude Opus 65 No 3 — Alexander Scriabin
  • “God Save the Queen” – The Sex Pistols
  • “Enter Sandman” – Metallica

* * *

Music taste has long been thought to offer a window to the soul. (Past research has found, for example, that open-minded people are more likely to enjoy the blues, jazz, and folk, while extraverts like pop, electronica, and religious music.) It’s why people at parties ask each other “What music do you listen to?”

Still, this study doesn’t account for the fact that the answer to that question is, more often than not, “A little bit of everything.” Many people listen to Avicii when they run and to Bon Iver when they’re writing a memo in an open-plan office. It’s hard to imagine someone who listens only to Norah Jones on loop—although I would like to meet that person and ask them for stress-management tips.

The results could still be helpful, though, when it comes to things like understanding autism (some think people with autism are just extreme systemizers), or in determining whether listening to different types of music could help people build empathy.

Or, perhaps less nobly but more lucratively, the findings could be useful for companies like Pandora and Spotify.

“A lot of money is put into algorithms to choose what music you may want to listen to,” Greenberg said in a release. “By knowing an individual’s thinking style, such services might in future be able to fine tune their music recommendations to an individual.”

This article was originally published at

26 Jun 12:15

When Missed Periods Are a Metabolic Problem

by Sydney Parker

Ovaries :(

ET1972 / Shutterstock

When the former NFL cheerleader Natalie Nirchi stopped menstruating at age 17, she was diagnosed with polycystic ovary syndrome (PCOS), a hormone disorder affecting up to 10 percent of women of reproductive age. She didn’t initially show any of the physical symptoms, like excess hair growth, cystic acne, or obesity, but a blood test revealed that she had high levels of testosterone and an ultrasound showed cysts on her ovaries.

“My doctor mentioned that one day I might have trouble getting pregnant, but didn’t offer any other information about the disorder,” Nirichi said. Other than the absence of her period, PCOS did not significantly impact her life until college, when she began experiencing shooting pains in her pelvis, mood swings, and rapid weight gain despite a rigorous exercise routine.

“It wasn’t like I turned 21 and started partying, it was like I turned 21 and all of a sudden, I was extremely depressed. No matter what I did, I just kept building this layer of extra weight around my midsection,” she said.

PCOS is genetic and presents differently in each woman of childbearing age. For some women, symptoms emerge shortly after they begin menstruating. Others may not show signs of the disorder until later in life, or after substantial weight gain, and many don’t receive a diagnosis until they are struggling to get pregnant. A community-based prevalence study published in 2010 found that approximately 70 percent of the 728 women in the cohort had PCOS, but had no pre-existing diagnosis.  

Contrary to the implication of “polycystic,” some women with the condition don’t have any cysts. A diagnosis requires only two of the following three criteria to be met: elevated levels of male sex hormones (which can cause excess hair growth, acne, and baldness), irregular or absent periods, and/or at least 12 follicular cysts on one or both ovaries.

“If a woman has fewer than eight menstrual periods a year on a chronic basis, she probably has a 50 to 80 percent chance of having polycystic ovary syndrome based on that single observation,” said John Nestler, the chair of the department of internal medicine at Virginia Commonwealth University. “But if she has infrequent menstruation and she has elevated levels of androgens such as testosterone in the blood, than she has a greater than 90 percent chance of having the condition.”

When the syndrome was first described in 1935 by American gynecologists Irving Stein, and Michael Leventhal, it was considered a rare disorder. Today as many as five million women in the United States may be affected, according to the Department of Health and Human Services, but researchers are still just beginning to uncover the disorder’s full impact.

“Classically, we thought of PCOS primarily as an infertility disorder or a cosmetic annoyance, but we now know that it’s also a metabolic disorder and a serious long-term health concern,” Nestler said.

According to a recent study published in the Endocrine Society’s March 2015 issue of Journal of Clinical Endocrinology & Metabolism, women diagnosed with PCOS are twice as likely to be hospitalized for heart disease, diabetes, mental-health conditions, reproductive disorders, and cancer of the uterine lining. The cost of evaluating and providing care to women with PCOS is approximately $4.36 billion per year.

The definitive cause of PCOS is unknown, but researchers have found a strong link to insulin resistance, a genetic condition often associated with diabetes, in which the muscle, fat, and liver cells do not respond properly to insulin and thus cannot easily absorb glucose (sugar) from the bloodstream. As a result, the body produces higher and higher levels of insulin to help glucose enter the cells.

“The excess insulin that's being produced stimulates the ovary to make testosterone, which can interfere with ovulation, rendering many women infertile,” said Nestler. PCOS is the most common cause of infertility in industrialized nations. “The exact cellular and molecular mechanisms are still being explored and are not completely understood.”

In one study, insulin resistance was found in 95 percent of overweight women with PCOS and 75 percent of lean women with PCOS. Perhaps relatedly, women with PCOS have a more than 50 percent risk of getting Type 2 diabetes or pre-diabetes before age 40.

“We are seeing an explosion in polycystic ovary syndrome in adolescent girls, and I think it’s due to the fact that we are also seeing an explosion in obesity in adolescent girls,” Nestler said. “It’s quite possible that if those girls had remained a healthy weight, that they would still carry the genes that predispose them, but they wouldn’t be expressing the disorder.”

Healthy diet and exercise is the first line of intervention most doctors recommend for overweight women with PCOS. Research shows that a 5 to 7 percent reduction of body weight over a six-month period can lower insulin and androgen levels, restoring ovulation and fertility in more than 75 percent of patients.

Angela Grassi, a registered dietitian who also has PCOS, says that because women who are overweight are likely to experience more insulin resistance than those who are not, they can get locked into a cycle of weight gain. “The more weight you gain, the more corresponding insulin your body produces, and the more you continue to gain weight,” she said.

But this underlying metabolic dysfunction is at work even in women of a healthy weight, according to Daniel Dumesic, a reproductive endocrinologist at Ronald Reagan UCLA Medical Center.

“Research shows that unlike most women, lean women with PCOS tend to burn protein instead of fat while they’re sleeping. This might explain one of the reasons why despite their best efforts, it’s much harder for women with PCOS to lose weight,” he said.

Many doctors prescribe the drug metformin to help regulate the amount of glucose in the blood. The medication is traditionally used to treat Type 2 diabetes, as it makes the body more sensitive to insulin, and decreases the amount of glucose the liver releases. A meta-analysis published online in June in the journal Human Reproductive Update demonstrated that when metformin is combined with lifestyle modifications such as diet and exercise, it has been shown to help women with PCOS lose more body fat, achieve lower blood sugar, and improve menstruation better than lifestyle modification alone.

Regular menstruation is important for the prevention of endometrial cancer. Women with PCOS are three times more likely to have endometrial cancer than women without. When a woman isn’t menstruating on a frequent basis, the lining of the uterus (endometrium) can begin to grow excessively and undergo atypical cell changes resulting in a precancerous condition called endometrial hyperplasia. If left untreated, this can develop into full endometrial cancer. Hormonal birth-control pills are often prescribed to help women with PCOS shed their endometrium more regularly, an important measure for preventing the overgrowth of cells in the uterus.

“If a woman knows from a young age that she may have a more difficult time than her peers maintaining a healthy body weight and reproductive system, than she can make sustainable lifestyle changes early on,” said Dumesic.

Unfortunately, awareness of the condition is not widespread and many physicians do not perform the necessary diagnostic tests or recognize that PCOS has broad and potentially devastating consequences. According to the non-profit support organization, PCOS Challenge, Inc., PCOS awareness and support organizations receive less than 0.1 percent of the government, corporate, foundation, and community funding that other health conditions receive.

