A.N

On March 25, 2020, Hannah Davis was texting with two friends when she realized that she couldn’t understand one of their messages. In hindsight, that was the first sign that she had COVID-19. It was also her first experience with the phenomenon known as “brain fog,” and the moment when her old life contracted into her current one. She once worked in artificial intelligence and analyzed complex systems without hesitation, but now “runs into a mental wall” when faced with tasks as simple as filling out forms. Her memory, once vivid, feels frayed and fleeting. Former mundanities—buying food, making meals, cleaning up—can be agonizingly difficult. Her inner world—what she calls “the extras of thinking, like daydreaming, making plans, imagining”—is gone. The fog “is so encompassing,” she told me, “it affects every area of my life.” For more than 900 days, while other long-COVID symptoms have waxed and waned, her brain fog has never really lifted.

Of long COVID’s many possible symptoms, brain fog “is by far one of the most disabling and destructive,” Emma Ladds, a primary-care specialist from the University of Oxford, told me. It’s also among the most misunderstood. It wasn’t even included in the list of possible COVID symptoms when the coronavirus pandemic first began. But 20 to 30 percent of patients report brain fog three months after their initial infection, as do 65 to 85 percent of the long-haulers who stay sick for much longer. It can afflict people who were never ill enough to need a ventilator—or any hospital care. And it can affect young people in the prime of their mental lives.  

Long-haulers with brain fog say that it’s like none of the things that people—including many medical professionals—jeeringly compare it to. It is more profound than the clouded thinking that accompanies hangovers, stress, or fatigue. For Davis, it has been distinct from and worse than her experience with ADHD. It is not psychosomatic, and involves real changes to the structure and chemistry of the brain. It is not a mood disorder: “If anyone is saying that this is due to depression and anxiety, they have no basis for that, and data suggest it might be the other direction,” Joanna Hellmuth, a neurologist at UC San Francisco, told me.

And despite its nebulous name, brain fog is not an umbrella term for every possible mental problem. At its core, Hellmuth said, it is almost always a disorder of “executive function”—the set of mental abilities that includes focusing attention, holding information in mind, and blocking out distractions. These skills are so foundational that when they crumble, much of a person’s cognitive edifice collapses. Anything involving concentration, multitasking, and planning—that is, almost everything important—becomes absurdly arduous. “It raises what are unconscious processes for healthy people to the level of conscious decision making,” Fiona Robertson, a writer based in Aberdeen, Scotland, told me.

For example, Robertson’s brain often loses focus mid-sentence, leading to what she jokingly calls “so-yeah syndrome”: “I forget what I’m saying, tail off, and go, ‘So, yeah …’” she said. Brain fog stopped Kristen Tjaden from driving, because she’d forget her destination en route. For more than a year, she couldn’t read, either, because making sense of a series of words had become too difficult. Angela Meriquez Vázquez told me it once took her two hours to schedule a meeting over email: She’d check her calendar, but the information would slip in the second it took to bring up her inbox. At her worst, she couldn’t unload a dishwasher, because identifying an object, remembering where it should go, and putting it there was too complicated.

Memory suffers, too, but in a different way from degenerative conditions like Alzheimer’s. The memories are there, but with executive function malfunctioning, the brain neither chooses the important things to store nor retrieves that information efficiently. Davis, who is part of the Patient-Led Research Collaborative, can remember facts from scientific papers, but not events. When she thinks of her loved ones, or her old life, they feel distant. “Moments that affected me don’t feel like they’re part of me anymore,” she said. “It feels like I am a void and I’m living in a void.”

Most people with brain fog are not so severely affected, and gradually improve with time. But even when people recover enough to work, they can struggle with minds that are less nimble than before. “We’re used to driving a sports car, and now we are left with a jalopy,” Vázquez said. In some professions, a jalopy won’t cut it. “I’ve had surgeons who can’t go back to surgery, because they need their executive function,” Monica Verduzco-Gutierrez, a rehabilitation specialist at UT Health San Antonio, told me.

Robertson, meanwhile, was studying theoretical physics in college when she first got sick, and her fog occluded a career path that was once brightly lit. “I used to sparkle, like I could pull these things together and start to see how the universe works,” she told me. “I’ve never been able to access that sensation again, and I miss it, every day, like an ache.” That loss of identity was as disruptive as the physical aspects of the disease, which “I always thought I could deal with … if I could just think properly,” Robertson said. “This is the thing that’s destabilized me most.”

---

Robertson predicted that the pandemic would trigger a wave of cognitive impairment in March 2020. Her brain fog began two decades earlier, likely with a different viral illness, but she developed the same executive-function impairments that long-haulers experience, which then worsened when she got COVID last year. That specific constellation of problems also befalls many people living with HIV, epileptics after seizures, cancer patients experiencing so-called chemo brain, and people with several complex chronic illnesses such as fibromyalgia. It’s part of the diagnostic criteria for myalgic encephalomyelitis, also known as chronic fatigue syndrome, or ME/CFS—a condition that Davis and many other long-haulers now have. Brain fog existed well before COVID, affecting many people whose conditions were stigmatized, dismissed, or neglected. “For all of those years, people just treated it like it’s not worth researching,” Robertson told me. “So many of us were told, Oh, it’s just a bit of a depression.”

Several clinicians I spoke with argued that the term brain fog makes the condition sound like a temporary inconvenience and deprives patients of the legitimacy that more medicalized language like cognitive impairment would bestow. But Aparna Nair, a historian of disability at the University of Oklahoma, noted that disability communities have used the term for decades, and there are many other reasons behind brain fog’s dismissal beyond terminology. (A surfeit of syllables didn’t stop fibromyalgia and myalgic encephalomyelitis from being trivialized.)

For example, Hellmuth noted that in her field of cognitive neurology, “virtually all the infrastructure and teaching” centers on degenerative diseases like Alzheimer’s, in which rogue proteins afflict elderly brains. Few researchers know that viruses can cause cognitive disorders in younger people, so few study their effects. “As a result, no one learns about it in medical school,” Hellmuth said. And because “there’s not a lot of humility in medicine, people end up blaming patients instead of looking for answers,” she said.

People with brain fog also excel at hiding it: None of the long-haulers I’ve interviewed sounded cognitively impaired. But at times when her speech is obviously sluggish, “nobody except my husband and mother see me,” Robertson said. The stigma that long-haulers experience also motivates them to present as normal in social situations or doctor appointments, which compounds the mistaken sense that they’re less impaired than they claim—and can be debilitatingly draining. “They’ll do what is asked of them when you’re testing them, and your results will say they were normal,” David Putrino, who leads a long-COVID rehabilitation clinic at Mount Sinai, told me. “It’s only if you check in on them two days later that you’ll see you’ve wrecked them for a week.”

“We also don’t have the right tools for measuring brain fog,” Putrino said. Doctors often use the Montreal Cognitive Assessment, which was designed to uncover extreme mental problems in elderly people with dementia, and “isn’t validated for anyone under age 55,” Hellmuth told me. Even a person with severe brain fog can ace it. More sophisticated tests exist, but they still compare people with the population average rather than their previous baseline. “A high-functioning person with a decline in their abilities who falls within the normal range is told they don’t have a problem,” Hellmuth said.

This pattern exists for many long-COVID symptoms: Doctors order inappropriate or overly simplistic tests, whose negative results are used to discredit patients’ genuine symptoms. It doesn’t help that brain fog (and long COVID more generally) disproportionately affects women, who have a long history of being labeled as emotional or hysterical by the medical establishment. But every patient with brain fog “tells me the exact same story of executive-function symptoms,” Hellmuth said. “If people were making this up, the clinical narrative wouldn’t be the same.”

---

Earlier this year, a team of British researchers rendered the invisible nature of brain fog in the stark black-and-white imagery of MRI scans. Gwenaëlle Douaud at the University of Oxford and her colleagues analyzed data from the UK Biobank study, which had regularly scanned the brains of hundreds of volunteers for years prior to the pandemic. When some of those volunteers caught COVID, the team could compare their after scans to the before ones. They found that even mild infections can slightly shrink the brain and reduce the thickness of its neuron-rich gray matter. At their worst, these changes were comparable to a decade of aging. They were especially pronounced in areas such as the parahippocampal gyrus, which is important for encoding and retrieving memories, and the orbitofrontal cortex, which is important for executive function. They were still apparent in people who hadn’t been hospitalized. And they were accompanied by cognitive problems.

Although SARS-CoV-2, the coronavirus that causes COVID, can enter and infect the central nervous system, it doesn’t do so efficiently, persistently, or frequently, Michelle Monje, a neuro-oncologist at Stanford, told me. Instead, she thinks that in most cases the virus harms the brain without directly infecting it. She and her colleagues recently showed that when mice experience mild bouts of COVID, inflammatory chemicals can travel from the lungs to the brain, where they disrupt cells called microglia. Normally, microglia act as groundskeepers, supporting neurons by pruning unnecessary connections and cleaning unwanted debris. When inflamed, their efforts become overenthusiastic and destructive. In their presence, the hippocampus—a region crucial for memory—produces fewer fresh neurons, while many existing neurons lose their insulating coats, so electric signals now course along these cells more slowly. These are the same changes that Monje sees in cancer patients with “chemo fog.” And although she and her team did their COVID experiments in mice, they found high levels of the same inflammatory chemicals in long-haulers with brain fog.

Monje suspects that neuro-inflammation is “probably the most common way” that COVID results in brain fog, but that there are likely many such routes. COVID could possibly trigger autoimmune problems in which the immune system mistakenly attacks the nervous system, or reactivate dormant viruses such as Epstein-Barr virus, which has been linked to conditions including ME/CFS and multiple sclerosis. By damaging blood vessels and filling them with small clots, COVID also throttles the brain’s blood supply, depriving this most energetically demanding of organs of oxygen and fuel. This oxygen shortfall isn’t stark enough to kill neurons or send people to an ICU, but “the brain isn’t getting what it needs to fire on all cylinders,” Putrino told me. (The severe oxygen deprivation that forces some people with COVID into critical care causes different cognitive problems than what most long-haulers experience.)

None of these explanations is set in stone, but they can collectively make sense of brain fog’s features. A lack of oxygen would affect sophisticated and energy-dependent cognitive tasks first, which explains why executive function and language “are the first ones to go,” Putrino said. Without insulating coats, neurons work more slowly, which explains why many long-haulers feel that their processing speed is shot: “You’re losing the thing that facilitates fast neural connection between brain regions,” Monje said. These problems can be exacerbated or mitigated by factors such as sleep and rest, which explains why many people with brain fog have good days and bad days. And although other respiratory viruses can wreak inflammatory havoc on the brain, SARS-CoV-2 does so more potently than, say, influenza, which explains both why people such as Robertson developed brain fog long before the current pandemic and why the symptom is especially prominent among COVID long-haulers.

Perhaps the most important implication of this emerging science is that brain fog is “potentially reversible,” Monje said. If the symptom was the work of a persistent brain infection, or the mass death of neurons following severe oxygen starvation, it would be hard to undo. But neuroinflammation isn’t destiny. Cancer researchers, for example, have developed drugs that can calm berserk microglia in mice and restore their cognitive abilities; some are being tested in early clinical trials. “I’m hopeful that we’ll find the same to be true in COVID,” she said.

---

Biomedical advances might take years to arrive, but long-haulers need help with brain fog now. Absent cures, most approaches to treatment are about helping people manage their symptoms. Sounder sleep, healthy eating, and other generic lifestyle changes can make the condition more tolerable. Breathing and relaxation techniques can help people through bad flare-ups; speech therapy can help those with problems finding words. Some over-the-counter medications such as antihistamines can ease inflammatory symptoms, while stimulants can boost lagging concentration.

“Some people spontaneously recover back to baseline,” Hellmuth told me, “but two and a half years on, a lot of patients I see are no better.” And between these extremes lies perhaps the largest group of long-haulers—those whose brain fog has improved but not vanished, and who can “maintain a relatively normal life, but only after making serious accommodations,” Putrino said. Long recovery periods and a slew of lifehacks make regular living possible, but more slowly and at higher cost.

Kristen Tjaden can read again, albeit for short bursts followed by long rests, but hasn’t returned to work. Angela Meriquez Vázquez can work but can’t multitask or process meetings in real time. Julia Moore Vogel, who helps lead a large biomedical research program, can muster enough executive function for her job, but “almost everything else in my life I’ve cut out to make room for that,” she told me. “I only leave the house or socialize once a week.” And she rarely talks about these problems openly because “in my field, your brain is your currency,” she said. “I know my value in many people’s eyes will be diminished by knowing that I have these cognitive challenges.”

Patients struggle to make peace with how much they’ve changed and the stigma associated with it, regardless of where they end up. Their desperation to return to normal can be dangerous, especially when combined with cultural norms around pressing on through challenges and post-exertional malaise—severe crashes in which all symptoms worsen after even minor physical or mental exertion. Many long-haulers try to push themselves back to work and instead “push themselves into a crash,” Robertson told me. When she tried to force her way to normalcy, she became mostly housebound for a year, needing full-time care. Even now, if she tries to concentrate in the middle of a bad day, “I end up with a physical reaction of exhaustion and pain, like I’ve run a marathon,” she said.

Post-exertional malaise is so common among long-haulers that “exercise as a treatment is inappropriate for people with long COVID,” Putrino said. Even brain-training games—which have questionable value but are often mentioned as potential treatments for brain fog—must be very carefully rationed because mental exertion is physical exertion. People with ME/CFS learned this lesson the hard way, and fought hard to get exercise therapy, once commonly prescribed for the condition, to be removed from official guidance in the U.S. and U.K. They’ve also learned the value of pacing—carefully sensing and managing their energy levels to avoid crashes.

Vogel does this with a wearable that tracks her heart rate, sleep, activity, and stress as a proxy for her energy levels; if they feel low, she forces herself to rest—cognitively as well as physically. Checking social media or responding to emails do not count. In those moments, “you have to accept that you have this medical crisis and the best thing you can do is literally nothing,” she said. When stuck in a fog, sometimes the only option is to stand still.

In the introduction to her book Essential Labor: Mothering as Social Change, Angela Garbes describes these times as “strange and difficult years of instability, loss, and grief—both general and intimate.” That’s it, I thought. Sometimes it feels as though decades of tragedy and erasure have been smashed into the past 30 months. During the upheaval of the summer of 2020, for example, my son also had his third unexplained seizure, and I faced the disorienting truth that I couldn’t promise to keep him safe, even within my own house.

It can be hard to find space to live and grow and breathe in the U.S., let alone mother. (Here I borrow from Alexis Pauline Gumbs, who defines mothering expansively as “the practice of creating, nurturing, affirming, and supporting life.”) How does one cultivate and pass along anything more than rage and despair?

For me, reading and writing can be restorative acts, even when they require me to face dark or uncertain realities. The right book can whisk you away; others draw you in without your permission. When I wrote my memoir, This Boy We Made, about my son’s medical and developmental challenges, re-creating scenes of hospital visits and emergencies drained me, and yet I knew that if I didn’t convey the intensity of those moments, my words wouldn’t connect with the readers I wanted them to reach. And, to find solace after dwelling in painful memories, I read widely. Books did not offer me an escape; instead, they inspired the hope that I can love deeply and create something beautiful in the world. The five titles below helped me reimagine how to mother in an inhospitable time and place.

---

We Live for the We: The Political Power of Black Motherhood, by Dani McClain

In McClain’s reported guide to parenting Black children, her prescience stands out. “I wonder … whether US institutions and our confidence in them will continue to collapse,” she wrote in 2019, ahead of the overturning of Roe v. Wade, the January 6 insurrection, and a devastating pandemic. “I also wonder just how bad things can get and how soon.” McClain’s work is notable for its vulnerability. She weaves together research, conversations with activists, and her personal experience of raising a Black daughter. McClain doesn’t provide us with pat answers, but she offers a wealth of perspectives that broaden our definitions of motherhood and family before returning her focus to what we can control. Community-based institutions can seed freedom and joy, she reminds us. “In these pages I have mentioned my desire to find a place where I could flee with my daughter, a place that will allow her to flourish into her full potential as a black girl,” she writes. “I know that no such perfect place exists. It’s not something to find but something to create.”

---

The Breaks: An Essay, by Julietta Singh

Singh opens this intimate and breathtaking letter to her 6-year-old by describing a common yet gutting event: Her daughter has come home from school with a picture book telling a whitewashed version of the Thanksgiving story. An initial feeling of pride that her daughter “colored all four children Brown like you” gives way to the need to explain how the holiday connects to a legacy of genocide. “My job as your mother is to tell you these stories differently,” she writes. Throughout the book, Singh fights to teach her daughter about her origins in a queer, mixed-raced family, and to consistently connect their lives to the global realities of climate change, racism, and colonialism. What pulls me to Singh is the way you can almost hear her voice breaking on the page, even as she gathers herself to press on: “No, I do not want to leave this planet,” she tells her daughter. “What I want is another world. And when I say another world, I mean this one, toppled and reborn.” This is a mother working to complicate simplified and harmful narratives—a mother I could stand and dream alongside.

[Read: Where to turn when you feel “at odds with being human”]

---

The Trayvon Generation, by Elizabeth Alexander

In her new book, Alexander expands on an essay published in The New Yorker in June 2020, about the generation whose lives have been shaped, for the past 25 years, by stories of Black people being killed by police officers or neighborhood vigilantes. This group includes her two sons, and she writes with a mother’s and poet’s touch. Every word cuts just so, like when she describes how “the specter of violence hangs as constantly as the moon over Black people.” Alongside visual artwork and poems by others, this writing dares to ask if art can really change us. It might seem an outrageous question, when, as Alexander puts it, Black mothers know “that we cannot fully protect our children.” Why, when the country casually marches on despite mass shootings, lynchings, and high Black maternal mortality rates, should we look to art? Because “artists make radical solutions all day long, soup from a stone, beauty from thin air,” Alexander answers. She ends her book with a powerful declaration that Black people have the distinct ability to articulate both the problems with and the possibilities of America, the kind of vision that has continually produced life and wonder even amid darkness and danger.

[Read: The civil-rights movement’s generation gap]

---

Breathe: A Letter to My Sons, by Imani Perry

The scholar and Atlantic contributing writer Perry constructed an unsparing, lyrical guide to motherhood in this dispatch to her Black sons. Similar to Singh, she’s honest with her children about the hostility they’ll face, but her warnings can be more urgent: “There are fingers itching to have a reason to cage or even slaughter you,” she writes, recalling a night when she feared that cops responding to a false alarm would mistakenly shoot one of her children. “My God, what hate for beauty this world breeds.” But Perry emphasizes that her boys are not the issue—“Mothering you is not a problem. It is a gift,” she writes tenderly. She also critiques the notion that more knowledge, more videos, more images can save America. “Awareness is not a virtue in and of itself, not without a moral imperative,” she notes, explaining her decision to stop watching videos of police shootings. “I knew the imperative wasn’t there.” The greatness Perry wants for her sons is not tied to money or prestige, but to imagination and connection. And the way she encourages her children to cherish small pleasures, like smooth sheets or a hug, makes existing and parenting when bad news never stops seem more bearable.

[Read: How we must raise our children now]

---

Hope in the Dark: Untold Histories, Wild Possibilities, by Rebecca Solnit

I was initially nervous about reading a book with hope in the title. How would the author speak to my experiences of despair and anxiety as a Black mother? But Solnit is a writer who can tear down the walls of your brain with a single acute observation, and she earned my attention early, in the 2016 reissue’s new foreword. “It’s important to say what hope is not,” she declares. “It is not the belief that everything was, is, or will be fine.” What she writes about is instead “an account of complexities and uncertainties, with openings.” It’s a hope that makes space for grief and asks us to remember times when the world did, indeed, change for the better. Progress often happens incrementally, and Solnit comes with detailed receipts. Crucially, she points to the merits of not knowing what will happen next: As long as there’s ambiguity, we have to leave room for the chance that we could build a future that will blow our minds again—in a good way.

---

​​When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

The story of America’s rabid raccoons begins in Florida. Rabies was once rarely found in raccoons, but in the ’50s, an outbreak began spreading from the Sunshine State. It diffused first to neighboring states and then made a great leap north into the mid-Atlantic, possibly via the shipment of over 3,500 Florida raccoons to hunting preserves in Virginia. From there, rabid raccoons ambled their way as far north as Canada and as far west as Ohio. The East Coast became “one solid belt of raccoon rabies,” says Charles Rupprecht, the former chief of the CDC’s rabies program.

In the early days of the outbreak, officials quickly realized that mass killings of raccoons would not be popular with the public. Residents on one Florida island with a rabies outbreak were so attached to their raccoons that a restaurant owner was feeding them 400 pounds of dog food a month.

For the past 30 years, the U.S. government has embarked on a far more unusual and elaborate campaign: mass immunization of raccoons. Every summer and fall, the USDA, in collaboration with local agencies, drops millions of packets of oral rabies vaccines over the U.S. by air and by hand. The vaccines come in two flavors: fish meal and vanilla. When a hungry raccoon bites into the packet, the liquid vaccine coats its mouth, immunizing it against the rabies virus. We’re now trying to save raccoons from the rabies outbreak we once unwittingly helped unleash. As far as management strategies for dangerous wildlife go, mass immunization is a pretty gentle one.

A similar vaccine campaign has already eliminated strains of rabies from coyotes and foxes in the Southwest. It has also slowly pushed back the northern front of rabid raccoons from Canada into Maine. The immediate objective is to prevent rabies from spreading any farther north or west, but eventually, says Richard Chipman, the national rabies-management coordinator at USDA, “our goal is to push back rabies to the ocean. We want raccoons rabies-free by 2063.”

This mass immunization effort in raccoons is ultimately a roundabout way of protecting humans. Rabid animals notoriously like to bite—the virus hijacks the central nervous system and makes animals unusually aggressive. So when rabies takes hold in a raccoon population, the virus tends to spread to other animals: feral cats, foxes, unvaccinated dogs, even humans. And rabies is virtually always fatal in humans, unless we get a timely dose of antibodies plus the vaccine, which together are known as rabies postexposure prophylaxis. When the outbreak reached New Jersey in 1989, the need for rabies postexposure prophylaxis “started going through the roof,” Rupprecht says. (The treatment costs thousands of dollars per person.) Eliminating rabies in raccoons wouldn’t eliminate rabies in the U.S. entirely, as bats are another important reservoir, but “it’s getting the biggest bang for the buck,” Chipman says. Human rabies exposures are 600 percent higher in areas where both raccoon and bat rabies circulate, compared with areas where there is only bat rabies.

Two types of vaccines are now used in raccoons. The first was jointly developed by the Wistar Institute in Pennsylvania and the French biotech company Transgene in the 1980s; scientists inserted a gene for a rabies protein into another live virus called vaccinia. This vaccine worked well in lab animals, but then came the problem of how to actually inoculate raccoons in the wild. Rupprecht, who was at Wistar at the time, remembers batting around ideas to grow the virus in eggs or put it inside Slim Jims or sausages. The breakthrough came when people trying to prevent raccoons from breaking in and eating their fish baits called the scientists for help. Rupprecht and his team weren’t in the raccoon-deterring business, but they were in the raccoon-attracting business—so they thought, Why not fish? They tried encasing vaccines in fish-meal-bait polymer, which worked brilliantly. The manufacturer now also makes plastic packets of the vaccine coated in fish oil and fish meal. “We typically sort of equate it to a small ketchup packet,” says Jordona Kirby, rabies field coordinator at the USDA.

The second vaccine is also made of the same rabies gene inserted into a different virus called adenovirus. This vaccine is loaded into a blister pack, which is in turn coated in edible vanilla wax. Technically, it’s still experimental; the USDA team has been field-testing it since 2011 and expects FDA approval soon. Their preliminary results, Chipman says, suggest that it stimulates much higher antibody levels in raccoons than the older vaccine does.

Distributing the vaccine is a three-pronged process. Small airplanes equipped with a conveyer belt—“a little bait treadmill,” Kirby says—drop the vaccines over large, empty rural expanses. Helicopters that can fly lower drop them over suburbs. Dense urban areas are the hardest to reach: The team actually walks around setting up bait stations or J-shaped tubes filled with the fish-meal polymer cubes. The idea is to make sure that raccoons, specifically, try to eat these; they can reach into the pipes with their dexterous hands, whereas possums, skunks, and feral cats cannot. The program is aiming to vaccinate at least 60 percent of raccoons in an area to stop the spread.

The team—and those who come after—still have a lot of work ahead in eliminating rabies in raccoons by 2063. “I’ll be, in fact, 103 then, but I hope to still be standing and smiling and cheering these guys on,” Chipman told me over the phone from West Virginia, where he had just finished supervising the distribution of rabies vaccines. In October, he’ll be out in the field again for the second leg of the campaign, this time starting in Virginia and going south until the ocean.

This delicious Grilled Chicken Panini with Zucchini, Tomato, and Mozzarella highlights end-of-summer vegetables on sour dough bread.

Chicken Panini with Zucchini, Tomato Mozzarella

There’s something about a hot sandwich that just feels more satisfying sometimes especially when you add protein like I did in this Grilled Chicken Panini. With the grilled chicken, this sandwich has 26 grams of protein! I usually use sour dough bread because it contains higher levels of vitamins, minerals, and antioxidants than many other breads. I served this for dinner with some tomato soup, which was so delicious. Some other panini recipes you might want to try are this Eggplant Panini with Pesto, Asparagus Prosciutto Panini with Garlic Mayo, and Chicken Arugula Provolone Panini with Chipotle.

(more…)

The post Grilled Chicken Panini with Zucchini, Tomato, and Mozzarella appeared first on Skinnytaste.

Author Jody Keisner comes to us today with some classic advice: face your fears. Or at least, don’t ignore them. Open up about them! Explore them. That’s exactly what she does in her memoir, Under My Bed.

JODY KEISNER:

My Big Idea started as My Big Humiliation.

“What is your greatest fear?” I asked the room of college students on the first day of a creative writing class. The question was from the Proust Questionnaire, named after the French essayist and novelist Marcel Proust. I used the questionnaire to break-the-ice and create a sense of intimacy, which was crucial since we’d be reading about each other’s personal lives for most of the semester. Composed of questions ranging from “What is your idea of perfect happiness?” to “What is the trait you most deplore in others?”, it was thought to uncover someone’s true self. 

Though I’d been answering the questions along with my students for as many years as I’d been teaching, I’d never revealed my true self, at least concerning fear. My greatest fear was also what I then perceived as my greatest humiliation. And so, I kept this part of myself hidden: I was a thirty-something woman living in the quiet, middle-class suburbs, who was afraid of being alone in her home at night. In other areas of my life, I felt daring, tough, and a little wild, just not in my own house. Only my husband and sister knew my secret.

One year, without forethought, instead of my usual vague answer, I blurted the truth:

My fear arrives out of nowhere. I’m reading a book or drinking a glass of wine, supposedly enjoying “me time,” when I’m startled by the creak of a floorboard or a doorknob rattling. The normal sounds of a normal house settling—or unsettling. The feeling that I’m not alone overwhelms me. There’s only one way to be sure. I have to check.

I saw my absurdity through my students’ eyes as I stood before them in my Ann Taylor skirt and coordinating blouse and told them how I opened closets, tugged back shower curtains, looked behind the couches and chairs, checked every latch on every window and door, and finally got down on my hands and knees and peered under my bed. I was looking for a prowler, a man waiting to rape or murder me. I felt childish and exposed. Why did I tell them? 

After a moment of silence that felt like years, the unexpected happened. Well, first the expected happened and they laughed. But then a handful of young women admitted experiencing a similar anxiety on occasion. Most of my students didn’t think I was absurd—though, as one student said, perhaps I was a touch obsessive-compulsive—and one student approached me after class to discuss her own under-the-bed checking. The male students in the room were more apt to confess humorous fears, like being frightened of boogers or death-by-zombies, though one acknowledged being “spooked” after watching horror movies. My students and I talked about how although girls and woman are assaulted—and murdered—every day in this country, I was greatly overestimating the probability of it happening to me. 

Still, my being vulnerable and open with them about my odd behavior invited them to be more vulnerable in their writing, flaws and all, which made their work more compelling. Which, of course, was exactly what I needed to do with the memoir I was writing, too.

Under My Bed and Other Essays was born out of a need to understand this anxious, hidden part of myself and the origin stories of all my greatest fears. From there it grew into an exploration of how fear carried on in my life and, more broadly and universally, the lives of all of us and especially women and mothers. Through my research and writing, I came to understand that my fears weren’t entirely illogical and didn’t really “arrive out of nowhere.” They came—as many fears and anxieties do—from a whole host of interconnected places, such as:

• media and film portrayals of horror and tragedy (“the chest chomp” scene in John Carpenter’s The Thing makes a cameo appearance in my memoir)
• proximity to danger (John Joubert, aka the Nebraska Boy Snatcher, lived within ten minutes of my childhood home)
• brain changes during pregnancy (scientists say that when a woman is pregnant, the part of the brain responsible for anxiety and fear increases in activity)
• family trauma (I grew up with a father who had an explosive temper, though he has mellowed over the years)
• mothering young girls (what do we teach our daughters about living in a society that teaches them to ignore their anger and rebellion and instead to always be accommodating and polite?)
• the cultural objectification and sexualization of the female body (the nationally covered murder of solo runner Mollie Tibbetts, as but one example of thousands)

I was, for once, revealing my authentic self, searching out the darkest corridors of my mind, and in doing so, I uncovered an opportunity to connect with readers as they, too, struggled to keep their greatest fears from getting close to them. 

In a recent post on this blog, Patrick O’Leary writes: “As the shrink says in my Door Number Three, ‘The only terror that heals. The terror of being yourself.’” The act of writing this book and being myself helped me to overcome fear. I will, however, never live completely without it. Does anyone? Should we even want to? Fear compels us to act and make change.

Naming my fears was ultimately empowering for me, as I hope it will be for readers. I didn’t neglect the flip side of the coin in my memoir-in-essays: stories of hope, triumph, and love. Ultimately, it wasn’t only fear that propelled my writing—it was also fear’s antidote: curiosity. My beloved grandmother used to say, “Don’t be afraid. Try everything once.”

In memoir writing, the courage to be vulnerable is everything.

—-

Under My Bed and Other Essays: Amazon|Barnes & Noble|IndieBound|Powell’s|University of Nebraska Press|The Bookworm

Visit the author’s site. Follow her on Twitter. 

On August 21, 1831, enslaved American Nat Turner led about 70 of his enslaved and free Black neighbors in a rebellion to awaken his white neighbors to the inherent brutality of slaveholding and the dangers it presented to their own safety. Turner and his friends traveled from house to house in their neighborhood in Southampton County, Virginia, freeing enslaved people and murdering about 60 of the white men, women, and children they encountered. Their goal, Turner later told an interviewer, was “to carry terror and devastation wherever we went.”

State militia put down the rebellion in a couple of days, and both the legal system and white vigilantes killed at least 200 Black Virginians, many of whom were not involved in Turner’s bid to end enslavement. Turner himself was captured in October, tried in November, sentenced to death, and hanged.

But white Virginians, and white folks in neighboring southern states, remained frightened. Turner had been, in their minds, a well-treated, educated enslaved man, who knew his Bible well and seemed the very last sort of person they would have expected to revolt. And so they responded to the rebellion in two ways. They turned against the idea that enslavement was a bad thing and instead began to argue that human enslavement was a positive good.

And states across the South passed laws making it a crime to teach enslaved Americans to read and write.

Denying enslaved Black Americans access to education exiled them from a place in the nation. The Framers had quite explicitly organized the United States not on the principles of religion or tradition, but rather on the principles of the Enlightenment: the idea that, by applying knowledge and reasoning to the natural world, men could figure out the best way to order society. Someone excluded from access to education could not participate in that national project. Instead, that person was read out of society, doomed to be controlled by leaders who marshaled propaganda and religion to defend their dominance.

In 1858, South Carolina Senator James Henry Hammond explained that society needed “a class to do the menial duties, to perform the drudgery of life. That is, a class requiring but a low order of intellect and but little skill.”

But when they organized in the 1850s to push back against the efforts of elite enslavers like Hammond to take over the national government, members of the fledgling Republican Party recognized the importance of education. In 1859, Illinois lawyer Abraham Lincoln explained that those who adhered to the “mud-sill” theory “assumed that labor and education are incompatible; and any practical combination of them impossible…. According to that theory, the education of laborers, is not only useless, but pernicious, and dangerous.”

Lincoln argued that workers were not simply drudges but rather were the heart of the economy. “The prudent, penniless beginner in the world, labors for wages awhile, saves a surplus with which to buy tools or land, for himself; then labors on his own account another while, and at length hires another new beginner to help him.” He tied the political vision of the Framers to this economic vision. In order to prosper, he argued, men needed “book-learning,” and he called for universal education. An educated community, he said, “will be alike independent of crowned-kings, money-kings, and land-kings.”

When they were in control of the federal government in the 1860s, Republicans passed the Land Grant College Act, funding public universities so that men without wealthy fathers might have access to higher education. In the aftermath of the Civil War, Republicans also tried to use the federal government to fund public schools for poor Black and white Americans, dividing money up according to illiteracy rates. 

But President Andrew Johnson vetoed that bill on the grounds that the federal government had no business protecting Black education; that process, he said, belonged to the states—which for the next century denied Black and Brown people equal access to schools, excluding them from full participation in American society and condemning them to menial labor.

Then, in 1954, after decades of pressure from Black and Brown Americans for equal access to public schools, the Supreme Court under Chief Justice Earl Warren, a former Republican governor of California, unanimously agreed that separate schools were inherently unequal, and thus unconstitutional. The federal government stepped in to make sure the states could not deny education to the children who lived within their boundaries. 

And now, in 2022, we are in a new educational moment. Between January 2021 and January 2022, the legislatures of 35 states introduced 137 bills to keep students from learning about issues of race, LBGTQ+ issues, politics, and American history. More recently, the Republican-dominated legislature of Florida passed the Stop the Wrongs to Our Kids and Employees (Stop WOKE) Act, tightly controlling how schools and employee training can talk about race or gender discrimination. 

Republican-dominated legislatures and school districts are also purging books from school libraries and notifying parents each time a child checks out a book. Most of the books removed are by or about Black people, people of color, or LGBTQ+ individuals.

Both sets of laws are likely to result in teachers censoring themselves or leaving the profession out of concern they will inadvertently run afoul of the new laws, a disastrous outcome when the nation’s teaching profession is already in crisis. School districts facing catastrophic teacher shortages are trying to keep classrooms open by doubling up classes, cutting the school week down to four days, and permitting veterans without educational training to teach—all of which will likely hurt students trying to regain their educational footing after the worst of the pandemic.   