Only a small number of researchers receive funding to study PCOS and most of the money goes toward studying the infertility side of the disorder. Nestler says women would benefit if more of the funding went toward researching the metabolic mechanisms of PCOS that underlie the development of diabetes and heart disease.

Dumesic believes the complex metabolic, hypothalamic, pituitary, ovarian, and adrenal interactions that characterize the condition may be to blame for the deficit in PCOS specialists and researchers.

“When any condition crosses disciplines and doesn’t have a full investment in [one of them], it often falls through the cracks. There are elements of reproduction in PCOS, but most reproductive endocrinologists mostly do in-vitro fertilization and are not necessarily interested in metabolism. Medical endocrinologists, who are mostly interested in metabolism, aren’t usually interested in reproduction and ovarian function,” Dumesic said.

For women who don’t receive timely, appropriate care for PCOS in early adolescence, the development of symptoms such as facial hair growth can become more challenging to treat. Brandy Cramer, 33, a program officer at The Cameron Foundation, from Midlothian, Virginia says her doctors told her she just wasn’t trying hard enough to lose weight and dismissed her when she requested they run blood tests or suggest alternatives to the birth-control pills that gave her intense migraines. Cramer grew a full beard and has only been able to remove 50 percent of it, even after expensive laser hair-removal treatment.

“I had no support or resources to learn how to manage my PCOS. It wasn’t until I was able to connect with other women who had it that I started to feel less isolated and learned how to advocate for myself,” said Cramer.

Gretchen Kubacky, a health psychologist who also has PCOS, says the condition has a significant impact on the mental health of her clients on both a situational and chemical level.

“Often times the cosmetic issues are huge, depending on the severity. When you summarize the typical PCOS patient as someone who is fat, has acne, and male-pattern baldness, that is definitely depressing, but that in and of itself is not enough to cause depression,” she said. “It’s the hormonal imbalances that have a real neurobiological affect on the brain and we have evidence that the excess of androgens in women is definitely linked to depression.”

Sara Eaton, a 30-year-old ballroom dance teacher based in Augusta, Georgia, says PCOS has had a significant impact on her health, body image, and self-confidence since she was diagnosed at age 15.

“It’s a frustrating, difficult, and sometimes heartbreaking thing to deal with,” Eaton said. Eaton’s PCOS has given her male-pattern baldness, acne, obesity, and skin tags. In spite of her challenging symptoms, she dances and works out several times a week. “There aren't many women who look like me who can get on the floor and move like I do, who are comfortable enough in their skin to step into the spotlight and demand that people look at them,” she said.

Until PCOS is better-understood, Eaton says women need to look out for themselves and their fellow “cysters.”

“Don't just trust what the first doctor you see says without doing some research,” she says. “Find another woman with PCOS, go online to some of these support groups. Find a reproductive endocrinologist who knows what they're doing. Talk to other cysters, read the articles, look for doctor recommendations. We have a syndrome that is so complicated and confusing, one of the best ways we can help ourselves is to be proactive and make sure we find the best and most knowledgeable caregivers available to us.”

This article was originally published at

13 Jul 18:55

Trump Nation Speaks

by James Fallows


Part of the crowd at Saturday's Trump rally in Arizona. I believe I have heard from this guy. (Nancy Wiechec / Reuters)

In my post last night, I said that the passions that Donald Trump is whipping up, and riding on, might deserve press attention, even though his candidacy itself did not. I also said that I’d write nothing more about a “campaign” that had no chance of leading to the presidency until Trump plays whatever role he is going to play during the next GOP debate.

But it’s consistent with all of that to quote some reader reactions that either reveal, or discuss, the sentiments Trump is playing to. Here you go:

Your liberal butt.”

A reader who uses a pseudonym speaks for many, many people who wrote in:

I hope The Atlantic makes your liberal butt write the article explaining all the reasons why Donald Trump was elected to be the 45th and 46th President of the United States of America.

I promise that I will indeed write that article should the need arise. Similarly, from another reader using a pseudonym:

About your latest article, sounds like someone is telling you to right this stuff, because anyone with common sense can see, the last thing this country needs is another politician for president, we need a real business man, and its obvious that all politicians are scared of donald that's why everyone trying black flag him, there scared because he speaks the truth and no one can control him because he doesnt need there money!!!! Thats why the American people are going to vote him in!

Why we need someone without prior experience.

I pointed out that every one of presidents #1 through #44 had some prior public-office experience in an elective, appointive, or military role. A reader says that’s exactly what we don’t need for #45:

I served 4 years in the military, 2 more as a federal employee, and 2 more as a state employee. The one thing I can tell you, I've never seen as many lazy, unmotivated drains to society in one place at one time as I did in my time as a public "servant."  And, I've never witnessed such utter disregard and gross negligence for other people's money, or such unfathomable fraud, waste, and abuse of resources, time, and money, as I did in my eye opening tenure within these various levels of government.

Regarding your article on Trump, I'm not sure why you want the world leader to develop these horrible, life altering habits that you state are a prerequisite to being the head man (or woman).  I think that's exactly why the idea of a Trump Presidency is refreshingly optimistic, he's never been a public leech.

Your argument's facts may be true, but your conclusion renders it quite invalid.

Why he will win.

That is the contention of reader Daniel Stanton:

I told my father in the first quarter of 2013 that, given the way things are going, I would not be surprised by a Trump Presidency.  That is not to say merely because Obama's failings are so great, nor that they are anything more than an extension and amplification of Bush's failings; it is to say that it is because of them both.  In Trump, there's the one person who can benefit, politically, from bashing both.  

This is because of his particular brand of bombast, mastery of publicity and his transcendent celebrity.  He's unique and an anomaly in more ways than one.

On your points:

1) US Elective Precedent

Before Obama, there was never before elected a black POTUS.  Furthermore, before Obama, there was never before elected a nonwhite POTUS.  I haven't looked into this, but to extend the comparison to Europe, I'm pretty sure there have never been elected any nonwhite heads of state either.  Has Japan, China, the nations of the Mid East, etc. gone on to feature support of leaders who are minorities to their native populations?  

My point here is that America remains unique itself, despite our ailments and imperfections.  That is, we tend to buck the trend, make history .... set new precedents.  

Looking honestly at it, Obama should not have been electable either.  He had a limp record as state senator, as US Senator one where his accomplishments were naming a Post Office in Illinois and sending some more taxpayer money to Africa, but the guy had a certain appeal because of his ability to give a speech and the uniqueness of his persona.  

Not character.  Not record.  Not precedent.  Persona.  Trump is the same in terms of this denominator, which seems to be the dominant one by most of the voting electorate anymore.  

2) Novelty

Cain + Bachmann + Palin = Trump?  That is not a working equation.  The sentiment he's tapped into may have briefly blew winds into the sails of those three, but that gust has only grown more as national negligence on behalf of the political class and media cheerleaders and cohorts widdle away at what is perceived to be the mores of Americana.

Don't try to make that leap to read whiteness, to try to equate the influx of illegals with that of Irish and Polish and Italian immigrants of the past.  This is way different.  The government, alongside corporate America, are united in the importation of low or unskilled and, often, criminal elements of the third world.   Sanctuary cities have released of 8,000 imprisoned illegals back into American cities and the Obama Administration has a massive program to disperse illegals across all 50 states.  Clearly this is part of the Transformation of America, at the expense of the citizenry and society.  

So when people look up and there are atrocities being performed, repeatedly and increasingly, by those who should not be here to begin with, you can understand the slow boil is getting close to tipping.  Especially when we have political leaders who seem interested in looking the other way and probably ensuring amnesty both happens and illegals continue to get here.  

Trump is far more effective at capturing the spotlight, period, and when there is this glaring problem that is really an easy one to fix that just doesn't get fixed, well it becomes a microcosm of all that is wrong with the American political system and guess what, Trump is not a part of it and he can exploit that in ways the three, well, pawns you mentioned.

3) Anecdotes & Generalities

Everyone has 'em but media are selective in their deployment and application.  The fact that Webb has a personal story about a hispanic serviceman he fought with in Vietnam has nothing to do with the problem of the US having an insecure border and immigration system invested (both by neglecting to act and encouraging it to happen - see the US ads in Mexico) in allowing Tens of Millions of illegals to flood American towns and cities.  

Trump didn't besmirch all things Mexican.  He spoke of the border being the point of entry.  Mexico is the one who is actively letting it happen while America looks the other way.  Well it stands to reason that the nation that is the staging ground for illegal entry into American would naturally have the most numbers of people trying to gain access, doesn't it?  The USAF has a huge counter-narco terrorism unit to monitor Latin America b/c so many of their governments are corrupt and/or compromised by murderous drug cartels.  Hell, the most dangerous drug lord just escaped again from Mexico today!  We have a huge border problem, everyone knows it, and the American political class is every bit as guilty for that as Mexico is.  

This truth is all you need to know because that is what people understand.  Again, the border and illegals are the microcosm of what is wrong with our government as a whole..  

Lastly, another overlooked truth:

4) Gain

Where's the Gain for Trump?  Every time you look up, someone has pulled out of a deal with him.  You think he'd be doing this if his candidacy were not real?  I don't.  (I used to since he was always flirting with the idea ever since my eyes have been open.)  I think he's sincere about it.  I do doubt he will get the presidency, but I will not be surprised if he should since that is what America has always been:  rule-breaker and record-setter.

Actually, he does have something to gain.

From another reader, making the opposite argument to Daniel Stanton’s point #4:

It should be fairly obvious that both Trump and the Media are after the same thing. MONEY.

The Donald's candidacy is yet another brilliant PR tactic. As was the "Apprentice", so it shall be that "Candidate Trump" will boost the real estate mogul's public exposure at the expense of  the Media customers (voters).

The Media benefits simply from increased  traffic through the broadcast programs covering the election, via advertising revenue. That's why,  after all,  campaigns cost so much- the media placement is astronomically expensive.

The American  public simply views it all as entertainment in the same  vein of a 'reality show' such as "The Apprentice " or a 'talent show' such as "American Idol".

The FAA comes to its senses.  

Thanks to all my pilot friends who wrote in about the FAA’s response to Trump’s candidacy. As described in this AvWeb posting (and this NYT story), the FAA has decided to change some of the five-letter “waypoints” it uses to define pathways through the sky. As Deb Fallows has described here and here, waypoint nomenclature can be surprisingly playful. A famous sequence of waypoints leading into the Portsmouth, New Hampshire airport reads, in order, ITAWT ITAWA PUDYE TTATT (sound it out), followed by IDEED.

As involves Donald Trump, five years ago an FAA official and Trump admirer in Florida decided to create a departure sequence known as IVANKA.ONE. It included waypoints called DONLD, TRMMP, IVNKA, AMNDA (for one of Trump’s assistants), and UFIRD. Incredibly—remember, this is a federal agency, during the time of Barack Obama’s presidency— it also had a waypoint called BRTHR. Don’t believe it? Here’s the FAA plate, helpfully highlighted by me:

The FAA’s IVANKA.ONE departure procedure from Palm Beach airport

Congrats to cooler heads at the FAA for saying they will clean this up.

“I bet you’d love North Korea!”

And, to wrap things up before that first GOP debate, here is a note from reader Ernest Petito that represents in tone and content most of the response I’ve gotten from Trump Nation. To be fair, it is distinctive in its punctuation. The author gets through seven full paragraphs without once having to use a period.

Hello! First off I’m not a writer! You might think your something special but you’re a no body in my book! Have not heard of you till today! I just read the lousy things you said about Trump in your article you wrote! Your about as AMERICAN as a red ant from Africa!

You have a right to your opinion but I don't see anything about the corrupt politicians that been ruining this great country USA for decades in your work that I looked up just now too! I can tell you thousands of problems going on here! You must live is a small space! And all you do is write crap! You don't seem to talk about more important things going on that's why I have to wonder if you were paid maybe by a democrat to write what you said! Every single one of these bad politicians running for office DEM or rep are afraid of the Donald and what he stands for the majority of AMERICA PEOPLE!

You’re a terrible person because Trump is one of the  greatest persons to run for president that this great country ever saw!

He is an honest, sincere, very successful, business man, born leader! Someone finally steps up to the plate with a pair, is not afraid to tell the truth and not lie like the rest of garbage politicians that are ruining our great country USA for decades but also financially burying the rest of the middle and poor classes alive!

Sorry I disagree with your tactics which I know they are and if they are not you should go to the nearest hospital ASAP!

Unbelievable what comes from someone that maybe has some talent but abuses it!

PS You might want to consider taking a very long vacation to IRAN! If not North Korea, China and Russia I'm sure would take you too!

TRUMP 2016  

That really is all.

This article was originally published at

13 Jun 00:10

The Kid From ‘Jurassic Park’ Has The Best Twitter Account Of All Time

by Madeline Roth

You. Are. Welcome.

Tim Murphy, the fictional kid from "Jurassic Park," has the most hilarious Twitter account.
09 Jun 16:38

Why Would a Paper Company Finally Agree to Stop Destroying Forests?

by Saki Knafo

FYI, a lot of the work I've done over the past 5 years has been supporting and facilitating this and I am SUPER FREAKING EXCITED about it! Feeling good about the world.

Beawiharta Beawiharta / Reuters

For years, Asia Pulp and Paper ruled over a corporate kingdom built on environmental ruin. A subsidiary of the Indonesian conglomerate Sinar Mas, APP converted several square miles of Indonesian rainforest each month into pulp used for books, magazines, fast-food wrappers, toy packaging, and toilet paper. In other words, the company’s standard operating procedures meant that people all around the world were literally flushing the pulverized remains of tiger habitat down the toilet.

So it was quite a reversal when, two and a half years ago, APP announced that it would immediately bring its rainforest-clearing operations to a halt. Looking back now, it's clear that this was the start of something  bigger: Last week, APP’s largest competitor, Asia Pacific Resources International Holdings, pledged to stop cutting down forests too. As Amy Moas, an environmental scientist and a Greenpeace activist, put it, “This is massive.” Together, APP and APRIL account for about 80 percent of all the pulp and paper produced by Indonesia, the most prolific paper-producing country in the world.

Of course, there’s no way of knowing whether these companies will follow through on their commitments in the long run, and even if they do, significant portions of the natural forests have already been damaged. Still, for the vast array of species that live in them, including orangutans, elephants, and the last few hundred surviving Sumatran tigers, there’s suddenly cause for hope. APP’s about-face may hold some useful lessons for businesses and environmentalists alike: It’s a case study in how even the most stubbornly destructive companies can be persuaded to change their ways.