This, in turn, adds weight to the move to divert public money from the public schools into private schools that are not overseen by state authorities. In Florida, the Republican-controlled legislature has dramatically expanded the state’s use of vouchers recently, arguing that tying money to students rather than schools expands parents’ choices while leaving unspoken that defunded public schools will be less and less attractive. In June, in Carson v. Makin, the Supreme Court expanded the voucher system to include religious schools, ruling that Maine, which provides vouchers in towns that don’t have public high schools, must allow those vouchers to go to religious schools as well as secular ones. Thus tax dollars will support religious schools. 

In 2022, it seems worth remembering that in 1831, lawmakers afraid that Black Americans exposed to the ideas in books and schools would claim the equality that was their birthright under the Declaration of Independence made sure their Black neighbors could not get an education.

—

Notes:

https://www.cnn.com/2022/06/21/politics/supreme-court-religious-schools/index.html

https://www.nbcnews.com/news/us-news/judge-blocks-floridas-stop-woke-act-pushed-gov-desantis-rcna43908

https://www.flsenate.gov/Committees/BillSummaries/2022/html/2809

https://www.washingtonpost.com/education/2022/08/17/book-ban-restriction-access-lgbtq/

https://www.washingtonpost.com/education/2022/08/03/school-teacher-shortage/

https://www.heraldtribune.com/story/news/education/2022/08/12/sarasota-schools-library-book-purchases-donations-frozen/10307632002/

Share

The last time I tried to wait out the pandemic, I drove south. My dog and I traveled nine hours from San Francisco to the Anza-Borrego Desert, which sprawls over more than half a million acres near the Mexican border. Most of that territory is untouched wilderness, rocky washes home to deer, pumas, and golden eagles.

The place felt solitary. That’s why I chose it. I work as a doctor in an emergency room, a hospital, and an HIV clinic. I also take powerful immunosuppressants for autoimmune disease, one of which rendered the coronavirus vaccines far less effective in my body. My co-workers had tried to see all of the COVID patients to protect me, but as Omicron exploded in January, that became impossible. The woman who’d broken her ankle tested positive. The grandfather who’d lacerated his scalp did too, just like the middle-aged man who wanted to detox. Treatments for COVID were in short supply, and I wanted to get through the surge alive. So for several weeks, I canceled work, a privilege most can’t afford. Forced into isolation, I decided to spend a week where solitude felt deliberate.

Back then I would have described my trip to the desert, and pandemic life broadly, as an intermission. The moment caseloads tumbled and hospitals stocked treatments, I would go hiking in Japan. I would brave the dating scene after a two-year hiatus. I would deploy with Doctors Without Borders. Meanwhile, I reassured myself that I just had to hold out a few months longer, even though the deadline kept retreating. Mine was an outlook equally comforting and wrong.

[Read: The millions of people stuck in pandemic limbo]

Kurt Vonnegut famously taught about six archetypes that underpin stories. In a video of one of his lectures, he draws on a chalkboard an x-axis for time and a y-axis for degree of good fortune, then traces a sine wave that plummets before rising again. “We call this story ‘Man in Hole,’ but it needn’t be about a man, and it needn’t be about somebody getting into a hole,” Vonnegut says. It’s a tale—of fall and salvation, of mettle forged through trials, of ultimate catharsis and victory—that humans tell naturally. And it needn’t be about a man and a hole. It could be about a world and a virus.

People in the U.S. have heard this story repeatedly over the past two and a half years, the media and government casting the downturn of each surge or advent of each therapeutic as the ladder that would soon carry us from the hole of the pandemic. Until that deliverance, we could cultivate rooftop gardens and sourdough starters to stave off our impatience. It’s less scary to rewrite reality into a reassuring plot arc—one with a familiar contour and clean resolution—than to envision a story that doesn’t end, or one whose ending permanently reconfigures our world.

But nearly eight months after my return from Anza-Borrego, the bridge of my nose is raw from my N95 mask. Yet another Omicron subvariant is spreading, as one strain supersedes another. Despite stunning progress in vaccines and drugs, COVID still threatens to hospitalize or disable me, and I don’t foresee that reality changing imminently. While the mirage of normalcy recedes, glittering and unattainable, I remain marooned in another desert, staring down the truth that a sense of closure won’t arrive anytime soon.

[Read: The BA.5 wave is what COVID normal looks like]

SARS-CoV-2 is only the latest pathogen to upend people’s lives. Working as a doctor who specializes in HIV—a virus that profoundly affects my patients yet is ignored by most Americans—has taught me some truths about pandemics. The first time someone asked me whether HIV was “still a problem,” at a Christmas party years ago, I almost choked on my drink. But the question made twisted sense in a country where the notion that a pandemic is over depends little on science and more on which communities are affected.

The people I treat who gasp from pneumonia or seize from meningitis because they can’t access or adhere to HIV medications are invariably poor, and many are Black or Latino. My acquaintance at the party was a straight, white, wealthy man in his 60s. He could exist in a story where the man had climbed out of the hole. Tale concluded, the credits rolled. That conversation is the reason why, whenever someone says the coronavirus pandemic is over, my first question is always, “Over for whom?”

Though I‘ve endured a sliver of the adversity my patients have, I’m learning what it’s like to embody a less comfortable story than the one others are telling. I walk by packed bars. I scroll through photos of maskless crowds at concerts. I hear people use the phrase “during the pandemic,” as if it’s ended. After multiple false starts, the man in the dominant version of the story escaped the hole after the Omicron surge once and for all.

That narrative has real consequences, including lax precautions, risky workplace policies, and woefully inadequate funds for global COVID efforts. It sidelines millions of Americans: not only people like me dealing with high-risk medical conditions, but also survivors confronting long COVID, frontline workers depleted by burnout, and loved ones grieving those who have died, disproportionately people of color. I don’t want my fellow San Franciscans to stop eating out or traveling; their lives will be freer than mine, a situation I accept as unavoidable even if it saddens me. I do wish, though, that the government would value my life by investing in preventing COVID transmission rather than issuing ever more anemic guidelines. And amid such policy failures, I wish people with less to fear from the virus would shift the burden off the shoulders of the more vulnerable, by wearing masks on public transit, staying home when they’re sick until a rapid test turns negative, and keeping up to date on boosters.

[Read: The pandemic’s soft closing]

After far too long, I have stopped clutching the myth of Man in Hole, in which I must either pretend the pandemic is over—a self-deception that could land me in the hospital—or else wait indefinitely for a ladder, watching clouds scud over desert lowlands as I forfeit plans and dreams. I need a story to replace it, and for that, I’ve turned to my patients.

A few years ago, I treated a young man who had contracted HIV just out of college. A pandemic that had never touched him suddenly shaded his life, and for months, that paralyzed him. He didn’t look for work; he played video games all day and nearly lost his housing. Then, six months after his diagnosis, he started bringing a notebook to our visits. In it, he fashioned a plan. Nothing sweeping: Stop by two restaurants to ask about jobs. Get glasses. Post a dating profile. A year into our time together, he was working in a café, had an adoring boyfriend who knew his status, had undergone a long-overdue surgery, and had started graduate school.

I started carrying a notebook recently. The plans I scribble down differ from those I might have conceived before the pandemic but share one feature: They are possible despite my constraints. I rode my bike from Seattle to Vancouver for an outdoor vacation. I attended a wedding in an N95 mask. I made enchiladas with friends after we all took rapid tests. I spoke on the radio about the injustices of pandemic policy, because adapting to my new reality doesn’t mean abdicating the battle for a better one. That, too, I learned from people with HIV, who formed committees to pressure the FDA and the NIH, demanded inclusion in policy decisions, and were jailed for protesting for effective antiretrovirals, including one used in COVID treatment.

[Read: COVID long-haulers are fighting for their future]

I still seethe whenever I show up to an event that’s too overcrowded and underventilated for me to stay, or board a plane where the overturned mask rule reminds me of the nation’s disregard for my health. But action is nonetheless a relief after spending so long stymied. If I were to chart my life on Vonnegut’s chalkboard now, I’d draw a steep plunge followed by a slow and bumpy incline that hasn’t yet neared the original precipice. It’s a tale less tantalizing than Man in Hole, and galling in its incrementalism, but it does have one advantage: It’s true.

Some people visit Anza-Borrego only after the rains, in perfect conditions, when a riot of wildflowers suffuses the land with color. I never have. People tend to assume that this is when the desert is most alive, but in truth, even in the most arid conditions, bobcats prowl, coyotes slink, and foxes rear their kits. When the wild sheep can’t find water, they ram barrel cacti and devour the wet pulp. These animals know well that the rains don’t always come. During the dry spells, life carries on.

I had the Midjourney AI art generator give me a few pictures of a cat in a library, in the style of Gustav Klimt. This was my favorite, both for the absolutely unimpressed expression but also because in the cat’s “fur” you can see hints of books and bookshelves, which is actually quite clever for an artist without actual sentience. It was worth sharing on this slow summer weekend, so here it is. Enjoy the rest of your weekend. Maybe read a book.

— JS

The neglected or endangered child—the orphan, the vagrant, the waif—is a character with deep roots in the Western canon. Beginning perhaps with the binding of Isaac in the Bible, this figure appears everywhere: in Johann Wolfgang von Goethe’s The Sorrows of Young Werther, in Charles Dickens’s oeuvre and, more recently, in Toni Morrison’s. These stories captivate young and old readers, provoking thrill and worry. Children who are lost fill us with grief; kids who wish to rise above their tough circumstances or go on an epic adventure bring us the highest joy, and we seek these narratives out in books as disparate as Maurice Sendak’s Where the Wild Things Are and Tove Ditlevsen’s The Copenhagen Trilogy. Why? Because each of us knows, in some measure, what they’re feeling.

We all understand what it means to feel abandoned, ignored, or underestimated. Some of us may have experienced it for just a moment, or a day; others may have felt it for a decade, or a lifetime. Regardless, we carry those memories for the rest of our lives, and we have been trying to express those feelings for as long as we, as a species, have known how to express anything.

In the sea of great literature that tells these tales, here are some of the titles that helped me write about my own complex childhood in my new memoir, Dirtbag, Massachusetts. Their circumstances are varied, but their depictions of the unique ways kids feel delight and pain will resonate with any reader.

---

Another Bullshit Night in Suck City, by Nick Flynn

To not mention this book—and to not mention it first—would be a crime. Flynn’s memoir is about his family’s struggles with alcoholism and with one another; it’s set in Boston and centers on a homeless shelter where Flynn himself worked. When I first read it, I was surprised by the number of places, emotions, and even experiences that overlapped between the author’s life and my own: addiction, mental illness, generational trauma. I was spellbound by how Flynn structured the narrative, which was inspired by Herman Melville’s Moby-Dick. In that novel, the reader is aware of the titular white whale for most of the story through hearsay, with the giant beast appearing only in the final pages. In the same way, Flynn’s father casts a shadow over his own family history and life, without being present during his childhood. Only after meeting his father does Flynn begin to work on himself. When I finished it in my early, early 20s, I remember thinking, That’s the type of book I want to write—vulnerable, poetic, kind.

---

The Yellow House, by Sarah M. Broom

What I love about this memoir, which won the National Book Award for Nonfiction in 2019, is its incredible sense of place. Broom’s story is submerged in one of the most lionized—and complex—cities in America: New Orleans. More specifically, she focuses on New Orleans East and the yellow shotgun house that the author’s steadfast mother, Ivory Mae, bought in 1961, and where Broom grew up as the youngest of 12 siblings. The Yellow House takes on history and structural racism while also telling small, intimate stories that show how families, like neighborhoods and cities, are evolving, living things that shift and affect their members in an endless dance. Broom’s brilliant book demonstrates that context and setting are crucial to telling a story, and will ring true for anyone who also grew up in a house that loomed large over everything that happened to their family.

[Read: How to write the book no one wants you to write]

---

Wolf in White Van, by John Darnielle

In this novel, the wounds of youth are carried for a lifetime. Its author is the man behind The Mountain Goats, a band I’ve adored for more than two decades. Wolf in White Van tells the story of Sean Phillips, who suffered a disfiguring injury when he was 17 and became a recluse. When we meet him, he has invented an intricate, mail-based role-playing game to allow for a modicum of human connection. But when something terrible happens to a couple of teenage players of the game, he is forced to enter the real world again. Wolf in White Van is a master class in restraint. Darnielle paints a picture of isolation and loneliness, but by not giving away the whole truth of what happened to Sean until the very end, he dares the reader to figure out the complexities of the novel in almost the same way they untangle the complexities of the game. It encouraged me to not turn away from the anger in my younger years—and to keep some of its causes unseen until the last pages of my own book.

---

Heavy, by Kiese Laymon

This memoir is incredible. The writing talent on display is undeniable, and every sentence sings. “My body knew things my mouth and my mind couldn’t, or maybe wouldn’t, express,” Laymon writes early in the book. That sentence hit my heart; it was something I knew to be true, but had never been able to articulate. At the book’s center are Laymon’s relationships with his mother and with his own body. Who among us has not had difficulty with our body? With our mother? (If you haven’t, I’d love to hear your secret.) What truly inspires is not the book’s universal themes, but instead Laymon’s incredible striving. Here is a man trying to find the truth, to communicate something to his parent and find common ground or, if not that, an understanding of what their relationship has become and why. To do so, Laymon examines sex, gambling, racism in America, and himself. Digging into how he grew up becomes a way to finally say aloud what he’s always carried with him—and to hope for a better future.

[Read: The personal cost of Black success]

---

Skippy Dies, by Paul Murray

In the opening pages of this raucous novel filled with unforgettable characters, Skippy, a hapless 14-year-old pupil at a fancy boys’ school, writes a mysterious message in jelly filling on the floor of a doughnut shop and drops dead. But this mystery wasn’t what drew me to the book, nor the fact that it focuses on adolescents who attend a boarding school, as I did. The core of Murray’s writing is its humor: Skippy’s experience at his school, Seabrook, is raunchy, searching, and complex, but always deeply funny. Told from numerous different perspectives, stretching across a wide variety of subjects—string theory, organized religion, folklore, poetry—Skippy Dies is a tutorial in the ability to find laughter in the bleakness of growing up.

---

The Nickel Boys, by Colson Whitehead

This 2020 Pulitzer Prize–winner is tragic and unrelenting. A report released in 2016 documented more than 50 skeletons buried on the grounds of the Dozier School for Boys, in Florida, which operated from 1900 to 2011 housing orphans, wards of the state, and children convicted of crimes. Whitehead uses that real-life horror to weave an incredibly powerful novel about the cruel, racist abuse suffered in the name of rehabilitation at the titular Nickel Academy. At the center of the story are two young boys, Elwood Curtis and Jack Turner, who both end up there in the 1960s. The Nickel Boys is about how the smallest bit of bad luck can have a rippling effect throughout one’s entire life—but it’s also about how the people we love can change us in ways we might not ever be able to imagine.

[Read: What is crime in a country built on it?]

---

The Goldfinch, by Donna Tartt

One of the biggest titles of the past decade, The Goldfinch, a kaleidoscopic achievement, covers so much ground. It’s the story of Theo Decker, whose mother is killed during a bombing at the Metropolitan Museum of Art. Young Theo slips away from the explosion with a painting by the Dutch artist Carel Fabritius, the titular Goldfinch. The whole book is masterful and has indelible moments in both New York City and Amsterdam, but the section that I absolutely love is set in the sandy outskirts of Las Vegas, in the novel’s middle. Here, Theo and Boris Pavlikovsky, two friends without much parental supervision, forge the bonds of young rascals; they drink, take drugs, and try to figure out what to do with Theo’s stolen, priceless painting. As someone who grew up playing violent games in the woods with real BB guns and turning old hair-spray cans into flamethrowers with my friend, I can attest that The Goldfinch artfully displays the reckless abandon that comes from a feral, unsupervised youth.

---

The Collected Breece D’J Pancake: Stories, Fragments, Letters, by Breece D’J Pancake

This assemblage of Pancake’s work—especially its 12 bleak, beautiful stories about trilobites and coal country and truckers and also tenderness, in their way—is a fundamental stepping-stone in my evolution as a reader. Pancake writes about Virginia and West Virginia, places that I had never been when my father gave me my first copy. But here was writing that reflected my own experiences growing up in a low-income area in North-Central Massachusetts: people in trailers. Hunting. Rural isolation. The joys and hardships that come from living in the woods. The prose is unpolished, yet Pancake’s lyricism somehow manages to shine, whether it’s describing a pregnant farm wife or a snowplow driver with a secret. The mythos of the collection is also part of its pull. Pancake died by suicide at 26; I have grappled with suicidal ideation, and this galvanizing book convinced me that my account might also have some value.

---

​​When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

This month’s Fantastic Strangeling Book Club choice is so, so good. It’s The Book Eaters by Sunyi Dean. I devoured this atmospherically creepy and gorgeous novel.  Well, not literally.  But after reading the book I kind of wanted to.   In fact, I loved it so much I made my own book house inspired by the cover and onlyContinue reading "It’s a good month for reading"

These days, middle-class families run ragged by their kids’ competitive-sports schedules are achingly common across America: Weekends are devoured by tournaments and practice, family dinners replaced by mandatory strength-training sessions, and vacations forever postponed. During my five years of researching and writing about youth sports for my book Take Back the Game, I heard so many variations of these stories, and the burden on burned-out teenagers is clear. Less obvious is the effect of relentless overtraining on the rest of the household. In the ever-earlier scramble to develop their kids’ athletic skills, mothers and fathers frequently find themselves giving up the integrity of the family as a whole.