The shift began a little over a decade ago, when powerful companies were "destroying an area of rainforest the size of Belgium every year," said Bustar Maitar, the director of the Greenpeace campaign to end rainforest destruction in the country. In 2003, Greenpeace released “Partners In Crime,” a report on Indonesia’s illegal logging industry. While the exposé focused on the plywood trade and not on the two biggest causes of forest destruction, paper and palm-oil production, it set the template for future fights by highlighting the links between Indonesian companies and their Western business partners. This indirect tactic— going after Indonesian businesses by shaming the name-brand companies that buy from them—would prove to be the key to Greenpeace’s success with Sinar Mas, the parent company of APP.

In 2009, Greenpeace took aim at Nestlé, then a buyer of Sinar Mas palm oil. In many ways, what followed was typical of Greenpeace’s broader strategy. The organization chose a single charismatic animal species—in this case, the orangutan—to serve as a symbol of the larger issues at stake. It released a report exposing the connections between Nestlé and Sinar Mas, and printed billboards and leaflets that parodied ads for Kit Kat bars, turning the brand’s universal recognizability into a liability.

It enlisted people in physical stunts—such as rappelling from the ceiling at a shareholder meeting in Switzerland—as well as virtual ones. In a fake Kit Kat commercial released on YouTube, an office worker was shown taking a bloody bite into a severed orangutan finger. When Nestlé demanded that the video be taken down, Greenpeace supporters blasted the company on Facebook. Eight weeks later, a chastened Nestlé announced that it would eliminate companies that razed jungles from its supply chain. (When asked for comment, a Nestlé spokesperson did not dispute this account.)

Within a year, one Sinar Mas subsidiary, Golden Agri-Resources, agreed to stop turning ancient forests into palm-tree plantations. Yet its sister company, APP, was still at it, chopping down habitat to make paper for companies such as Danone and Xerox. So, with the Nestlé battle behind them, Greenpeace’s activists set their sights on the pulp-and-paper sector, and on APP specifically. After learning that Mattel, an APP customer, was using rainforest paper to package Barbie dolls, activists draped a four-story banner of a sternly disapproving Ken from the roof of Mattel’s headquarters, near Los Angeles.

Demonstrations and stunts like these helped persuade more than 100 companies to drop APP as a supplier. “This is a story of people taking action,” Maitar declared in a promotional booklet recounting the effort. “It is the story of millions of people from Indonesia and all around the world, who answered our calls to action and made those in power sit up and pay attention.”

Maitar’s account is a touch triumphant, but it’s not an exaggeration to say that Greenpeace played an important role in getting APP to change. "It is fair to say that we might not be where we are today without the relentless intervention of Bustar Maitar and his global Greenpeace team members,” acknowledged Aida Greenbury, the managing director of sustainability at APP. She added that the company is now working closely with Greenpeace and other groups to make good on its promise. In doing so, Greenpeace has gone from “outspoken campaigning critic to critical friend,” she said.  

For some inhabitants of the forest, though, it may be too late. In April, the conservation site Mongabay reported that an Indonesian rhino subspecies known as the Bornean rhino may already be extinct in the wild. Writing in The Jakarta Post, Ketut Putra, the vice president of Conservation International Indonesia, explained why the new policies adopted by APP and now APRIL won’t add up to save the forest  on their own. “The root of the problem,” he wrote, “is that the people who are clearing much of this forest are very poor and in need of reliable income.”

It’s clear that for activists, businesses and policy makers, there's a lot of work to be done. But the changes at APP and APRIL are a start.

This article was originally published at

11 Jun 17:11

'Trouble With Girls': The Enduring Sexism in Science

by Julie Beck


Wolfgang Rattay / Reuters

“Let me tell you about my trouble with girls,” the Nobel Laureate Tim Hunt reportedly said on Monday at the World Conference of Science Journalists in South Korea. “Three things happen when they are in the lab: You fall in love with them, they fall in love with you, and when you criticize them they cry.”

Those are the only three things that happen. Romance and tears. What does not happen, apparently, is science.

Following a backlash from conference attendees, on social media, and in regular media, Hunt offered a half-hearted apology on Wednesday, speaking to BBC Radio 4.

“I’m really sorry I said what I said. It was a very stupid thing to do in the presence of all those journalists,” he said. “What was intended is a light-hearted ironic comment. Apparently it was interpreted deadly seriously by my audience.”

Then he added, “I did mean the part about having trouble with girls. It's terribly important that you can criticize people’s ideas without criticizing them and if they burst into tears, it means that you tend to hold back from getting at the absolute truth. Science is about nothing but getting at the truth.”

On Thursday, Hunt, a biochemist, resigned from his faculty position at University College London.

“UCL was the first university in England to admit women students on equal terms to men, and the university believes that this outcome is compatible with our commitment to gender equality,” the university said in a statement.

I guess they weren’t moved by his apology either.

Hunt’s comment is just one in a recent string of highly publicized instances of sexism in the sciences. Add it to the pile along with the column in Science that advised a woman to “put up with” her advisor looking down her shirt, and the peer-reviewer for PLOS One who suggested two female researchers find a male co-author for their paper.

The thing is, all these examples are pretty egregious, and all were later walked back in some way. Hunt resigned, Science apologized and removed the column, and PLOS One removed the offending reviewer. It would be easy to think that once such blatant offenses are punished, the dragon is slain, so to speak. It would be easy to think these people are outliers.

In so thinking, “we miss the bigger problem and tend to want to scapegoat,” says Heather Metcalf, the director of research and analysis for the Association for Women in Science. Instances like this are part of a bigger systemic problem—“really entrenched biases against women in the sciences that have shifted over time but are still very present,” she says.

In other words, it would be a mistake to listen to the foghorn of Hunt’s comments and ignore the boat it’s signaling.

Women in science, as in so many other fields, are paid significantly less than men on average. In 2008, the median salary for a full-time female scientist or engineer was $24,000 less than for a man. The Scientist’s 2014 Life Sciences Salary Survey found a pay gap that widened with every subsequent science degree earned—from bachelor’s, to master’s, to doctorate.

Average Compensation for U.S. Life Science Professionals, by Gender

From The Scientist, "2014 Life Sciences Salary Survey," November 2014, with permission.

While making less money, women scientists also often face harassment. A survey from 2014 found that 70 percent of women scientists had faced sexual harassment while working in the field, and 26 percent had experienced sexual assault. In another study, professors hiring for a lab-manager job judged men to be more competent than women with the same qualifications, and offered them higher salaries.

These are just a handful of the studies showing objective evidence of this gender bias, and while you would think that in the realm of science, data would be the thing to convince people, that doesn’t always seem to be the case. A study analyzing the comments left on articles about evidence of sexism in science found that 9.5 percent of comments argued it didn’t exist. Some commenters, mostly men, offered justifications for sexist behavior, and many of those arguments were rooted in biology.

“The way that biases function is that everyone has them,” Metcalf says. “It doesn’t necessarily make you a bad person to have these kinds of biases but they do have real impacts if we don’t become aware of the biases we’re carrying with us. Once we do realize, we have a choice in how we behave. A lot of times these things go unlooked at or unquestioned.”

While over-the-top comments like Hunt’s are often quickly smacked down, Metcalf worries that women could internalize more subtle instances of sexism—being passed over for a promotion, say, or someone questioning a woman scientist’s skills or merit. Someone may wonder if she’s being discriminated against, or if she just really didn’t deserve the promotion.

“We have social beliefs for what it means to be a scientist,” Metcalf says. “We also have those sorts of beliefs surrounding gender. And if we really think about what those expectations are, sometimes we see those conflicting. So there needs to be a lot of work that’s done within scientific culture to challenge and question those roles and expectations.”

When it comes to Hunt, he may well have come of age as a scientist in a time when biases were more explicitly displayed. But “that behavior is coming from something that he’s learned and that has been validated throughout the course of his career,” Metcalf says. When something like this happens, it’s not just a fluke or a leftover from an earlier era that we’ve now transcended. As Metcalf puts it, “The blatant acts and the subtle acts are all coming from the same place.”

This article was originally published at

28 May 10:07

How to Fix a Broken Police Department

by Alana Semuels

This was FASCINATING. PS, after 2 years or whatever, I've finally shared something.

Alana Semuels / The Atlantic

CINCINNATI—Citizens were throwing stones and beer bottles at police officers in front of City Hall, and Maris Herold didn’t understand what they wanted.

She was a police officer herself, and knew that her department had made some missteps. Most recently, an officer gunned down a 19-year-old unarmed black man, Timothy Thomas—the fifteenth black man to die at the hands of police in five years.

But, Herold knew, the police were investigating the incident. They were listening to the community. They were working 12-hour shifts to protect the city from looting and fires, though the disturbance would soon turn into the worst riots in the U.S. in a decade.

“I was like, ‘We’re doing everything right, obviously the police officers made mistakes and we’re trying to get to the bottom of it,’” she told me recently. Herold, who joined the police force after a career in social work, couldn’t understand what more the police could do to make amends with the community.

That was in 2001. “In the police department, we thought we had great relationships with the majority of our communities,” Tom Streicher, who was police chief from 1999 to 2011, told me. “The reality was that we found out we had superficial relationships.”

Herold now sees how little she understood about policing, transparency, and the community back then. She’s now a District Commander in the Cincinnati Police Department, where more than a decade of negotiations have led to significant reforms. Herold believes that the changes made in the department are the best way to guarantee a good relationship between a city and its police force.

“I had all of these things running through my mind, but I had only half the picture at that point,” she told me.

It took a long time for Cincinnati police to get the other half of the picture. The public commitment to reform came in the immediate aftermath of the riots, but five years elapsed before the police started making meaningful changes. Though they were required by the Justice Department to reform their procedures, police still chafed at being told to fix a problem they didn’t think existed. Even now, police reform in Cincinnati remains a delicate issue. The various stakeholders, including the African American community, elected officials, civil-rights lawyers and law-enforcement leaders, constantly discuss and evaluate their progress. As part of the reforms, police agreed to adopt a strategy that required them to interact frequently with members of the community, and continually re-affirmed their commitment to that strategy.

The city that once served as a prime example of broken policing now stands as a model of effective reform. Cincinnati’s lessons seem newly relevant as officials call for police reform in the aftermath of the deaths of Freddie Gray in Baltimore, Michael Brown in Ferguson and Tamir Rice in Cleveland. Indeed, the recently released report from President Obama’s Task Force on 21st Century Policing recommends that departments adopt some of the strategies used by Cincinnati. A task force convened by Ohio Governor John Kasich cited Cincinnati as a model for community-oriented policing and recommended that other law-enforcement agencies in that state develop similar reforms.

And on Tuesday, when the Justice Department and the city of Cleveland announced they’d entered into an agreement over how to resolve policing problems, their consent decree looked very similar to what had been drawn up in Cincinnati. Both documents stress the need for deep community involvement in policing as part of the reforms.

“The central component is the community policing,” Cleveland Police Chief Calvin Williams said at a news conference Tuesday. “If we don’t ensure that our officers and our community have a better relationship, then a lot of what we’re trying to implement now in terms of this agreement is going to be hard to do.”

But the lessons of Cincinnati are complicated. Success required not just the adoption of a new method of policing, but also sustained pressure from federal officials, active support by the mayor, and the participation of local communities. If Cincinnati is a model of reform, then it is equally a sobering reminder of how difficult it can be to change entrenched systems.

* * *

Looking back, the results of Cincinnati’s reform efforts are startling. Between 1999 and 2014, Cincinnati saw a 69 percent reduction in police use-of-force incidents, a 42 percent reduction in citizen complaints and a 56 percent reduction in citizen injuries during encounters with police, according to a report by Robin S. Engel and M. Murat Ozer of the Institute of Crime Science at the University of Cincinnati. Violent crimes dropped from a high of 4,137 in the year after the riots, to 2,352 last year.  Misdemeanor arrests dropped from 41,708 in 2000 to 17,913 last year.

Yet it might not be so simple to adopt Cincinnati’s changes in other cities. It took a long time—five to ten years, by some counts—to get police to actually buy into the reforms. Nobody likes it when somebody comes into their workplace and tells them how to do their job. The changes Cincinnati adopted were nothing short of a complete turnaround in how the city approached incarceration, crime and its relationship with its residents. And to make sure they were adopted, the federal government had to apply constant pressure, reminding all parties involved about the need to stay vigilant about reform.

“In the early 2000s and late 90s, Cincinnati was just a hotbed of problems, and we got the city and the police department to agree to certain reforms,” said Mike Brickner, senior policy director with the ACLU of Ohio, which sued the city shortly before the riots over discriminatory policing practices. “It’s gratifying for me to see that people are coming back several years later and recognizing how successful it was.”

Some of the changes were small: The police department vowed to hold a press conference within 12 hours of any officer-involved shooting and to provide information as well as camera footage from the event. It agreed to track officers who received an inordinate number of complaints or who violated policies, and take disciplinary action if needed. It established a Citizen Complaint Authority with investigative and subpoena powers over police. It adopted new use-of-force policies, changed guidelines on when to use chemical spray, and established a mental-health response team to deal with incidents in which a suspect may have mental-health problems.

But those changes were tiny in contrast to what Herold and others say completely altered the department over the course of a decade: the adoption of a new strategy for how to police. The settlement agreement for the ACLU lawsuit, dubbed the Collaborative, required Cincinnati police to adopt community problem-oriented policing, or CPOP. The strategy required them to do fewer out-and-out arrests, and instead focus on solving the problems that cause people to commit crimes in the first place.

The Cincinnati model lowers incarceration rates and crime rates, advocates say, and makes for a much better relationship between city residents and police. Though the city was only required to adopt the strategy for five years, police have constantly re-affirmed their commitment to it, and still attend meetings every six weeks to update the community on their progress.

“There are lots of different strategies that don’t rely on arresting black people and feeding more mass incarceration, and that’s what we’ve worked so hard on,” said Al Gerhardstein, the lawyer who sued the city for the ACLU (and who was also the lead counsel in the latest gay marriage case in front of the Supreme Court). “I think it really worked. For years, our police officers have become real fans of the Collaborative, they like problem solving. They like solving the underlying reasons of the crimes.”

Even those who constantly worry that policing in Cincinnati will some day revert back to the old ways of doing things say that other cities need to learn from Cincinnati. They include Iris Roley, a community activist who was an integral part of the Collaborative and who traveled to Ferguson last year to distribute copies of the Collaborative, hoping to suggest a way forward.

“I think where we are in 2015 is that every police municipality needs to take a look at itself, and wherever it can, change and institute community-driven, focused reforms,” she told me.

* * *

There were certain things that were expected of Maris Herold when she first became a cop. She was expected to write a few traffic tickets a month, issue some parking tickets, and get a misdemeanor arrest, a felony arrest, and a DUI arrest. If police were out making arrests, the thinking went, they were proactively preventing crime. So Herold followed the guidelines, got positive evaluations, and was seen by supervisors as a good cop.