In my observation, this is most common among competitive club sports, which for many kids begin during elementary school and extend through high school. For all the evidence that shows how exercise and sports benefit children, comparatively little research exists on the costs of competitive youth sports participation to the unpaid support network that enables it—specifically, the young athletes’ families. What of the marriages, siblings, and extended relatives who are pulled in or dragged along or left out when one child takes up soccer or tennis with gusto, and the parents go all in? Besides so much else that’s wrong with contemporary elite youth sports—the prohibitive cost, erosion of fun, epidemic of injuries—disrupted families should be added to the list.

[Read: The downsides of America’s hyper-competitive youth-soccer industry]

For parents, the financial costs alone are steep—even when their kids aren’t high-level athletes. According to a 2019 study conducted by the Aspen Institute think tank and Utah State University of 1,032 adults with kids who played sports at the recreational, high-school, or club level, families spend an average of $693 annually for each sport a child plays. Though the high price squeezes many low-income kids out entirely, in households earning less than $50,000, parents still pay an average of $475 annually per child per sport. And raising a highly promising child athlete can require major financial trade-offs. A Harris Poll survey on behalf of TD Ameritrade queried 1,001 adults who had at least one child playing for a club or an “elite competitive” nonschool team and found that 19 percent had taken a second job or worked overtime, or would be willing to, in order to fund their kid’s sports. In this survey, parents also reported spending an average of 12 hours each week on their child’s athletic activities. In my research, I’ve found that the biggest drain on parents’ time comes from attending sports events. One mother told me that she and her husband had eliminated what she called “meaningful family vacations” to afford her three daughters’ soccer and lacrosse expenses.

One of the few academic studies exploring how youth sports affect marriages discovered a significant impact on quality partner communication. Of the seven couples interviewed, all of whom had been married for at least 10 years, some reported that their child’s participation on an elite team had turned family life into an endless discussion about logistics. “Our conversations go something like, ‘What are you doing? Where are you going? When are you going to be here?’ You know, typical kind of coordination-type stuff,” one mother explained. “Sometimes we don’t talk. He’s at the field picking them up at 10:00 p.m. There are some weeks it feels they have practice after school five days a week, and he is either in the car or at the field,” another said about her husband.

The sports psychologist Jim Taylor, who has been counseling athletes and their families for more than 35 years, told me that pressure on parents comes up constantly in his practice. Parents clash over spending and worry about the lack of attention they devote to each other and to their other children. Family bonds can become even more frayed when a parent relocates with one child to advance their athletic prospects, leaving the rest of the family behind. This happens most in solo sports such as ski racing, figure skating, and gymnastics, Taylor said, where some parents believe that the child needs to leave home to get top coaching and elite competition.

Then there are brothers and sisters, who often suffer from what Taylor calls “neglected-sibling syndrome,” when all the family’s attention is focused on the athletic child. For most families, the cultivation of sports means less resources for other activities or children. Jordan Blazo, a sports-psychology professor at Louisiana Tech University, has studied the younger siblings of serious athletes—in his research, Division I collegiate players who had earned an athletic scholarship. Some younger children delighted in their sibling’s success and found the family focus on athletics “an agent of cohesion”; the older sibling’s distant games allowed the family to travel together to new places. Others resented having to traipse around in their elder’s shadow, bristled at being compared frequently with the family star, and felt overlooked by the parents, all of which damaged their relationship with the older sibling. “It kind of ate me up because of all the attention that she would get,” one younger sibling in the study said.

In her landmark study of 12 families with varied socioeconomic backgrounds, Annette Lareau, a sociology professor at the University of Pennsylvania, found that middle-class children who were ferried from activity to activity—including but not limited to sports—had uneasier relationships with their brothers and sisters than the kids living less structured lives. Children on the receiving end of “concerted cultivation,” as Lareau dubbed this frenzied approach to child-rearing, seemed to be more aggressive with their siblings, sometimes making casual references to “hating” a brother or sister. She speculated that this stemmed from siblings spending so much time in activities and having limited interactions with family.

[Read: How to quit intensive parenting]

Blazo—himself a former high-school soccer player and the second son in a family of five boys—reminded me that sibling relationships move through cycles, and that conflict in adolescence doesn’t lock in a lifetime of estrangement. In some households, an athletic brother or sister might be an encouraging role model, a steady playmate, a reliable confidant. But Blazo cautions mothers and fathers to consider how the child who doesn’t play sports will perceive the value their parents attach to athletics. Even the most conscientious parent will be up against a culture that exalts athletic achievement. When professional players are rewarded with riches and attention, about half a million young adults compete in college, and children are frequently nudged into sports as soon as they can walk, convincing kids that it’s okay to bail on soccer or skip the baseball tryout can be a tough sell.

In my reporting, I’ve often asked parents caught up in competitive youth sports if they’d ever considered withdrawing their kids from the circuit. Some told me they feel like they have no choice: Their child loves it, or it will help them get into a better college. Families might be strung out and split up, they seemed to be saying, but no matter. In elite sports families, individual athletic triumphs still seem to justify every household sacrifice.

At 36, I am just old enough to remember when sunscreen wasn’t a big deal. My mom, despite being among the palest people alive, does not remember bringing it on our earliest vacations, or hearing any mention of sun protection by our pediatrician. The first memories I have of sunscreen are from the day camp that my brother and I attended in the 1990s, where we spent every day on a playground in the direct Georgia sun but were prompted to slather it on only once every two weeks, when we were bused to a community pool. On those days, mom dropped an ancient bottle of Coppertone, expiration date unknown, into my backpack, where I usually left it. In 2000, I started high school, just in time for the golden age of the tanning bed.

The preponderance of babies in rashguards and bucket hats that you now see at the beach shows how much has changed, and how quickly. Skyrocketing skin-cancer rates, specifically for fair-skinned people, among whom the disease is more prevalent, have scared plenty of people into rethinking their tans, as has the realization that sun exposure causes—horror of horrors—wrinkles and other visible signs of aging. Now SPF is ubiquitous. You can find it in lotions, sprays, gels, oils, powders, and implements that look like grade-school glue sticks, as well as infused into skin-care products, lip balms, makeup, and clothing. Sun care has its own aisle at big-box stores, and beauty companies worth hundreds of millions of dollars have been built from the ground up by offering only products that block ultraviolet rays.

Yet if sun protection, and specifically sunscreen, has become a very big deal in a relatively short amount of time, the UV blockers Americans are slathering on have barely evolved at all. While some of the more expensive U.S. products are better than they used to be in terms of texture and how they look on skin, their active ingredients remain stubbornly unchanged. To make matters worse, we’ve brought this situation on ourselves. Consumers in Europe and Asia are not locked in, as we are, to a small and outmoded set of active ingredients. Simply put: They have better sunscreen than we do. We should have it too.

[Read: How SPF ratings can do more harm than good]

Forgive me, but in order to understand what’s going on with the sun-protection market, we must briefly discuss chemistry. Sunscreen works by preventing two of the sun’s three types of ultraviolet rays—UVA and UVB—from penetrating your skin and doing cancer-causing damage. The ingredients that counteract those rays are called filters, and for the general public, they’re divided into two categories: physical and chemical. (Don’t be fooled by “natural” marketing—the active ingredients in both groups are synthetic chemicals.) Physical—a.k.a. mineral—sunscreens block both UVA and UVB rays, and tend to leave a residue that makes even pale people look like they’re doing some additional Casper the Friendly Ghost cosplay. Chemical filters, which absorb either UVA or UVB rays, are mixed together to create sunscreens that provide full-spectrum protection; they usually feel a bit oily or greasy.

In the U.S., sunscreen is regulated as an over-the-counter drug, which means that the FDA considers all filters, physical or chemical, to be active ingredients that must be evaluated and approved individually before they can be marketed. In general, this type of regulatory regime works out pretty well for the American public: cheap, off-brand anti-inflammatories, allergy medications, or cough syrups contain active ingredients that have been tested for efficacy and safety in just this way. The same is true for sunscreens. Whether you buy yours at Dollar General or Sephora, it will contain at least one FDA-approved UV filter in a clearly marked concentration.

The government currently allows 17 filters in American sunscreens, nine of which are rarely used, because they have undesirable side effects or because cosmetic chemists find them difficult to blend into the kinds of products that people like. The eight that you will find in the products at your local drugstore still leave something to be desired. “The ingredients that we have to work with can cause some challenges in creating a really elegant formula,” Kelly Dobos, a cosmetic chemist who teaches at the University of Toledo, told me. That’s especially true when filters are used in the concentrations necessary for high SPFs, she said. Maximum protection can sometimes mean maximum chalkiness or oiliness, although a skilled formulator will try to counteract these effects with tweaks to the formula or manufacturing process.

A sunscreen that has an unpleasant texture or turns your skin a strange color might be tolerable for a one-off excursion to the beach or an afternoon in the cheap seats at a baseball game, but it wouldn’t exactly encourage thorough and repeated applications of a sunscreen, which is necessary no matter which product you use. For everyday use, which is widely recommended by dermatologists, the obstacles are even harder to clear, from a formulation standpoint: Oily products don’t play nice with makeup, while chalky products look wild on pretty much everyone, especially people with darker skin tones. Adam Friedman, a dermatologist at George Washington University, told me such concerns are a huge obstacle for his patients. “You can have the best filter in the world,” he said. “If the vehicle in which that ingredient resides is visibly unacceptable or physically unacceptable in terms of application, it doesn’t matter.”

For many people, frustration with sunscreen means they don’t wear it as much as they should. For others, it means looking beyond the country’s shores for better products. In Europe, Australia, and much of Asia, sunscreens are regulated as cosmetics or health-bolstering goods, with simpler efficacy and safety standards than those in the U.S. In those markets, several dozen active ingredients are available for use in sunscreens, including some developed in the past decade that have intriguing properties. The allure of these new technologies has drawn Americans to scour the internet for supply lines that skirt FDA notice, which often means buying sunscreen through third-party sellers on Amazon. (The booming popularity of Korean beauty products in the U.S. has only added to this fervor.) A few international sunscreen products have recently become cult favorites among U.S. beauty fiends, including one that feels like a skin-care product and is marketed as a “watery essence” by Bioré, a Japanese company known to Americans mostly for producing the little paper strips that rip the gunk out of your pores.

Bioré markets some of its products in the U.S., but its ultra-popular facial sunscreen contains bemotrizinol, a chemical filter that’s popular overseas but has not yet been approved in the U.S. The substance is on a short list of those that Dobos told me have the strongest case for FDA approval—it’s widely used around the world and very effective at absorbing UV rays. Another ingredient at the top of her list is bisoctrizole, a favorite in Europe, which she said degrades more slowly in sunlight, is less readily absorbed by the wearer’s skin, and helps stabilize other UV filters when mixed with them, potentially improving their efficacy. Wearers don’t need to reapply it as often in order to remain protected, and they may not worry as much about the putative risks of carrying chemical filters in their bloodstream. (None of the experts I spoke with said there is any demonstrated danger from using standard products as directed. You probably shouldn’t eat your sunscreen, though.)

Dobos emphasized to me that she thinks the FDA’s strict regulation of sunscreen products is generally beneficial to the American public, but that the agency’s slow progress on new ingredients doesn’t match the urgency of skin cancer’s threat to public health. In formal statements and position papers, doctors and cancer-prevention advocates express considerable interest in bringing new sunscreen ingredients to the American market, but not a lot of optimism that any will be available soon. The FDA hasn’t added a new active ingredient to its sunscreen monograph—the document that details what is legally allowed in products marketed in the U.S.—in decades. The process for doing this is so onerous that L’Oreal, a French company, chose to go through a separate authorization process to get one of its sunscreen ingredients onto the consumer market in 2006—which meant that only a few specific beauty products containing that ingredient could be marketed legally.

In 2014, Congress passed a law attempting to speed access to sunscreen ingredients that have been in wide use in other countries for years, but it hasn’t really worked. “The FDA was supposed to be fast-tracking these ingredients for approval, because we have the safety data and safe history of usage from the European Union,” Dobos said. “But it seems to continually be stalled.” According to Courtney Rhodes, a spokesperson for the FDA, manufacturers have submitted eight new active ingredients for consideration. The agency has asked them to provide additional data in support of those applications, but none of them has yet satisfied the agency’s requirements.

“In the medical community, there is a significant frustration about the lack of availability of some of the sunscreen active ingredients,” Henry Lim, a dermatologist at Henry Ford Health, in Michigan, told me. The more filters are available to formulators, the more they can be mixed and matched in new ways, which stands to improve not just the efficacy of the final product, but how it feels and looks on your skin, and how easy it is to apply. On a very real level, making sunscreen less onerous to use can make it more effective. “The best sunscreen is going to be the one you’re going to use often and according to the directions,” Dobos said. Skin cancer is the most common type of cancer in the United States, and by one estimate, one in five Americans will develop it in their lifetime.

For many dermatologists, these lengthy regulatory battles and widespread issues with regular usage also underline a common recommendation that tends to go unheard by patients: Sunscreen is great, and sunscreen from Europe, Australia, and Asia may be better, but even the best, most cutting-edge SPF lotion is just one part of keeping your skin healthy. Floppy hats, big beach umbrellas, or loose, high-coverage clothing might not be your ideal beach look while you’re young, but if you can mostly cover up and stick to the shade, your elderly self will thank you.

One of the many horrifying scenes in Jordan Peele’s Nope occurs on the set of a ’90s sitcom, when a performing chimpanzee flies into a frenzy and attacks his castmates. This memory unfolds through the eyes of the child star Ricky Park (played as an adult by Steven Yeun), sheltering in terror in the ravaged room. At one point, his gaze alights on a strange, specific sight: a single shoe, balanced on its heel, pointing straight up in seeming defiance of gravity. It’s a tranquil image in a sea of chaos, so distinctive that Ricky has never forgotten it despite the trauma of the day.

Peele’s film never explains the mysteriously posed shoe; indeed, Nope is not concerned with explaining much. Instead, the focus is on spectacle, and the Herculean emotional and physical tolls that come from witnessing it, or, even worse, trying to capture it on camera. The central object of fascination for Nope’s ensemble is a saucer-shaped unidentified flying object that’s tooling around the hills outside Los Angeles. And yet Peele is not just making an inventive sci-fi thriller. Nope is tinged with the acidic satire that suffused his last two movies, as Peele examines why the easiest way to process horror these days is to turn it into breathtaking entertainment.

[Read: ‘Get Out’ is a funny and brilliantly subversive horror film]

The brother-and-sister leads of Nope are OJ (Daniel Kaluuya) and Emerald Haywood (Keke Palmer). They claim that they’re the descendants of the jockey who was the subject of The Horse in Motion, the first “moving picture” ever captured by a camera. They own a ranch in Agua Dulce, the dramatic mountain country just beyond Los Angeles that was the backdrop to many a classic Western, and they train horses for film appearances. In short, their entire livelihood depends on the movie business. The cheerfully obnoxious Emerald seems a born performer herself, but OJ is taciturn to a fault, the one true introvert amid the film’s portrayals of spotlight-seeking artists and actors.

Next door to the Haywood ranch is a chintzy amusement park operated by Ricky, who’s still coasting on the notoriety of his childhood sitcom horror, though completely unable to articulate the experience plainly. When asked about the chimpanzee attack, he cheerfully points to a Saturday Night Live parody of the event that “pretty much nailed it.” After spotting the UFO in the sky, he designs a whole live rodeo show around it, trying to conjure the magic of his youthful performances, even though that line of work led him to his darkest day. Ricky is one of Peele’s most compelling creations, a chipper yet vacant spirit who provides a brutal, if indirect, critique of the showbiz machine.

[Read: The kinetic horror of Lupita Nyong’o’s ‘Us’ performance]

Nope is filled with mesmerizing hangers-on; even though the glitz of Hollywood lurks in the background, the film rarely leaves the echoey terrain of Agua Dulce. Other oddballs include Angel Torres (Brandon Perea), a tech-store clerk who spouts conspiracy theories at OJ and Emerald as he helps them scan the skies for the flying saucer; a gravel-voiced filmmaker named Antlers Holst (an incredible Michael Wincott), forever in search of the perfect shot; and an enigmatic figure in a silver helmet whose introduction late in the action adds a poison-penned exclamation mark to Peele’s already sharp script.

The ensemble is diffuse, and Peele takes his time building out story lines that seem totally unrelated. One could argue that he’s due a little indulgence after the grand success of his films Get Out and Us, both of which were more tautly plotted and had third acts heavy with exposition. But the ambiguity is also justified by the unknowable invasive force at the center of Nope; what unites every character in the film is a desire to transmute it into something entertaining and impressive, to render a scary riddle into a conventional tale of interplanetary visitors. Nope has other ideas, and so does the swooshing saucer hiding in the California clouds.

Only OJ has the presence of mind to flee when confronted with the unknown—he mutters the film’s title to himself under his breath multiple times as a sort of reminder that he doesn’t have to charge into danger. But even he is eventually taken with the allure of capturing the saucer on film. Kaluuya plays that internal turmoil with the simmering intensity that’s made him one of his generation’s most enthralling actors. He’s a perfect muse for Peele, whose widening ambition with every project bucks the Hollywood trend of retreating to the safest artistic territory for the biggest spectacles.

On July 18, 1863, at dusk, the Black soldiers of the Massachusetts 54th Volunteer Infantry of the U.S. Army charged the walls of Fort Wagner, a fortification on Morris Island off Charleston Harbor in South Carolina. Because Fort Wagner covered the southern entrance to the harbor, it was key to enabling the U.S. government to take the city. 

The 600 soldiers of the 54th made up the first Black regiment for the Union, organized after the Emancipation Proclamation called for the enlistment of African American soldiers. The 54th's leader was a Boston abolitionist from a leading family: Colonel Robert Gould Shaw.

Shaw and his men had shipped out of Boston at the end of May 1863 for Beaufort, South Carolina, where the Union had gained an early foothold in its war to prevent the Confederates from dismembering the country. The men of the 54th knew they were not like other soldiers: they were symbols of how well Black men would fight for their country. This, in turn, would be a statement of whether Black men could truly be equal to white men under the country’s laws, once and for all, for in this era, fighting for the country gave men a key claim to citizenship.

The whole country was watching...and the soldiers knew it.

In the dark at Fort Wagner, the Massachusetts 54th proved that Black men were equal to any white men in the field. They fought with the determination that made African American regiments during the Civil War sustain higher losses than those of white regiments. The assault on the fort killed, wounded, or lost more than 250 of the 600 men and made the formerly enslaved Sergeant William Harvey Carney the first African American to be awarded a Medal of Honor. Badly wounded, Carney nonetheless defended the United States flag and carried it back to Union lines. United States soldiers did not take the fort that night, but no one could miss that Black men had proved themselves equal to their white comrades.

The Battle of Fort Wagner left 30 men of the 54th dead on the field—including Colonel Shaw—and hurt 24 more so badly they would later die from their wounds. Fifteen were captured; 52 were missing and presumed dead. Another 149 were wounded. Confederates intended to dishonor Colonel Shaw when they buried him in a mass grave with his men; instead, the family found it fitting.

In 2017 I had the chance to spend an evening in the house where the wounded soldiers of the 54th were taken after the battle.

It is a humbling thing to stand in that house that still looks so much as it did in 1863 and to realize that the men, carried hot and exhausted and bleeding and scared into it a century and a half before were just people like you and me, who did what they felt they had to in front of Fort Wagner, and then endured the boat ride back to Beaufort, and got carried up a flight of steps, and then lay on cots in small, crowded rooms, and hoped that what they had done was worth the horrific cost.

I am not one for ghosts, but I swear you could feel the blood in the floors.

Share

“Everyone knows how productive you can be when you’re avoiding something. We are currently experiencing the civilizational equivalent of that anxiety you feel when you have something due the next day that you haven’t even started thinking about and yet still you sit there, helplessly watching whole seasons of mediocre TV or compulsively clicking through quintillions of memes even as your brain screams at you — the same way we scream at our politicians about guns and abortion and climate change — to do something.”

It’s Time to Stop Living the American Scam, by Tim Kreider

Dedo is pretty. (Whispers: And expensive.)

Even as we watch the reservoirs and lakes of the West go dry, we keep watering our lawns, soaking our golf courses, and growing water-thirsty crops.

As inflation mounts and the national debt balloons, progressive politicians vote for ever more spending.

As the ice caps melt and record temperatures make the evening news, we figure that buying a Prius and recycling the boxes from our daily Amazon deliveries will suffice.

When TV news outlets broadcast video after video of people illegally crossing the nation’s southern border, many of us change the channel.

And when a renowned conservative former federal appellate judge testifies that we are already in a war for our democracy and that January 6, 2021, was a genuine constitutional crisis, MAGA loyalists snicker that he speaks slowly and celebrate that most people weren’t watching.

[Read: America is growing apart, possibly for good]

What accounts for the blithe dismissal of potentially cataclysmic threats? The left thinks the right is at fault for ignoring climate change and the attacks on our political system. The right thinks the left is the problem for ignoring illegal immigration and the national debt. But wishful thinking happens across the political spectrum. More and more, we are a nation in denial.

I have witnessed time and again—in myself and in others—a powerful impulse to believe what we hope to be the case. We don’t need to cut back on watering, because the drought is just part of a cycle that will reverse. With economic growth, the debt will take care of itself. January 6 was a false-flag operation. A classic example of denial comes from Donald Trump: “I won in a landslide.” Perhaps this is a branch of the same delusion that leads people to feed money into slot machines: Because I really want to win, I believe that I will win.

Bolstering our natural inclination toward wishful thinking are the carefully constructed, prejudice-confirming arguments from the usual gang of sophists, grifters, and truth-deniers. Watching angry commentators on cable news, I’m reminded of H. L. Mencken’s observation: “For every complex problem, there is a solution that is clear, simple, and wrong.”

When entire countries fail to confront serious challenges, it doesn't end well. During the past half century, we Americans have lived in a very forgiving time, and seeing the world through rose-colored glasses had limited consequences. The climate was stable, our economy dwarfed the competition, democracy was on the rise, and our military strength made the U.S. the sole global hyperpower. Today, every one of those things has changed. If we continue to ignore the real threats we face, America will inevitably suffer serious consequences.

What clears the scales from the eyes of a nation? Pearl Harbor did. 9/11 did. A crisis can shake the public consciousness. But a crisis may come too late for a course correction that can prevent tragedy. The only cure for wishful thinking is leadership. Winston Churchill emboldened a complacent Britain and rallied the world. Abraham Lincoln held the Union together. Ronald Reagan shook us from our malaise. Lech Wałęsa inaugurated a movement that brought down the Iron Curtain. Martin Luther King Jr. inspired us to “believe that unarmed truth and unconditional love will have the final word in reality.” And Volodymyr Zelensky’s stunning display of courage—“I need ammunition, not a ride”—showed us what real character looks like.

[Read: Liberation without victory]

President Joe Biden is a genuinely good man, but he has yet been unable to break through our national malady of denial, deceit, and distrust. A return of Donald Trump would feed the sickness, probably rendering it incurable. Congress is particularly disappointing: Our elected officials put a finger in the wind more frequently than they show backbone against it. Too often, Washington demonstrates the maxim that for evil to thrive only requires good men to do nothing.

I hope for a president who can rise above the din to unite us behind the truth. Several contenders with experience and smarts stand in the wings; we intently watch to see if they also possess the requisite character and ability to bring the nation together in confronting our common reality. While we wait, leadership must come from fathers and mothers, teachers and nurses, priests and rabbis, businessmen and businesswomen, journalists and pundits. That will require us all to rise above ourselves—above our grievances and resentments—and grasp the mantle of leadership our country so badly needs.

Personal News: I haven’t been feeling so hot the past few weeks, but good news, my pesky uterus and its fibroid passenger “Guillaume” are going to come out within the next several months. YEETERUS AT LAST.

Content Note: Brief mention of kink in the question. If you’re a child and/or the concept of D/s relationships irks you, skip this one.

Dear Captain,

I (they/them) am in a D/s relationship with a trans woman (she/they) involving mutual service dynamics, and one aspect is me being her “guard dog.” I very much enjoy being the protector, and love to be called her guard dog and such things, but sometimes when I really do need to protect her, I fail to do so. Being brave in terms of investigating noises or taking on situations that scare her is one thing, but I am really useless when it comes to helping with conflict. For example, if someone is transphobic to her in public, I often completely freeze up or say something really milquetoast in response. I am just completely filled with shame that in so many situations where I could actually help her, I’m a useless lump instead.

I am working on being braver and taking baby steps to being more assertive and standing my ground when it’s safe to do so, but it feels like I’m not really making much progress. And, any time I fail, it completely tanks my self image and for a long time afterwards, hearing her call me her guard dog just feels horrible. She doesn’t hold it against me, and she isn’t trying to call me out, but in the aftermath I just can’t help but feel like I’m a pathetic armchair warrior, playacting like they’re brave but hiding anytime things get real.

What can I do to get better at being brave and blunt in the moment? How do I learn in my bones that it’s okay to rock the boat when someone has tried to throw someone overboard? And in the meantime, how do I handle the shame and feeling like I don’t deserve her praise or the title of guardian?

–Big Bark, No Bite

Dear Big Bark,

Good news: Assertiveness in the moment is a skill and a habit that can be practiced and learned over time.

Medium news: If you didn’t grow up with the knack, it takes time and practice to unlearn old habits and social dynamics and acquire new ones. You’re not alone in freezing up during high conflict situations, and it feels hard to push back because bigots (and the misogynist, homophobic and transphobic racist culture that we’re all swimming in) makes it hard to push back.

Bigots assume that most people in the dominant group secretly agree with them, and they rely on pressuring anyone who doesn’t agree with them to remain “polite,” “calm,” “neutral,” “civil,” to “prove you’re the bigger person,” to “rise above it,” to “not get emotional,” or “ruin the occasion.” Everything in quotes in the prior sentence is a code for “STAY SILENT AND COMPLIANT AND DON’T REACT.” Bigots want to be able to say and do whatever hateful stuff they want and treat anything less than total compliance, welcome, and praise as proof that they are being persecuted by rude and uncivil forces. *Any* negative reaction from a non-bigot will be treated as an overreaction, as they try to turn attention away from the vile shit they said and blame you for ruining everyone’s fun when you don’t enjoy it. Does that make sense? You’re always going to feel “rude” when you respond to bigotry because bigots thrive by defining any opposition to their violent views and behavior as your faux pas, and the rest of the culture has been conditioned to police “possible rudeness” harder than outright eugenics as long as the horrible person never raises their voice.

Responding to a rude, transphobic remark can be as simple as saying a word or two: “Wow.” “Not cool.” “Yikes.” “Really.” “Yuck.” “Gross.” “Shame on you.” “That’s unacceptable.” “Awkward!” “How embarrassing.” “What an odd thing to say out loud.” You don’t have to be snappy, slay them with your wit, explain yourself, deliver a footnoted treatise on why it’s wrong, or debate with them (almost always a trap). It doesn’t have to be perfect, eloquent, or suave as long as you say or do *something* that indicates that you’re not okay with whatever is happening. Practice speaking up, practice dealing with the flood of pressure and weird feelings that rises afterward, and practice being very kind and gentle with yourself. It’s a process, but if you keep at it you’ll find your own style over time. If that style is more on the “milquetoast” end of things, but you are consistently able to express dismay and disapproval when you encounter bigotry? Then you’re probably doing great!

It’s not always safe to respond, especially for more marginalized people, and you (both you the Letter Writer and you the Reader) are going to be the best judge of when walking away quietly or other de-escalation tactics are necessary to avoid violence Just know that whenever you are able to say something back to a bigot, you are doing four very important things:

• You’re returning the awkwardness to sender. The bigot is the one who ruined everyone’s good time with their asshole remarks, you’re not making it weird by responding. [Remind yourself/bystanders of this by re-stating the facts of what the bigot said and did. “Oh, yes, I realize my ‘tone ‘is quite strident, but I’m not the one who casually suggested a genocide at Book Club.”  “Why are you more okay with [the exact horrible thing they said] than with me reacting to it? Weird!” ]
• You’re removing the bigot’s plausible deniability that their views are acceptable and that “everyone” agrees with them.
• You’re signaling to any nearby marginalized folks and fellow non-bigots that they’re not alone here.
• Even if there is no one else there to notice and nobody is on your side, by speaking up you are standing firm in your own integrity. This too takes practice!

These four things are true and important whether or not the bigot ever “learns a lesson.” It’s unlikely that anyone – especially a stranger in a public place! – changes their horrible views just because you made the right snappy comeback at the right time.

Now, Letter Writer, I want to delve into the specifics of the relationship a tiny bit here.

If you’re being asked to do something as part of a kinky exchange, and attempting that thing is consistently making you feel awful, then it’s probably time to renegotiate things with your partner. “Can we talk about ways we can both show up for each other and push back against transphobic interactions in public? The ‘guard dog’ role isn’t working for me when it involves other people, and I keep freezing up. Can we take that out of the package for the time being and focus on [stuff we both enjoy]?” 

You don’t enjoy this particular aspect of your relationship. That is not a failure on your part, and that is a good enough reason to change it. If it’s not working for you, then it’s not working, period.

That doesn’t mean you should stop speaking up altogether when you and your partner encounter transphobes in the wild. Standing up for your partner the way you would do for a friend, a stranger, or heck – yourself! -is still going to be a good idea for all the reasons stated above, and it’s still a good idea to practice and learn. But I think it will work better if the two of you are a team about it, and if your partner’s safety and agency around this isn’t outsourced to you under pressure of performing a certain way. Sometimes you speak up and they back you up, sometimes they speak up and you back them up, experiment! But overall, I suggest that you untangle the assertiveness skill-building from the kink for now, remove pressure, and see how you do.

More than two years into this pandemic, we finally have an antiviral treatment that works pretty darn well. Paxlovid cuts a vulnerable adult’s chances of hospitalization or death from COVID by nearly 90 percent if taken in the first few days of an infection. For adults without risk-heightening factors, it reduces that likelihood by 70 percent. Also, it might make your mouth taste like absolute garbage the whole time you’re taking the pills.

In Pfizer’s clinical trials, about 5.6 percent of patients reported an “altered sense of taste,” called dysgeusia in the medical literature. A Pfizer spokesperson assured me that “most events were mild” and “very few patients discontinued study as a result”; the outer packaging of the drug doesn’t mention it at all, and the patient fact sheet breezes past it. But Paxlovid-takers told me it’s absolutely dysgeusting.

The bad taste may come on shortly after people take their first set of pills. (If prescribed Paxlovid, you’re supposed to take three pills, twice daily, for five days.) For a 36-year-old dog walker in Washington, D.C., named sangam 'alopeke (who styles their name without capital letters), the effect emerged within about an hour of the first dose. Lindsay Wright, a 40-year-old creative director in Winnipeg, Canada, said she noticed it after 90 minutes. Sheila Borkar, a 30-year-old transportation engineer who also lives in Washington, took a pill before bed and woke up to the taste.

“I imagine this is what grapefruit juice mixed with soap would taste like,” Anna Valdez, a nursing professor in Sonoma Valley, California, told me. (We communicated over Twitter direct messages because Valdez had lost her voice from COVID.) “It is horrible and does not go away.” Borkar was reminded of acid reflux. “This didn’t taste like food,” she said. “It didn’t quite taste poisonous, but it definitely tasted like something that should not be consumed.” Her friend Jeffrey Holliday, a 33-year-old business analyst, told me, “It tasted like I chewed a bunch of vitamins.”

“I heard that for some people, it’s a metallic taste, and I’m a little jealous,” Wright said. “I’m describing it as, like, bitter, burnt grapefruit, but mixed with—you know that taste when you try to swallow Tylenol and it doesn’t go down the first time? It’s a little bit of that failed-Tylenol-swallow mixed in.”

While dysgeusia is listed as a side effect of many drugs, including antibiotics, chemotherapeutics, and antihistamines, the specific experience varies. In many cases, patients report a bitter or metallic taste, Steven Munger, the director of the University of Florida’s Center for Smell and Taste, told me. That might be because human mouths are more primed to detect bitterness, in all its subtleties, than other flavors. According to Munger, humans have one kind of taste receptor for sweetness, one for umami, one for salt, two for sourness, and a whopping 25 for bitterness. That makes evolutionary sense, he said: Many toxic substances are bitter, so it’s more important that we taste them. “If the sweet receptor misses something, okay, well, maybe there’s more food coming along. That’s not going to be a life-or-death situation. But ingesting something that’s toxic could kill you.”

[Read: The paradox of sour food]

Munger told me that Paxlovid Mouth might result from chemesthesis, a chemical-sensing process that we often conflate with taste. (We sense both the chill of menthol and the heat of chiles through chemesthesis, not taste.) Or it could just be plain old taste, or a combination of the two.

If taste is the culprit, one bitter-taste receptor in particular might be to blame: TAS2R7. Danielle Reed, of the nonprofit Monell Chemical Senses Center, told me that the receptor has a “metallic, bitter vibe to it.” TAS2R7 isn’t activated very often in our daily lives, Reed said, because the compounds that bind to it are not in our foods, because—again—they taste awful. That might explain why those with Paxlovid Mouth have had trouble naming exactly what they’re going through, and why it feels so strange. “I’m a pretty adventurous eater normally. I’m usually the one that likes flavors other people don’t like. But this was over the line,” Borkar said.

TAS2R7 can be activated by metal salts, including magnesium sulfate, a.k.a. Epsom salt. You’re not supposed to eat it, but Reed told me if I tasted it and spat it out, I’d probably be fine. All I had at home was lavender-scented Dr. Teal’s Pure Epsom Salt Soaking Solution, but I tried it anyway. When I put a few crystals on the tip of my tongue, I had the sensation of having licked a lamppost. When I tried some farther back on my tongue, the flavor was extremely sour, with hints of dime. I suddenly understood what Wright meant when she said, “I think I might be ruined for grapefruit for the rest of my life.”

When I asked Pfizer about the funny taste, a spokesperson said, “Paxlovid is a combination of nirmatrelvir and ritonavir tablets … Both nirmatrelvir and ritonavir are bitter substances, which may contribute to the reports of taste-related side effects.” That clears things up! Of course, most tastes last for about as long as you’re eating something. The same was true for Epsom salt: It activated my TAS2R7 receptor, but then stopped activating it after I’d washed my mouth out with water. But Paxlovid Mouth works differently: “It is constant now,” Valdez told me. “I can taste food for the first bite or two, and then the bitterness takes over.” (Even pine nuts have been associated with a metallic taste that can last for weeks after eating them.)