Even before the riots, though, community members could see that this approach wasn’t working. The strategy made police see the public as people who could, at any moment, be committing crimes. The effort to prevent crime led police to arrest all sorts of innocent people, souring the relationship between law enforcement and the community.

“What we did horribly wrong was we engaged in zero tolerance sweeps—that was our primary response when we'd have flare-ups in neighborhoods,” Herold told me. “That, I think, stretched any foundation that we had built with the community.”

A month before the riots, the ACLU and the Black United Front sued the city, alleging that police participated in racial profiling and discriminatory law enforcement. Some of the complaints about the police department seem eerily similar to those being leveled against other police departments today. There was the man who was tackled and arrested and died of asphyxiation in police custody. The mentally ill man who was shot by police after waving a brick in the air. The man whom police shot after pulling him over, although witnesses said he was not behaving erratically.

For a community already suspicious of police, the shooting of Timothy Thomas in April of 2001 was the last straw. The 19-year-old, who was wanted on 14 warrants, ran from police, according to the officer who shot him. That officer also claimed that Thomas did not respond to an order to show his hands. When community members marched to City Hall to protest the shooting, the City Council and the police had few answers for them. The crowd poured out into the streets, kicking off five days of clashes between residents and police, and bringing the nation’s attention to Cincinnati.

April 12, 2001, Cincinnati police officers arresting residents for violating curfew in the aftermath of the Timothy Thomas shooting. (Reuters)

The scope of that civil unrest convinced many people in the city that it wouldn’t be possible—or wise—to just settle the lawsuit and going on with policing as it had been done. The mayor asked the Department of Justice to review the police department’s use-of-force policy, and the Department of Justice then opened a “pattern or practice” inquiry.

After months of negotiations, the Department of Justice entered into a Memorandum of Agreement with the city and the police, requiring the police department to make a number of changes in how it conducted business. Even more importantly, to settle the lawsuits, the city, the police union, and the plaintiffs (represented by the ACLU and the Black United Front) entered into a separate agreement, called the Collaborative. It required that police use community problem-oriented policing and laid out metrics for how they would be held accountable for adopting it.

That broke with precedent. Department of Justice consent decrees typically involve the city and the federal government, but the Collaborative also brought in the community and the police union. And it also attempted to change not just specific practices, but the city’s entire approach to policing. The final report issued by the city’s independent monitor, Saul Green, stressed the novelty of this approach to police reform:

Justice Department agreements typically do not attempt to directly address policing strategies used by the department under investigation. The differences are so significant that the Monitor Team believed from the start that if the Cincinnati effort proved successful, Cincinnati could serve as an important model for police reform throughout the United States.

Problem-oriented policing was developed in 1979 by Herman Goldstein, a University of Wisconsin professor, and was first adopted in Newport News, Virginia. Other police departments, such as Baltimore, have used the method and then abandoned it, said John Eck, a criminologist at the University of Cincinnati who helped the city adopt problem-oriented policing (which it calls Community Problem-Oriented Policing). The strategy suggests that police should not just respond to calls for service. It says they should also look for patterns in these calls to service, determine what is causing the patterns and then implement solutions to solve them, he said.

If hospitals notice an inordinate number of emergency patients coming in with facial injuries due to glass beer bottles being broken over their heads in fights, as was the case in on British precinct, police work with the bottle manufacturer to make bottles are made out of material that won’t break, he said. If police notice a women is a repeat victim of domestic violence because her partner breaks into her ground-floor apartment, they work with the landlord to move her to a higher floor, link her to a social-services agency and help her find free daycare so she doesn’t have to rely on her abusive spouse for help. In another example, when police noticed an increase in metal thefts in a neighborhood, they worked with property owners to paint their copper pipes green, posted signs about the pipes being painted green and then informed scrap yards of the program to gain support, which led to a reduction in copper thefts.

Former Cincinnati Police Chief Streicher, 2003 (Reuters)

The strategy requires that police intimately know members of the community and listen to their concerns, even if doing so doesn’t lead to arrests. It requires that they get out of their cars and walk the streets, and it requires that they reach out to partners they traditionally would battle, such as the owners of buildings in high-crime spots, or community groups like Legal Aid.

New policing approaches come and go, seemingly every year, but leaders such as Herold say that problem-oriented policing differs in important ways from other strategies. Broken-windows policing, for example, holds that police can prevent bigger crimes by cracking down on disorder and small crimes in a neighborhood. But law-enforcement officers often end up just making a lot of arrests with broken-windows policing, instead of addressing the problems that lead to small or big crimes in the first place.

Similarly, Compstat, which was pioneered in New York City in the 1990s, uses statistics and mapping to identify crime patterns and direct resources there. It’s been credited with lowering crime in New York City, but also criticized by some criminologists for focusing on the numbers of arrests different officers make, rather than on protecting residents with the help of community input.

Hot-spots policing uses data to deploy officers to areas where crime and disorder are concentrated, but its effects are usually short-term because the approach rarely focuses on the causes of the crime, Eck said.

“Most cops, in any organization, have seen the reform du jour come through, and it varies from wearing your hats in a certain way to something more sophisticated,” Eck told me. “Police chiefs come, polices chiefs go, just as dumb ideas come, dumb ideas go.”

When I asked Eck how he knew that problem-oriented policing, which is also called problem-solving, isn’t just another fad, he admitted that sometimes he wonders the same thing. But when he tries to think of an alternative, he always comes back to the fact that unlike Compstat or other approaches, problem-solving deals with the complexity of what’s going on in a community. The police department, he says, is the only government institution that has a strong hierarchy and works around the clock, and so it can most effectively marshal resources and other departments to solve difficult problems.

Recent criticisms of police have focused on how conscious and unconscious biases may influence the ways in which individual officers act. But problem-oriented policing is also the best approach to reducing biases, Eck said, because it forces police to interact constantly with different members of the community.

“Whenever we come to a situation with a particular bias, that bias gets facilitated by lack of human contact,” he said. “The more you get police directly engaged with members of the public, the better it is.”

Still, no matter the policing approach leaders are trying to implement, officers are often skeptical that an outsider can really tell them the best way to do their job.

Captain Maris Herold in the Cincinnati Police District 4 office (Alana Semuels)

It’s a natural human reaction to being criticized so publicly by people who don’t actually have to do policing.

“It’s as if someone would come into your household and say, ‘You are really not a good housekeeper, your floors are dirty, your dishes are dirty, we recommend you get a better dishwasher, we’re going to check on you to make sure you do this correctly,’” said S. Gregory Baker, who was the head of the city’s department of public safety around the time of the Collaborative. “That’s how it was perceived within the police department.”

What’s more, police thought they had been doing a good job in the community. Yes, there were a few troubled officers, but 10 out of the 15 people who had been shot by police had pointed guns or shot at police themselves, police said. There were 50 community patrol officers in certain districts who knew what was happening on the ground, something that wasn’t done in most cities at the time.

“From my perspective, we were the leaders in community policing at that time — or at least we thought we were,” Herold told me.

In the first few years after the Collaborative, the police pushed back against change. A survey of police conducted in 2004 found that one-third of police wanted to leave the department, and that 85 percent thought that “the collaborative agreement to micromanage their jobs has been a waste of time,” according to a Cincinnati Enquirer column at the time.

In 2004, the independent monitor determined that the city was not complying with provisions of the collaborative, which constituted a material breach. The police department had barred plaintiffs from ride-alongs, denied the Department of Justice access to certain documents, publicly questioned the competence of the monitor, complained about the Collaborative, and kicked a member of the monitoring team out of police headquarters, according to the monitor.

“We walked into it very skeptical,” Streicher told me. “We didn’t think we were being treated fairly and objectively.”

In 2005, the city and the police department had to reaffirm their commitment to the Collaborative. Also in 2005, a RAND study on policing in Cincinnati found that residents of black neighborhoods were still subject to aggressive policing, traffic enforcement and pat-downs.

Meetings between the parties in the Collaborative were “unbelievably rancorous,” the monitor, Saul Green, told me. “The police and the city were extremely recalcitrant.”

It was bad enough that little seemed to have changed. But for a few years after the riots, it seemed like things were actually getting worse in Cincinnati. The Over-the-Rhine neighborhood, where Thomas had been shot, had been on the cusp of a recovery, but after the riots, it was boarded-up and once again riddled with blight. A boycott organized by community members who thought the reforms were moving too slowly caused more tensions in the city.

After the Collaborative, Cincinnati initially experienced a plague of “de-policing,” in which patrols stayed out of certain neighborhoods to avoid trouble, Baker said. Homicide and violent crime rates began to climb in 2002, and in 2006, the city had 85 homicides, which was the highest murder rate on record. Frustration seemed to be creeping into the report by the city’s independent monitor, too.

“It is highly disappointing that only a small number of the projects from this quarter contained in the Unit Commander reports reflect any familiarity with problem solving,” the monitor wrote, in December 2006. “Clearly there is a lack of oversight, guidance, coaching, and perhaps adequate training since the majority of the efforts should not be of this quality after four years of stated commitment” from the police department.

* * *

Police Officer Eric Dunn stands on a patch of green grass at the corner of Woodburn and Hewitt Avenues in the Evanston area of Cincinnati. Just a few years ago, this was one of the most violent areas in the city, a place where police sometimes had to respond 15 times a day, and where drug deals and murders were not uncommon. Across the street stood one of the city’s oldest public housing complexes, which was dilapidated and also a center of crime. On this very lot, at a store called Jacks Carry Out, a man was shot a year ago, and later died from his injuries.

This plot of grass is an example of how problem-oriented policing can change a city. When members of the Evanston community started to complain about crime in the vicinity of the store, police officers were at the meeting to listen. The data showed that the location was a place where disputes often turned fatal. They decided to minimize the number of people hanging out in front of the store, not by arresting people, but by moving a bus stop down the street and moving a phone booth further away. Then, when the store’s owner didn’t respond to requests by police to stop allowing drug deals to take place on his property, the city went after his liquor license, said Dunn, who was involved with the process. The city bought the building and tore it down, and is now seeking a developer to build a grocery store. The formerly violent corner is now transformed, because of the involvement of the community and a number of city departments, and, of course, the police.

“People talk about community policing, but they don’t have an idea of what it really looks like,” said Brickner, of the ACLU. “It wasn’t just about responding to crimes but instead hearing about the overall health of the community. Hearing about the blighted houses, where that’s contributing to poverty and crime, hearing about where young people are congregating and thinking about what kind of training is available to them.”

Many people in Cincinnati say the police finally started to buy into these reforms in 2006, after a new mayor had been elected and a new city manager appointed (Mayor Charlie Luken, who governed the city from 1999 to 2005, had asked the Justice Department to stop putting police through “this silliness,” in 2004.)

Green, the monitor, said the changes tracked very closely to new city leadership taking office. The police chief reports to the city manager, after all. New city manager Milton Dohoney Jr. started attending meetings of the parties in the Collaborative, and made sure that the rancor that had characterized them before wasn’t tolerated.

“They became much more business-like, and we were able to move forward,” Green said.

Dohoney seemed to understand that the city had signed an agreement and that it needed to come into compliance with the reforms, or face penalties, Green said.

A new attitude from people at the top made all the difference, Herold said. Police, at the end of the day, will do what they’re told. When they’re told to engage in problem-oriented policing, and are evaluated on how well they do that, their habits start to change.

Senior officers slowly started making it clear that officers weren’t going to get promoted if they didn’t embrace problem-solving and make an effort to listen to the community, Dunn said. That may be because those leaders had to answer to the independent monitor. The monitor looked closely at district reports for examples of problem-solving, held police accountable for training officers in problem-oriented policing, and constantly checked in with the Citizen Complaint Authority for police progress.

For his part, Streicher says that it only took three years or so for police to start implementing the changes. Cops on the ground started to realize that collaborating with the community made their jobs more pleasant, he said, and as the department realized problem-oriented policing was working, it started to push it more. Listening to the community helped too, he said.
“When people get the opportunity to vent and you listen, I guess it starts to sink in,” he told me. “We realize we aren’t as good as we thought we were.”

Mike Brickner, of the ACLU, says he first realized something might actually be changing in a 2006 community meeting with police officers and members of the Collaborative. A fellow staffer reported back that community members were standing up for the police at the meeting, rather than criticizing them.

“That was one of the first times that I really felt like, ‘Oh my gosh, we really are making progress,’” he told me.

In 2007, the police department changed its sworn officer job descriptions to emphasize the role of problem-oriented policing in their work. The same year, the city and the plaintiffs of the original ACLU lawsuit agreed to extend the Collaborative one more year than was originally planned to accelerate the adoption of community problem-oriented policing. In 2008, the independent monitor issued his final report, writing that the city had made “significant changes in the way it polices Cincinnati.”

“I truly believe that there originally was a we-they mentality when it came to certain citizens,” Dunn told me, about police.

Dunn may be a good example of how the police slowly began to court and win community support. Dunn, who was deeply embedded within the community, resigned from the Fraternal Order of Police in the aftermath of the riots. In time, though, after the FOP elected a new president, and after the police department appeared to be serious about reforms, Dunn rejoined the union.

Slowly, officers who had berated Dunn and his partner Scotty Johnson for allowing community members to address them by their first names either left, or converted to the new mentality. Same with those who had called the new method of policing “hug-a-thug” or “love police.” Slowly, police officers started to tell community members exactly what was going on at a crime scene, rather than stonewalling them.

And in a contrast to the stop-and-frisk policies that have gained popularity in cities across the country, which cast the widest possible net, Cincinnati police tried to focus their efforts more narrowly, targeting the 0.3 percent of people in the city who accounted for three-quarters of the city’s murders through a program called the Cincinnati Initiative to Reduce Violence, or CIRV. Through CIRV, officers talked to the family members of the violent gang members, as well as the gang members themselves, trying to help them transition out of a violent lifestyle.

The reforms soon began to make a difference on the ground. In a county that had to reduce jail space by one-third in 2008, officials were relieved to see that Cincinnati’s focus on problem-solving was leading to fewer arrests. Felony arrests fell from 6,367 in 2008 to 5,408 the following year; by 2014, they were down to 3,735. Misdemeanor arrests fell by 3,000 between 2008 and 2009, and dropped by an additional one-third between 2008 and 2014, according to Engel, the Cincinnati professor. And in the same years, even as arrests were falling, almost every major category of crime also declined.

In New York City, by contrast, between 2005 and 2010, where stop and frisk was being implemented as policy,misdemeanor arrests increased 28 percent. The misdemeanor arrest rate jumped 190.5 percent between 1980 and 2013.

Misdemeanor Arrests in Cincinnati

The Role of Police in Pretrial Justice: Changing How Police View Arrest/Robin S. Engel

“Law enforcement officials in Hamilton County learned that more arrests do not equate to increases in public safety; rather public safety is enhanced when arrests are limited and strategically focused,” Engel and co-authors wrote, in an unpublished document prepared for a recent roundtable at John Jay College.