Two possible mechanisms could explain that lingering, Reed said. Some molecules simply stick to our taste buds better than others, even when you try to wash them off by rinsing your mouth or brushing your teeth. (Many people experience this with high-intensity sweeteners, such as the ones in diet sodas.) Other molecules have a way of tickling our taste receptors even after they’re absorbed into the bloodstream; some medications, for example, can be excreted back into the mouth via saliva.

[Read: Families are going rogue with rapid tests]

The sticking-around-in-the-bloodstream theory makes particular sense given what Pfizer told me about the combination of drugs in Paxlovid: “Nirmatrelvir is a novel molecule designed to inhibit viral replication at a stage known as proteolysis, which occurs before viral RNA replication. Co-administration with a low dose of ritonavir helps slow the metabolism, or breakdown, of nirmatrelvir in order for it to remain active in the body for longer periods of time at higher concentrations to help combat the virus.” So if nirmatrelvir is causing the dysgeusia, ritonavir could be working to extend the effect.

The Paxlovid Mouthers have been coping with their lasting flavor in different ways. “I’m, like, constantly with a lozenge or Tic Tacs or mints or like something in my mouth to try and mask it a little bit. But nothing really takes it away,” Wright said. 'alopeke has mostly been eating applesauce, which “doesn’t have a ton of flavor already, but is at least not actively disgusting to mix with the Paxlovid taste.”

Still, everyone I spoke with who had experienced Paxlovid Mouth said they’d take the drug again if they were reinfected and had another bout of COVID. “It’s a hell of a lot better than a ventilator,” Wright said. She’s immunocompromised, and has taken her fair share of medicines throughout her life.  “It’s not my first encounter with a medication that leaves kind of a taste in your mouth,” she told me. “But I’ve never experienced anything this extreme. This is next-level.”

Updated at 2:55 p.m. on May 10, 2022

In the two years since she caught the coronavirus, 38-year-old Jessica McGovern has cycled through “well over 100 drugs, supplements, and therapies” to try to keep her long-COVID symptoms at bay. In almost all cases, she told me, the interventions were to no avail: Exhaustion, weakness, and aches still lashed her to the couch; she still felt suffocating chest pain that worsened when she inhaled; her upper body was still haunted by a sharp, staticky sensation that reminded her of running hot water over frozen hands. McGovern would fall asleep in agony, then dream of more agony.

Then, around the start of April, she began a five-day course of Paxlovid, Pfizer’s antiviral pill. By her second day on the drug, McGovern “could feel the messaging in my body shifting.” Four weeks later, her fatigue, aches, and labored breathing remain. But the screaming, nerves-on-fire pain that gripped her body for two dozen months “is basically gone,” she told me. She’s recovered some mobility. She’s spending more time with her three young kids. A flutist for nearly three decades, she’s playing her instrument again after a two-year hiatus, “which feels incredible,” like reclaiming a shade of her former self.

To date, no established treatments exist for long COVID. But in recent weeks, a smattering of long-haulers—McGovern among them—have been surprised to feel their sicknesses subside after taking Pfizer’s new drug. The case for treating long COVID with antivirals is far from open-and-shut. But should these anecdotal reports augur a flood of similar data, Paxlovid might offer a surprisingly straightforward fix to one of the pandemic’s biggest puzzles. Long COVID is so ranging, so diverse, so capable of wreaking havoc on a multitude of tissues that treatment, for many, will undoubtedly require the rehabilitation of many bodily systems at once. Maybe, though, for a subset of long-haulers, a few days of antiviral pills could be all it takes to rev the healing process into gear.

[Read: The pandemic after the pandemic]

That Paxlovid may quench anyone’s long-COVID symptoms is itself a bit mysterious: The drug works best when delivered fast and early, futzing with the virus’s ability to xerox itself inside human cells and making it easier for the immune system to jettison the bug. But long COVID can take weeks or months to manifest, and hasn’t been proven to have a persistent viral source. Experts still don’t know how common, or lasting, post-pill reprieves might be; they can’t say with confidence why the drug could have palliative effects, or—if said effects are substantiated—which long-haulers stand to benefit most.

Even in the rosiest scenario, Paxlovid won’t be a panacea. But if it has a chance of doing something, even for just a fraction of long-haulers, “we have to at least try,” says Jeanne Marrazzo, the director of the division of infectious diseases at the University of Alabama at Birmingham School of Medicine, “because we have nothing else.” Millions of people in the United States alone are estimated to have developed long COVID’s harrowing symptoms since the pandemic’s start; their numbers grow with each additional wave. “This is an intervention that should [have been] under clinical trial yesterday,” says David Putrino, a neuroscientist and rehabilitation specialist at Mount Sinai. And yet there are, to date, no well-designed studies investigating Paxlovid’s potential as a long-COVID drug, and none publicly poised to begin.

---

The search for long-COVID therapies has been stymied, in part, by the nature of long COVID. The condition, like cancer, appears to be not a single disease but a category of related-but-distinct syndromes, each of which could manifest with its own set of symptoms, require its own treatments, and stem from a slightly different cause. In some proportion of long-haulers, maybe the majority, the virus is believed to have come and gone, leaving behind physiological devastation—battered tissues, raging inflammation, self-attacking antibodies, discombobulated nerves, a freckling of blood clots. In these cases, experts told me, Paxlovid probably won’t do diddly-squat. But perhaps the drug could help another group of long-haulers, who are thought to harbor hard-to-reach reservoirs of virus that regularly rile the body up.

The snarl is that no one has yet provided slam-dunk evidence of these hidden viral caches. Many scientists, including Yale’s Akiko Iwasaki, one of the world’s top long-COVID researchers, argue that strong hints are there: SARS-CoV-2 certainly can stick around in certain people’s bodies for months, and can also mosey out of the airway to colonize other tissues, including ones that certain immune fighters can’t easily access. Researchers have seen traces of the virus’s genetic material and proteins in a mélange of organs, sometimes months after infections begin. But while those fragments could represent active virus, they could also be bits of stray microbial trash. To help clinch the case, researchers would have to recruit tons of long-haulers, guess where the virus might be lurking, and see if they could extract enough of the microbe from that tissue to infect new cells in the lab—studies that are invasive, “long and slow and painful” to get just right, and couldn’t even prove that the virus was causing the symptoms at hand, says Catherine Blish, an immunologist at Stanford.

Still, Vineet Menachery, a coronavirus expert at the University of Texas Medical Branch, believes long-term infection is probably “more common than we think,” he told me. People’s lived experiences support that too. Some long-haulers have reported feeling a massive, unexpected upswing in well-being after receiving COVID vaccines—a trend several experts attribute to the shots galvanizing immune cells into finally, finally kicking out remnant virus.

The handful of post-Paxlovid improvement stories now emerging echo what other long-haulers felt with the vaccines. A group of Stanford researchers, led by the physician Linda Geng, recently reported that a 47-year-old woman’s long-COVID symptoms—among them, fatigue, insomnia, body aches, cognitive issues, and a racing heartbeat—evaporated after she took Paxlovid for a possible reinfection. “She was able to go back to work, and started exercising again,” Geng told me. A couple of long-haulers being treated at a clinic at UCSF may be on a similar trajectory. Lavanya Visvabharathy, a 37-year-old immunologist at Northwestern University, experienced a bounceback as well. After months of headaches, fatigue, and disturbed sleep, she nabbed Paxlovid at the end of March, and “all my symptoms went away,” she told me. Visvabharathy, who takes immunosuppressive drugs to manage her rheumatoid arthritis, had been repeatedly testing antigen-positive. But after she finished Pfizer’s pills, she saw a negative for the first time since she was infected, in December.

Anecdotes and case studies alone won’t be enough. So far, the reports of post-Paxlovid improvements have been too inconsistent, too scant “to gauge what’s really happening,” Angela Meriquez Vázquez, who runs Body Politic, an advocacy group that offers support to people with long COVID, told me. Many long-haulers do not qualify to take Paxlovid, because they haven’t recently tested positive and are not considered at “high risk” of developing severe COVID. Long COVID’s symptoms can also naturally wax and wane, making it difficult to tie relief to a definitive cause. To show with any real clarity whether Paxlovid’s doing what many long-haulers hope, someone needs to test the theory with rigorous clinical trials, ideally with the help of the company that’s manufacturing the drug.

---

Pfizer doesn’t seem actively opposed. The company is “considering how we would potentially study it,” Kit Longley, a spokesperson for Pfizer, wrote in an email, but declined to clarify why the company has no study under way. That frustrates Putrino, of Mount Sinai, who thinks Pfizer will need to spearhead many of these efforts; it’s Pfizer’s drug, after all, and the company has the best data on it, and the means to move it forward. The NIH, whose RECOVER initiative has a budget of more than $1 billion to study long COVID, recently sought proposals for clinical trials of new long-COVID therapies, including, potentially, antivirals—a promising step, Stanford’s Geng told me. But the agency has been sharply criticized for dillydallying in the year-plus since the program launched, and for de-emphasizing treatment-focused trials. And there’s no guarantee that Paxlovid will be among the treatments tested. When asked to elaborate on Paxlovid’s experimental status, the NIH said only that the agency “is very interested in long term viral activity as a potential cause of PASC (long COVID), and antivirals such as Paxlovid are in the class of treatments being considered for the clinical trials.”

In all fairness, a Paxlovid–long-COVID trial would be tough. Researchers still haven’t reached a consensus on how to define or diagnose long COVID, or what it means for patients to markedly improve. Drugs against severe disease have an ultra-clear readout: “You count the number of people who end up in the hospital,” says Steven Deeks, a long-COVID researcher at UCSF. Long COVID’s sprawling scope, however, means no single ruler can measure the drug’s potential impact. Many of the experts I spoke with felt a bit daunted by the idea of trying to quantify the disease’s qualitative symptoms pre- and post-Paxlovid. That challenge, they said, could be a stumbling block for any research effort. But JD Davids, the co-founder of the Strategies for High Impact and its National Network for Long COVID Justice, who has long COVID, told me scientists don’t have to look far for inspiration. Researchers have already developed metrics for another chronic illness, ME/CFS (which Davids also has) to rate, for instance, the severity of fatigue, mobility limitations, and pain. “You just have to believe that people can tell you how they are feeling,” Davids said.

[Read: Long-haulers are fighting for their future]

Then there’s the question of whom to enroll, and how many of them. If only a small fraction of long-haulers are duking it out with persistent virus, “you might not see the benefit” in trials, unless they’re gargantuan in size, says Daniel Griffin, an infectious-disease physician at Columbia. Researchers could hedge their bets by selectively recruiting long-haulers who continually shed bits of virus genetic material in their feces, say, or who only recently developed long-COVID symptoms and might be more likely to have SARS-CoV-2 still inside them. But select the wrong subset, and a trial could tank. Iwasaki, of Yale, wants to explicitly study the drug’s effects in a wide range of people. “The goal is not to cure everyone but understand who benefits,” she told me—and when. In some people, long COVID could evolve from a viral problem into an autoimmune one, making early intervention essential.

Paxlovid has baggage too. In recent weeks, some people taking the five-day pill course for new infections have reported a rebound in symptoms and test positivity—a likely indication, UTMB’s Menachery told me, that the pills aren’t sweeping all the SARS-CoV-2 out. It’s still unclear how common the relapses are, and the problem may be cropping up with long COVID too. Alisa Valdes, a 53-year-old writer who has battled more than 220 long-COVID symptoms, “felt normal for the first time in 25 months” after taking Paxlovid in April. “I was skipping, I was jumping,” she told me. “I thought, This is a miracle.” But within a day of the drugs running out, her body was once again aching, feverish, and inflamed; angry red rashes that had disappeared came roaring right back.

Visvabharathy, the Northwestern immunologist, told me that a few weeks after taking Paxlovid, she felt some symptoms creeping back as well. A test she took at the end of April also came up positive. Perhaps Paxlovid’s five-day regimen for acute COVID will need to be lengthened in some newly infected patients; long-haulers may require something more extended still. Such a tweak could prompt a slew of safety questions. The original clinical trials turned up side effects—occasional bouts of diarrhea, a nasty sour tang in the mouth—that did not raise huge concerns, but after months of unabating illness, long-haulers’ bodies may not react in the same way to the drugs, especially when dosed on an extra-long course. Paxlovid also interferes with a hefty list of other medications, some of which can’t be paused for extended periods.

[Read: Paxlovid mouth is real—and gross]

Right now, long-haulers are gambling with all of those question marks as they seek the drug out—some of them through loopholes in the health-care system, with the help of providers sympathetic to their cause. With so few options on the table, people are “itching for any type of treatment,” Body Politic’s Vázquez told me, and some are willing to stomach a bit of risk. But in the absence of real data and rigorous research, and with so many unable to access the drug at all, others are hesitant and confused—and afraid of being once again let down.

---

From the start of the pandemic, skepticism has dogged long COVID and the people who live with it. McGovern, the flutist, spent much of 2020 being repeatedly told that her symptoms were just anxiety, or that she was feeling off because she was allergic to her pet parrots. (She is not.) Attitudes have improved in the years since—but some doctors, once unsure of long COVID’s existence, now struggle to wrap their head around the prospect of out-of-the-box treatments. At one point, I asked McGovern which of the many therapies she’s tried actually helped. “Aside from my family and close friends, you’re the first person to ask me that,” she told me. “I’ve never had a physician ask me ‘What has worked for you?’”

This skepticism can extend to research too. Benjamin tenOever, a virologist at NYU, told me that he recently had NIH funding pulled from a project that would have investigated whether antivirals could combat long-COVID symptoms in a hamster model. His contact at the agency said the study had “no merit,” tenOever told me. “They were like, This doesn’t make sense, because why would Paxlovid ever help long COVID? The virus is long gone.” (When I reached out to NIH, Clint Wright, the director of the Division of Clinical Research at the National Institute of Neurological Disorders and Stroke, responded that “we can’t comment on research that is not funded.”) Others posited that the possible benefit of antivirals for long-haulers might not feel worth the effort required to prove it: Even if viral persistence plays a role, it may be quite uncommon. Yale’s Iwasaki dismisses this. “Say it’s only 10 percent of patients that respond positively,” she told me. That’s still potentially millions of people in the U.S. alone.

America’s neglectful posture on long COVID is choreographed into just about every aspect of what’s left of the country’s pandemic response. Vaccines can’t totally block long COVID, but are being billed, via boosters, as one of the only interventions people need; the CDC’s newest guidelines on masks almost entirely elide the condition’s existence, as it’s not classically considered to be clinically “severe.” Researchers aren’t even sure if early-acting treatments such as antivirals slash people’s chances of getting long COVID, though Iwasaki is hopeful that they do. With so few protections against long COVID available or in use, its burden only stands to grow. Therapies, at least, could finally construct an exit ramp.

Paxlovid could still be a bust. But the process of figuring that out could shift the landscape for long COVID. Carefully testing this drug in long-haulers could help researchers build templates for even more clinical trials, Davids, of the National Network for Long COVID Justice, told me. And perhaps other, more powerful therapies would follow: antivirals specifically tailored for long-haulers’ needs, or immune-modulating drugs to combat the cases of long COVID that are less about the virus and more about the body attacking itself. Long COVID’s problem has always been a self-reinforcing one. It is difficult to address, so it goes unaddressed; countries do not know how to deal with it, so they don’t, and simply never learn. Reversing that trend, Davids and other long-haulers told me, means not just describing the condition but tackling it; not just counting the people who live with it but working to reduce their ranks. The world has to start that process now, or risk falling further behind.

Pregnancy, in this age of modern medicine, comes with a series of routinely recommended prenatal tests: At 11 weeks, a blood draw and an ultrasound to check for conditions such as Down syndrome. At 15 weeks, another blood test, for anomalies such as spina bifida. At 18 to 22, an ultrasound anatomy scan of the baby’s heart, brain, lungs, bones, stomach, fingers, and toes. This is when many parents learn if they’re expecting a boy or girl—but the more pressing medical reason is to look for anatomical defects, including severe ones such as missing kidneys or missing parts of the brain and skull.

With Roe v. Wade in place in America, women undergoing prenatal tests have typically had the legal right to end a pregnancy based on the information they learn. But abortion restrictions in certain states—by gestational age or by fetal anomaly—have already started limiting that choice. And if the Supreme Court overturns Roe, as seems likely, it will be further curtailed in some states. Routine parts of prenatal care could start to look quite different in states that ban abortion than in states that allow it.

Even now, laws in more than a dozen states that restrict abortion past 20 weeks are changing the use of the second-trimester anatomy scans. “People are moving those tests backward, doing them earlier than is optimal,” says Laura Hercher, a genetic counselor at Sarah Lawrence College who recently conducted a survey of genetic counselors in abortion-restrictive states. But the earlier the scan, the less doctors can see. Certain brain structures, such as the cavum septum pellucidum, might not develop until week 20, says Chloe Zera, an obstetrician in Massachusetts. Being unable to find this structure could indicate a brain anomaly, or just that the scan was done too early. Doctors might also pick up evidence of a heart defect but not know how severe or fixable it is. At 20 weeks, the heart is only the size of a dime.

[Read: The future of abortion in post-Roe America]

Six states also currently restrict abortions on the basis of genetic anomalies. These laws typically target Down syndrome, or trisomy 21, in which the presence of a third chromosome 21 can have a range of physical and mental effects, milder in some children than others. Some states’ laws specifically mention Down syndrome; others extend the restrictions to a much wider range of genetic anomalies, many far more life-limiting than Down syndrome. In trisomy 13, for example, the physical anomalies are so severe that most babies live only for days or weeks. More than 90 percent do not survive past their first year.

In states that currently restrict abortion based on genetic anomalies but still allow it for other reasons under Roe, patients can get an abortion if they do not mention the genetic anomaly. This puts doctors and genetic counselors in a bind. For instance, says Leilah Zahedi, a maternal-fetal-medicine physician in Tennessee, what if doctors see a severe heart defect on an ultrasound? The underlying cause of many such heart problems is Down syndrome. But Tennessee restricts abortions specifically on the basis of trisomy 21. Should doctors tell patients about the connection to Down syndrome? Should they do the genetic testing? It could help parents prepare for everything else that comes with Down syndrome. But it would make it harder for them to get an abortion, if they chose to have one. They would need to go to a different doctor who does not know about the diagnosis, and take care not to reveal it.

Many of the current abortion restrictions do contain exemptions for cases with the most dramatic medical consequences: a fatal fetal anomaly or risk to the mother’s life. If Roe is overturned, many of the “trigger laws” that will immediately ban abortion in some states contain such exemptions as well. But what is “fatal” to the baby and what risk is acceptable to the mother are not entirely clear criteria. “There are very few bright lines in medicine,” says Cara Heuser, a maternal-fetal-medicine physician in Utah. “Laws really do not allow for all the nuance we see in medicine. They ignore the uncertainty.”

When it comes to fetal anomalies, “it’s very rare we can say, ‘This is universally fatal,’” Zera told me. For example, in the case of a massive brain hemorrhage that destroys most of the brain tissue but leaves the brain stem intact, the baby can breathe at birth but will need other medical care. Does fatal mean fatal in the absence of certain medical interventions? Which ones? And does an anomaly have to be fatal immediately, or within some period after birth?

[Read: When a right becomes a privilege]

There is ambiguity in exceptions for the life of the mother, too. A genetic counselor in Texas told me about a recent patient whose fetus was triploid, meaning it had a complete extra set of 23 chromosomes. This is one of the universally lethal conditions. But triploidy also poses an extra risk to the mother, because these pregnancies are linked to preeclampsia, or dangerously high blood pressure. Texas currently restricts abortions past about six weeks except in “medical emergencies.” High blood pressure may not be an immediate medical emergency, but it can become one. “What’s scary about being a person who is pregnant in Texas,” says the genetic counselor, whom I agreed not to name because this person feared legal retribution in the state, is that many physicians will wait to provide treatment “until mom’s life is truly in danger.” The fetus will not survive, and delaying may only increase the risk to the mother, but “we have to wait until you get sick enough to deliver you.” These laws create a general climate where doctors who fear prosecution may hesitate to treat the mother. “Sometimes,” Heuser says, “that hesitation can be fatal.”

If Roe is overturned and abortion is banned in many states, testing could take on a different role in prenatal care. Zahedi told me, anecdotally, of one recent patient whose doctor told her there wasn’t a point to genetic screening anymore. But she doesn’t actually think abortion bans will change the use of testing, even if they will limit what patients can do afterward. Most of her patients in Tennessee already do not choose abortion, she said, but the tests can provide information that inform obstetric care and prepare parents for what’s to come.

Others brought up the possibility, in the long term, of insurance companies dropping coverage for prenatal tests. Cumulatively, “all of these types of screenings and tests are incredibly expensive,” Hercher, of Sarah Lawrence, told me. Insurance currently has a financial incentive to cover them because preventing the birth of a child with severe medical needs saves on costs down the line. But if abortion is illegal in many states, Hercher asks, will insurance companies, especially regional ones, want to continue covering these tests? Or will patients have to pay for them out of pocket? These tests are currently routine for pregnant women, but whether they stay that way in the future could depend on where you live and what you can afford.

Sudden infant death syndrome, or SIDS, “will be a thing of the past,” according to Carmel Harrington, a sleep researcher at the Children’s Hospital at Westmead, in Australia. A press release describes her new study, out this month, as a “game-changing” effort and a “world-first breakthrough” that could prevent future deaths from the tragic illness. Celebrations quickly spread on social media: “THEY FOUND THE CAUSE OF SIDS. Excuse me while I cry for all the parents,” one viral tweet declared. “Closest thing to a miracle in a long time,” said another. The press soon picked up the story. On Friday, a segment on Good Morning America touted Harrington’s “very, very important study” of SIDS, while a story in the New York Post promised that her data would “bring closure to countless parents who have endured the nightmare of losing a child.”

Rarely is a medical research finding a "breakthrough." But this one - discovering a biomarker in blood that indicates babies' risk for SIDS - qualifies. https://t.co/EKZBlFvxTx

— Nancy Lapid (@NancyLapid) May 13, 2022

Sadly, these claims are quite absurd. The original research paper, published on May 6, described a small-scale but interesting project: Harrington and her colleagues measured activity levels of a protein called butyrylcholinesterase in dried blood collected from about 600 babies shortly after birth, including 26 who died from SIDS and 30 who went on to die from a different condition during their first two years of life. On average, those who died from SIDS had somewhat less butyrylcholinesterase activity in their blood than healthy newborns did. According to the study’s authors, this suggests that, with further work, the protein “could potentially be used as a biomarker to identify and prevent future SIDS deaths.” If that qualifies as a scientific “miracle,” the bar is inches from the ground.

Even after decades of research, SIDS remains “unexpected, dramatic, and devastating,” as three prominent doctors put it in a New England Journal of Medicine editorial published over the weekend. If researchers had really pinpointed a biological cause for these deaths—as some press reports have claimed—it would salve parents’ anxiety and might lead to future treatments. But one need only read the new paper in its entirety to see they haven’t reached this goal.

At best, the study represents an incremental advance. This is not meant to be an insult; science works in increments. But the numbers don’t suggest that a screening test for SIDS is really in the works, let alone one that will quickly end the scourge of infant deaths. The authors report that protein-activity levels were measured in a range of 1.7 to 23.3 units per milligram for healthy newborns, and from 2.9 to 10.8 for those who died of SIDS. Though the group averages were different overall (7.7 versus 5.6), individual values still overlapped a great deal. In other words, a low protein-activity level at birth could be found in a baby who might end up dying from SIDS, as well as one who would go on to live a healthy life.

I reached out to Harrington and her co-author Karen Waters, a professor of child and adolescent health at the Children’s Hospital at Westmead, to ask about this issue, among others. Measuring the protein “will not work as a universal screening test, for precisely the reasons that you have highlighted,” Waters told me via email. Harrington said that their “finding represents the possibility for the future identification of infants at risk for SIDS” and that the study identifies “a measurable biochemical marker (not cause)” of the condition.

The confusing and controversial status of SIDS as a formal diagnosis adds to the uncertainty. SIDS is considered a “diagnosis of exclusion,” which means that it applies only when other causes have been carefully ruled out, and also that it is likely to comprise a number of different conditions. Some forensic pathologists have abandoned the diagnosis entirely on account of this ambiguity, James Gill, the chief medical examiner of Connecticut, told me. The authors of this month’s study did not have access to autopsy details for any of their subjects, and relied in most cases on a coroner’s assessment that SIDS had been the cause of death.

Even if it were possible to develop a screening test for SIDS, we might not want to use it. As a hospital pathologist myself—which is to say, as a doctor who specializes in diagnostic testing—I know that every form of screening makes mistakes. Sometimes, the benefits from these tools are worth the harm of an occasional error. Cervical-cancer screening, for example, greatly reduces deaths even though pap smears regularly lead to unhelpful results. But a wonky SIDS test would have catastrophic ill effects. A false positive result would terrify new parents. A false negative could lead them to abandon safe-sleeping practices—or far worse, make them seem at fault if SIDS did strike. Even true results might not be much help, because early-detection tests are only as good as the treatments we use in response to them. An aggressive campaign by pediatricians to promote safer sleep practices has caused the number of SIDS deaths to plummet since the 1990s. That campaign’s advice is already given out to everyone, and would not change on the basis of a blood test.

[Read: Get ready for a wave of missed infections]

Given that no further interventions would be available for infants flagged as high-risk by a screening test for SIDS, I asked the authors whether it makes sense to measure babies in this way. Waters responded by citing the “fundamental principle” that you should not screen newborns for disease unless you can “affect the outcome for the child.” Harrington has suggested in an interview that the researchers “don’t know the shape of what the intervention will be at this stage.”

If the study’s findings were ambiguous, and its implications dubious, why did the research get so much attention in the media? Many outlets seemed impressed by its connection to The Lancet, founded in 1823, and one the world’s most prestigious medical journals. The SIDS paper did not actually appear in The Lancet, but rather in a lesser-known periodical called eBioMedicine, which happens to be published under The Lancet’s umbrella brand (along with more than 20 other journals). Media coverage glossed over that distinction, though, or ignored it altogether. (Good Morning America managed to combine the two journals’ names into a fictional publication called “eLancet.”) These errors are understandable; prominent Lancet branding on eBioMedicine’s website and web address make it easy to get confused, and journal editors sometimes take advantage of academic prestige to court media attention.

The study’s tenuous connection to The Lancet was just one small part of its appeal. More significant was Harrington’s own story: She’d lost her son to SIDS 29 years ago, and then watched as a friend lost a baby to the same ailment a few years later. Harrington spent the intervening decades trying to discover a way to prevent this tragedy for others. “I made a solemn resolution there and then to leave no stone unturned in my quest to solve the mystery of the Sudden Infant Death Syndrome,” she wrote in a request to crowdfund her research that was first posted in August 2018. Before the study was published this month, the campaign hadn’t received a contribution since 2019; now donations have been pouring in. As of yesterday, the campaign had raised about $50,000, mostly in small increments. “Since we have published our research, I have continued to be overwhelmed by the generosity of the community,” Harrington told me.

There’s no shame in soliciting funds for a good cause, and Harrington’s scrappy effort to keep her research going could be seen to merit praise. But Harrington herself has linked improbable claims about the science to overt requests for money: “To get us there, we need a lot of funding,” she told an interviewer, moments after saying that she “knows” that SIDS will be eradicated in “three to five years’ time.” (The hospital, which manages the endeavor’s charitable account, lent credence to this accelerated time frame in its press release.) An article from the Australian Broadcasting Corporation quoted Harrington making a plea for further backing: “We know what we have to do. It’s just actually getting the funding for it.” But the story, like numerous others, did not provide any appraisal of the research from independent experts, which would have helped inform potential donors. Harrington, in her email to me, reiterated her claim that screening tests and interventions “could be 3-5 years away” with appropriate funding.

Many outlets also neglected to mention the study’s known limitations, as described in the paper. In that context, the authors acknowledge that they examined relatively few subjects, and that the tested blood was more than two years old. Their results could, therefore, turn out quite differently if the technique were put into widespread practice. “There is a lot more work to be done before this can be heralded as a solution,” Waters told me in her email. “As we said in the paper, it offers new directions for research in the field.” Harrington told me that “this finding is only one bit of the puzzle and there is so much more to learn.”

Harrington’s personal accomplishments cannot be dismissed, even if new tests and treatments seem further away than she claims. Most of us never generate a speck of new scientific knowledge. To come back from tragedy, toil for decades, and then produce a promising approach for closer study … well, that may not be miraculous, but it matters all the same.

With the Supreme Court poised to overturn Roe v. Wade, abortion access for tens of millions of women and girls across the nation may soon be a matter of the past. For many women of means, who can travel and pay for child care, the loss of Roe will be disruptive. For many poor women—particularly poor women of color—the loss will be deadly. This is the coming of the new Jane Crow.

Certain aspects of the era of the new Jane Crow are already predictable. First, high rates of maternal mortality will persist, and Black and brown women will disproportionately experience the blow and brunt of these deaths. Medicaid will not be expanded in anti-abortion states, nor will welfare benefits increase to meet families’ needs.

Second, states will turn to civil and criminal punishments of women and girls who seek abortions through medication or by traveling out of state. Even now, before Roe has fallen, lawmakers are working on such legislation. Third, just as the Jim Crow era sanctioned racism and racial profiling, the Jane Crow era will be marked by greater surveillance of pregnant women and the curation of laws, practices, and policies to justify stalking, watching, and policing women’s bodies. That is our near future.

Already today, we know how dangerous pregnancy and delivery can be. An American woman is 14 times more likely to die by carrying a pregnancy to term than by having an abortion—a fact the Supreme Court itself acknowledged in Whole Woman’s Health v. Hellerstedt just six years ago. In Louisiana, giving birth is roughly 57 times more dangerous for women than having an abortion. For Black women, the risk of death is especially dire—and especially in states eager to ban abortions. For example, according to the Mississippi Department of Health’s most recent investigation of maternal health and mortality, Black women accounted for “nearly 80% of pregnancy-related cardiac deaths” in that state; they also suffered from far greater rates of gestational diabetes, sepsis, and hemorrhaging. Black women in Mississippi are 118 times more likely to die from giving birth than from having an abortion. To be Black and pregnant in America is a deadly combination.

[Elizabeth Bruenig: Nothing beautiful survives the culture war]

Some of this devastation is the result of the anti-abortion movement itself, and in particular its white, male champions in statehouses across the South. These legislatures have targeted abortion providers for decades, stripping them of their ability to provide essential health-care services for poor women, including pap smears, cancer screenings, and contraception. Their efforts have contributed to the United States being the deadliest country in the developed world to be pregnant.

Surely Justice Samuel Alito and the four justices who, according to Politico, voted to sign on to his draft opinion are aware of this. But do they find such data relevant? Seemingly not, as the draft opinion barely acknowledges maternal deaths—and does so only in reference to 1973, not 2022.

Alito’s draft opinion is disturbing for many reasons, including its fundamental proposition that constitutional rights do not exist unless explicitly articulated or enumerated in the Constitution. (This principle casts into doubt the legitimacy of corporate religious personhood—an artful contrivance of law innovated in 2014 by Justice Alito himself in Burwell v. Hobby Lobby, a case that bestowed religious liberties on for-profit corporations that sought to limit contraceptive access for female employees on their insurance plans. Nowhere in the Constitution or the Religious Freedom Restoration Act of 1993 is it mentioned that for-profit corporations shall have religious identities and liberties. But here we are.)

Moreover, despite Alito’s apparent commitment to originalism and textualism, one of the most glaring omissions in his draft is the Constitution’s declaration that “all persons born or naturalized in the United States … are citizens of the United States.” The Constitution does not mention embryos, fetuses, or “unborn children.”

[Adam Serwer: Alito’s plan to repeal the 20th century]

Perhaps most troubling are the authorities Alito turns to. Alito writes about and relies on “Blackstone, Coke, Hale, and the like”—legal scholars who claimed that women had no independent existence apart from their husbands and fathers, were property, and could lawfully be subjected to physical punishment and even rape by their husband. According to the English jurist William Blackstone, this was for “her protection and benefit; so great a favourite is the female sex of the laws of England.”

In 1736, Matthew Hale’s treatise Historia Placitorum Coronae (“The History of the Pleas of the Crown”) maintained that a woman could not be raped by her husband. Hale proclaimed that marriage conveys unconditional consent: A wife has entered a binding contract and “hath given up herself in this kind unto her husband, which she cannot retract.”

For centuries, U.S. legislatures and judges, just like Alito, relied on Hale to justify the most egregious harms inflicted on women. Not until the late ’90s was marital rape finally punishable throughout the entirety of the United States—as this was ultimately a states’-rights issue. Ostensibly, Alito now proposes a states’-rights approach to rape and incest exceptions in abortion bans.

Leaving the protection of people who can become pregnant to the devices of hostile state legislatures has been and will be disastrous. In the past, such states’-rights approaches resulted in lower courts dismissing cases that involved spousal rape and incest. A century ago, in Roller v. Roller, the Washington Supreme Court ruled that a girl could not sue her father for rape. The court claimed that doing so would interrupt “domestic harmony.” But whose domestic harmony mattered? Certainly not that of the daughter who had been raped. In making such decisions, states relied on the very sources now cited by Alito to subject women and girls to second-class citizenship. It is those men from another century who are shaping the grim future ahead.

You may have seen it on TV, in your workplace, or at school drop-off. Maybe you’ve had firsthand experience, been warned of its impending arrival, or met someone who’s had it themselves. It’s both a neurobiological phenomenon and an institutional failure. I’m talking about the malady—and the misconception—of “mom brain.”

When women invoke “mom brain,” they’re typically describing the experience of feeling scattered, distracted, forgetful, or disorganized as a result of being pregnant or having children. It’s frequently used as an apology (“So sorry I left my keys in the front door! I was juggling the groceries and our toddler! Mom brain!”). Obviously, parenthood comes along with sleep deprivation, especially in the newborn phase, and losing track of time or tasks is an expected side effect. There’s also evidence that pregnant women undergo shrinkages in the volume of gray matter in their brain that may be permanent, though many experts consider those shifts to be more of an adaptive “pruning” than a dulling.

Research has also shown that the brains of fathers and nonbiological parents change with caregiving experience, but one never hears about “dad brain”—there must be some kind of miraculous dad hormone that makes them immune to the affliction. And even though many neurobiological changes are beneficial, the connotations of “mom brain” are almost always negative. Pop culture is full of the stereotype of the harried, forgetful mom—like Kate McCallister from Home Alone, forgetting her youngest child in the chaos of trying to get out the door on vacation with four others. Mothers in real life use “mom brain” as an explanation or to apologize for when they drop balls or mismanage things on their to-do list. But much of the time, what’s really happening is that mom brains—like all other brains—short-circuit when they are overwhelmed.