* * *

Police and the community still struggle to maintain the changes. A new chief, James E. Craig, appointed in 2011, wanted the department to implement Compstat and do away with problem-solving. When current chief, Jeffrey Blackwell, became head of the department in 2013, he wasn’t familiar with problem-oriented policing, but has since embraced it.

“We had to fight hard to keep problem solving,” Herold told me. “Every time we have a new leader, I’m worried that it’s going to go away.”

Of course, not everything is perfect now in the Cincinnati police department. Two families filed lawsuits against police, for example, after two separate run-ins with the same police officer, whose dashcam was turned off during both encounters.

Some police officers still discriminate on the basis of race, said Dion Branhan and Mike Dodson, two black men I met near the University of Cincinnati.

“I haven't seen much of a difference,” Branhan said.

“They still need some type of cultural-diversity training,” Dodson added.

In Over-the-Rhine, the now-bustling downtown neighborhood where the riots began, black men say they’re hustled by police who don’t want them standing around on the street, even though white people are allowed to stand around outside the bars and restaurants nearby. One man I spoke to in that neighborhood, who goes by the name of Big Quartar, said he was stopped and put in the back of a police cruiser recently because he was mistaken for somebody else. Although one of the officers knew him, her partner rolled up the windows and made Quartar sit in the hot car for a long time, without explanation, he said.

“All they do is look at me with nasty attitudes,” he told me. “They do a lot of foul things.”

What’s more, he said, any policing changes since 2001 have done little to remedy economic inequality in the city. Many of the people he knows can’t find a job, even as the nearby neighborhood prospers. For all the talk of police as social-service officers, police reform can’t fix an economy that’s tougher for people at the bottom.

“People need help in the streets—they don’t need help from police,” he told me. “They can’t give you a job.”

Roley, the community activist, has the same complaints. In the aftermath of the riots, a Minority Business Accelerator was created in the city, but the black community is being pushed out of Over-the-Rhine, she said. She sometimes wonders if the police reforms are meaningful without a corresponding degree of economic change.

Cincinnati has more income inequality than any municipal area in Ohio except Cleveland, and fares worse on that measure than other similar cities, including Pittsburgh, Louisville, St. Louis and Indianapolis, said Julie Heath, the director of the University of Cincinnati’s Economic Center. The median household income in Cincinnati in 2001 was $21,000 for African Americans and $36,500 for whites, she said. In 2013, the median household income for African Americans had only gone up a few hundred dollars, to $21,300, while white median income jumped to $48,000 in Cincinnati.

In some ways, though, the widening of the gap between the rich and the poor makes Cincinnati’s police reforms in the years since 2001 even more impressive. In a city in which incomes diverged and in which residents had ample reason to stay angry with police, residents and cops instead ending up working together.

By 2009, when RAND conducted a lengthy, data-driven report on how policing in Cincinnati had changed since the Collaborative, it concluded that relations were improving. Black residents surveyed perceived greater police professionalism in 2008 than in 2005, and less racial profiling in the later year. Crime was decreasing at the time of the report, and, according to RAND, “police-community relations in Cincinnati have improved in a number of ways.”

Sgt. Ron Hale, left and Spc. Scotty Johnson with Anzora Adkins on the former site of Jack’s Carry Out (Alana Semuels)  

Officer Dunn sees that improvement when he sets foot on the street, or helps walk kids home from school, or engages in problem solving with the community.  Or when he visits Evanston, where residents know him by name. As Dunn, Johnson and I talked in front of the area where Jack’s Carry Out had been located, an older black woman came striding towards us with purpose.

“You’re supposed to stop over there, every time,” she said, jokingly, to Johnson, who no longer is on patrol in the area. Then she gave him a big hug.

She is Anzora Adkins, president of the Evanston Community Council, a revitalization group.  She has lived in Evanston for 45 years, and has seen it go from a middle-class neighborhood to an area with one of the city’s highest crime rates. Now it’s on its way back up, she says, in no small part because of the collaboration between police, her council, and other city departments.

“In any group or situation, communication is key,” she told me.

* * *

Cincinnati’s reforms won’t be easy to replicate in other cities. Each time I asked a participant in the Collaborative about whether other police departments could follow Cincinnati’s lead, I got the same answer: Probably not without a Justice Department order to do so.

“I think it's very hard,” Mayor John Cranley told me. “It's a combination of carrots and sticks, and the Justice Department is a pretty big stick.”

Police departments may adopt some principles of problem-oriented policing, but it’s much easier to just continue policing as they always have, Herold said. Without a document like the Collaborative to refer to whenever an issue arises, departments will likely move onto the next fad, said Eck, the criminologist. And without city money to train police officers, hold community meetings and pay an independent monitor, it will be difficult for police to change.

“Reality tells us that it does not occur without this federal intervention,” said Streicher, who now consults police departments trying to reform. “You can very easily slide back into the same problems and issues you had in the past, unless your feet are held to the fire and the person you’re answering to is a federal judge.”

A Justice Department investigation also brings with it a mandate for resources. The city spent more than $20 million to implement reforms, Streicher said, and in an era of cash-strapped municipalities, it’s very unlikely that any city would spend that much on police reforms without a legal requirement to do so.

Even if other cities did have the funds to implement reforms, and the Justice Department compels them to do so, it won’t happen overnight. Iris Roley remembers feeling furious when a monitor told her change would take 10 years. He ended up being right, she said.

It’s unclear whether some of the state-wide mandates could be enough incentive for departments. After Ohio’s Task Force issued its report last month, Governor John Kasich created a permanent standards-writing body that will make recommendations for police departments in the state. When police departments meet those standards, which include training officers in problem-oriented policing, they’ll get certified by the state, said Joe Andrews, a spokesman for the Ohio Department of Public Safety.

Whether that will be enough to mend relationships with torn communities remains to be seen.

“Everyone breathes a sigh of relief when consent decrees are signed,” Green, the monitor said. “But that’s when the work really starts.”

But even if other departments don’t adopt the reforms undertaken in Cincinnati, the city seems determined to continue on the problem-solving path, 14 years after the shooting of Timothy Thomas. Other cities that implemented problem-oriented policing, including San Diego and Charlotte, later abandoned it when new leadership came into the police department, criminologists told me. Eck, the professor, says that Cincinnati built a constituency of people within the police department and public who will constantly remind new officials that the city is dedicated to problem-oriented policing. Leaders’s dedication to maintaining the Collaborative is unusual, observers say.

Mayor Cranley says that as long as he’s around, he’ll make sure the police adhere to community problem-oriented policing. He was elected in November of 2013, and had been the head of the public-safety subcommittee on the City Council at the time of the riots.

“As long as I’m here, I’m going to keep it,” he told me, about problem solving. “I was here the last time, and we do not want to go back to that.”

If Cincinnati is unique in its decision to adopt problem-oriented policing on a citywide basis, it is even more unique in its dedication to maintaining the strategy more than a decade after the riots. People there have pushed hard for the Collaborative through three mayors and three police chiefs, and some seem even more dedicated than ever to prove that a partnership between police and the community is the best form of law enforcement.

There’s inequality throughout the country still, and there’s still police brutality and a growing problem with incarceration. But in Cincinnati, a diverse group of people, including police officers and citizens, are trying to understand one another. That’s led to fewer arrests, fewer people in jail, less crime, and more dialogue between police and the community that pays them to do their job. For a great many other cities, Cincinnati’s imperfect present provides a glimpse of a much better future.

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