[Read: The many faces of the “wine mom”]

In fact, “a lot of the ‘mom brain’ is just toxic stress … because of how much shit we are carrying, how much cognitive labor we’re doing,” Eve Rodsky, the author of the division-of-labor guide Fair Play, told me. Even before the pandemic, women were already doing two hours more daily housework than men. According to one survey, the majority of moms in mixed-sex relationships reported doing “more than their spouse or partner when it came to managing their children’s schedules and activities.” The pandemic only made things worse. Data show that in the early months of the pandemic, mothers who had previously been doing the majority of the household labor somehow took on even more, and in another study nearly half of parents reported an increase in stress. One study published in the Journal of Family Psychology found that time spent doing chores was linked to higher levels of the stress hormone cortisol. Furthermore, the higher the share of the housework someone was doing, the slower that cortisol went away. “To whatever extent we expect the household to be women’s domain, then that sort of extra stress burden is going to be disproportionate,” Darby Saxbe, the lead author on the paper and a University of Southern California psychology professor, told me.

This was roughly my own experience: The start of the pandemic coincided with the birth of our daughter, which was an extraordinarily stressful time. Since then, my husband has gone through two years of an internal-medicine residency at Walter Reed while I work from home full-time and have ended up managing the bulk of our domestic and parenting responsibilities. One time, when I flaked on a (luckily low-stakes) item on my to-do list, I took stock of everything else I had been worrying about that week: working my full-time job, solo parenting for days at a time while my husband worked, making calls to clinics to try and get help having a second baby, chasing down a package delivery that had been sent to the wrong house twice, going to the grocery store, getting our dryer vent fixed, troubleshooting our Roomba. The list goes on. That kind of multitasking is exhausting, and it’s no wonder that when things get really busy, I start dropping balls. When I’m that stressed, I also sometimes suffer from restlessness, panic attacks, and GI distress. I have to stop myself from saying I have “mom brain” when I can’t keep up with everything. I should be demanding the help I so clearly need, but between my husband’s nonnegotiable schedule at the hospital, my own fear of becoming the stereotype of a nagging shrew, and my anxiety around overextending our family financially by trying to outsource, that’s much easier said than done.

[Read: Becoming a parent during the pandemic was the hardest thing I’ve ever done]

Jessica Calarco, a sociology professor at Indiana University, told me she believes that what we think of as mom brain “is a product of the unequal burden that we have placed on women to do both the physical caregiving for children and also the logistical and mental work of caring for a whole household.” This is a particularly taxing psychological burden, by nature amorphous, impossible to schedule, and happening in the back of your mind 24/7. It’s things like noticing which groceries are running low and knowing what food the kids will eat, or being the one who plans family vacations—and makes sure everyone wakes up on time to make the flight. “The cognitive labor of running a household is as intense as running a Fortune 500 company,” Rodsky said. And her research supports this: Qualitative data from interviews conducted by Rodsky’s team from 2016 to 2018 revealed that, among 200 mothers who were managing more than two-thirds of the “conception and planning” of their household tasks while also working for pay, every single one had a physical manifestation of stress, such as a flare-up of an autoimmune disorder or insomnia.

Overwhelm can affect people’s psychological and physical condition. Chronic stress can trigger major psychiatric disorders, exacerbate cardiovascular strain, and have consequences related to poor birth outcomes. “There is absolutely reason to be concerned about the health of women exposed to chronic stress,” Christin Drake, a psychiatrist at NYU Langone, told me. Although “there are some important differences between women living in extremely stressful conditions like poverty and lack of safety and those experiencing stresses related to big jobs and limited child care, there is likely some overlap in the processes impacting these groups.” And for those who are overwhelmed by household responsibilities, while also experiencing other intense stressors like poverty, the effects could be even worse. When our culture dismisses “mom brain” as a punch line, it is abdicating responsibility for the overwork women are experiencing and its effects on their health.

While a little joke now and then is hardly responsible for such a complex problem, the phrase mom brain subtly sets mothers up to think there’s something wrong with us or one another, Lauren Smith Brody, the author of The Fifth Trimester and a co-founder of mothers’ rights collective Chamber of Mothers, told me. “In reality, there’s nothing wrong. We just are working in systems that don’t support us.”

Mothers don’t have to live like this. Paid leave, for example, is widely shown to not only benefit the birthing parent while they recover from a physical trauma and adapt to their new responsibilities; it also sets up non-birthing partners to be more involved in child-rearing in the future. If two parents in a household take paid leave, that time allows the family to set a healthy precedent for division of labor. A number of experts I spoke with mentioned that expanded access to postpartum health care could relieve some stress. (“Anything that makes a woman feel like she’s still the boss of her body elevates feelings of competency,” explained Kimberly Bell, the clinical director of a nonprofit in Shaker Heights, Ohio, that offers support and education for early childhood development and families). Communities can establish mom groups where mothers can find support and understanding. Partners can help by stepping up and improving their commitment to splitting chores. By treating mothering like an individualistic endeavor instead of a public responsibility, “we’re setting up mothers to fail,” Saxbe told me.

“Mom brain” isn’t some irreparable, irreversible symptom of motherhood. It’s a symptom of a society that doesn’t support mothers even as they contribute trillions of dollars worth of unpaid labor. “We are putting women at harm in terms of putting all these expectations on them,” says Sinmi Bamgbose, a reproductive psychiatrist in Los Angeles. “Mom brain” shouldn’t be something accepted as the status quo. Moms “please everybody, take care of everyone’s needs,” Bamgbose says. “I think they are breaking.”

Late last month, Oklahoma became the first state in the country to explicitly prohibit a nonbinary gender marker on birth certificates. The legislation not only shows a profound disregard for the humanity of nonbinary people; it also rests on a mistaken belief that birth certificates are fixed records of neutral facts, and not subject to changing social values.

Sheila Dills, the Republican lawmaker who introduced the Oklahoma legislation, explained the rationale behind the law, saying, “We want clarity and truth on official state documents. Information should be based on established medical fact and not an ever-changing social dialogue.” In fact, the information that states record on birth certificates has fluctuated numerous times in the past century. And very often those changes came in response to a “social dialogue” in which Americans pushed back against state-imposed designations that encouraged stigmatization and discrimination.

The most prominent examples are state decisions to stop recording information about illegitimacy, adoption, and race on birth certificates. At one time, these classifications were required to be noted, meaning Americans often had to reveal these facts about themselves when applying for a job, a driver’s license, a marriage license, a passport—or in any other situation that would involve producing a birth certificate. But from 1930 to 1970, advocates for children and civil-rights proponents began to argue that such designations did more harm than good.

[Garrett Epps: How birth certificates are being weaponized against trans people]

In 1920, birth certificates in all states marked whether a baby was “legitimate” or not. Being born in or out of wedlock at the time was considered a salient fact about a person, one that determined, for instance, whether a child or an adult had a right to financial support or inheritance. Being labeled “illegitimate”—or worse, a “bastard”—also carried a social stigma. Because of this, in the 1920s, child-welfare advocates started making the case that states should no longer require the designation.

Writing in 1936, Lavinia Keys, of the South Carolina Department of Public Welfare, explained that she could find “no reason” that the state should record whether a birth was out of wedlock. “Certainly from a social point of view,” she continued, “it can do a great deal of harm.” During the ’30s and ’40s, as social mores continued to change, more and more states adopted Keys’s point of view. By 1960, the category had disappeared from birth records in every state.

Adoption followed a similar pattern. In 1920, an adopted child’s birth certificate would have shown that the adoptive parents were not the biological parents. By the middle of the 20th century, however, most states were issuing new birth certificates that recorded a child’s adoptive parents as the only parents, completely erasing the fact of adoption. As with illegitimacy, this change overlooked what Dills might term “clarity and truth” in the name of protecting the vulnerable from undue social stigma. Adoptees often were presumed to be the fruit of nonmarital sex; revealing that a child was adopted was as good as a public proclamation of illegitimacy.

Recording the race of a baby on a birth certificate was the last of these pillars to fall, but fall it did. During the Jim Crow era, racial classification on birth certificates was used to enforce segregation in contexts such as schooling, marriage, employment, and military service. It was also used, in states like Virginia, to force a binary Black/white racial system on multiracial communities and on groups that were neither Black nor white, such as Native Americans. Virginia’s Native people were forced to identify themselves on state documents as Black.

Beginning in the 1950s, Black doctors and civil-rights organizations began to question the classification, arguing that, as the NAACP put it at the time, “a statement of race had negligible scientific value and only served to lend a social stigma to an individual.” By 1968, the U.S. Census Bureau began issuing a “model” birth certificate for use in the states that no longer included any racial markers. Not only did every state eventually adopt this model; some, such as Massachusetts and California, passed legislation allowing people whose births had been registered before 1968 to apply for a new certificate that eliminated racial markers.

[Read: A birth certificate is a person’s first possession]

In all these cases, there was hardly consensus about whether and how to change birth certificates. With adoption, for example, some registrars of vital statistics objected that they were being made to issue documents that were no longer, in a strict sense, “true.” When the New York City Health Department became the first in the nation to issue race-neutral birth certificates, in 1961, the health commissioner of New Orleans responded by declaring that no one born in New York City would be able to marry in Louisiana, because the state’s law banning interracial marriage required the parties to submit a birth certificate to prove their race.

It’s not surprising that birth certificates have become a topic of debate again in 2022; many government documents are imperfect records of a population that is constantly changing. But there is a long American tradition of adapting birth documents to better suit the people they identify. Today, 15 states and the District of Columbia have added a nonbinary designation on birth certificates, and the U.S. State Department recently announced it will begin issuing gender-neutral passports.

Oklahoma’s recent law, however, carries on a darker tradition—of states like Virginia forcing people into categories as a form of discrimination, and in ways that diminish their true identities. In the past, American society has been willing to adjust birth documents to try to protect, rather than harm, those they identify. Will we do so again now?

The uproar over the leaked draft of the Supreme Court decision overturning Roe v. Wade continues. You can tell just how furious the reaction has been by the fact that establishment Republicans are desperately trying to turn the public conversation to the question of who leaked the document. They are baselessly blaming the opposition to the decision—a Newsmax host blamed Judge Ketanji Brown Jackson, who hasn’t even taken her seat yet—for the leak, although observers point out that the leak seems more likely to have come from a hard-core right-wing antiabortion activist, since it will make it very hard for any of those justices currently in the majority to soften their stance.

The draft decision takes a sweepingly broad position against Roe v. Wade, declaring that the Fourteenth Amendment cannot protect the right to abortion because such a right is not “deeply rooted in this Nation’s history and tradition.” This opens the door to similar attacks on constitutional rights previously established by the Supreme Court: the right to use birth control, marry regardless of race and gender lines, and engage in sexual intimacy between consenting adults.

Republican lawmakers are downplaying the reach of the apparent decision, avoiding the question of whether gay rights are next on the chopping block. Bryan Metzger of Business Insider asked “nearly a dozen” Republican senators whether they think the draft decision overturning Roe v. Wade threatens the 2015 Obergefell v. Hodges decision recognizing the right to same-sex marriage, and whether they supported overturning the Obergefell decision. Metzger wrote: “None gave a clear yes or no answer, and several outright declined to comment.” A year ago, seventy percent of Americans supported gay marriage.

The popularity of civil rights might not matter much: law professors Melissa Murray and Leah Litman noted in the Washington Post that “[p]erhaps the most stunning feature of the opinion is that its indignant tone and aggressive reasoning make clear how empowered this conservative majority believes itself to be.”

Indeed, right-wing commentators are emboldened by the apparent success of their drive to take away the constitutional right to abortion. The Committee on Administration of Criminal Justice in the Louisiana legislature today reported favorably on a fetal personhood bill that protects “human life, created in the image of God…equally…from fertilization to natural death,” meaning that abortion is homicide and prosecutors can charge patients with murder.

Right-wing commentators today called for the court to end recognition of the right to gay marriage, and Texas governor Greg Abbott said that Texas might challenge the 1982 Plyler v. Doe decision, in which the Supreme Court ruled that the state could not withhold state funds to educate undocumented immigrant children from local school districts. “I think we will resurrect that case and challenge this issue again,” Abbott told a talk show host, “because the expenses are extraordinary and the times are different than when Plyler versus Doe was issued many decades ago.”

The draft decision has been a clarifying moment for the country. Washington Post columnist Jennifer Rubin told journalists to stop referring to the convulsions in the country today as “culture wars,” as if they were “a battle between two sides over hemlines or movie ratings.” Instead, she wrote, “This is religious tyranny…in which the right seeks to break through all restraints on government power in an effort to establish a society that aligns with a minority view of America as a White, Christian country.”

When reporters asked him about the draft, President Joe Biden said: “This MAGA crowd is really the most extreme political organization that’s existed in American history.”

Today documents from the Department of Justice revealed that on the evening of January 6th, after the rioters had left the Capitol, Stewart Rhodes, the leader of the right-wing Oath Keepers militia group, begged an individual who was in contact with then-president Trump to authorize his and similar groups to stop the transfer of power with force. The group had quick reaction force (QRF) teams, firearms, and combat gear stashed outside the city to use if called upon.

The individual refused to put Rhodes into direct contact with Trump, but the person appears to have been within the president’s inner circle, bringing the investigation closer to Trump. That night, court documents recorded, “Rhodes continued to discuss the need to prepare for a larger fight against the government akin to the American Revolutionary War.” (There seem to be an awful lot of references to 1776 around January 6, don’t there?)

Yet another leaked tape from House minority leader Kevin McCarthy (R-CA), in which he said that “what the president did is atrocious and totally wrong,” showed that immediately after the insurrection, even Republicans realized that Trump had gone too far, and their hope was simply to move him offstage and get people to focus on moving forward. The party quickly snapped back to his side, though, when it became clear that his base wouldn’t abandon him.

”One of the most stunning and sad things in my view that has happened since January 6 has been the realization that the vast majority of...my party, when the chips were down and the time of testing came, they didn't do the right thing,” Representative Liz Cheney (R-WY), one of the two Republicans to sit on the House Select Committee to Investigate the January 6th Attack on the U.S. Capitol, said today.

The events of January 6 did not prompt many leading supporters to break from the Republican Party, but this attempt to erase our rights and establish a state religion might spark a political realignment.

This moment seems to echo the days after the 1857 Dred Scott v Sandford decision took away voters’ ability to stop the spread of human enslavement. Like the draft decision we have seen this week, that decision was clearly political and drew on appallingly bad history to reach a conclusion that gave extraordinary power to the country’s wealthiest men. Horace Greeley, the prominent editor of the New York Daily Tribune, wrote that the Dred Scott decision was “entitled to just so much moral weight as would be the judgment of a majority of those congregated in any Washington bar-room.”

Three months later, the Illinois Republican Party nominated Abraham Lincoln for senator. With his acceptance speech, he began the process of reclaiming equality as the central principle of the United States by giving his famous House Divided speech in which he warned that there was a plan afoot to spread enslavement across the entire country.

In the present, not only are the streets full of protesters, but also the three Republican governors in New England—Charlie Baker (MA), Chris Sununu (NH), and Phil Scott (VT)-—have all said they will protect abortion rights in their states. Levi Strauss & Company, the clothing manufacturer, today called on business leaders to protect the health and well-being of their employees, defending the reproductive rights that have enabled women to participate more fully in the economy in the past 50 years.

The world has changed since the Supreme Court decided Roe v. Wade in 1973. Levi Strauss noted that today, 58% of its workforce is female. And as Rebecca Solnit pointed out in The Guardian, the various groups now under attack form a broad coalition. “It doesn’t really matter if they’re coming for you, because they’re coming for us,” she wrote. And “[u]s these days means pretty much everyone who’s not a straight white Christian man with rightwing politics.”

Justice Samuel Alito, the author of the draft opinion, has canceled a public appearance tomorrow. And tonight, according to Washington, D.C., journalist Lindsay Watts, security officials have begun to install non-scalable fencing around the Supreme Court.

—

Notes:

https://www.legis.la.gov/Legis/ViewDocument.aspx?d=1259299

https://www.washingtonpost.com/opinions/2022/05/04/justice-alito-leaked-supreme-court-abortion-ruling-way-beyond-roe/

https://www.statesman.com/story/news/2022/05/04/gov-greg-abbott-supreme-court-case-requiring-education-undocumented-children/9652463002/

https://www.nytimes.com/live/2022/05/04/us/roe-v-wade-supreme-court-abortion#in-new-england-republican-governors-vow-to-support-abortion-rights

https://www.businessinsider.com/republican-senators-scotus-same-sex-marriage-abortion-obergefell-2022-5

https://www.washingtonpost.com/opinions/2022/05/04/culture-wars-diminishes-danger/

https://www.axios.com/2022/05/04/biden-maga-crowd-extreme

https://www.justice.gov/usao-dc/press-release/file/1499056/download

https://www.theguardian.com/us-news/2022/may/04/trump-oath-keepers-capitol-attack

https://www.cnn.com/2022/05/04/politics/mccarthy-audio-25th-amendment-biden/index.html

https://www.levistrauss.com/2022/05/04/protecting-reproductive-rights-a-business-imperative/

https://www.theguardian.com/commentisfree/2022/may/03/heres-how-americans-can-fight-back-to-protect-abortion-rights

Share

This Dog Kibble Dispenser has me mesmerized. (I am currently using this for my dog food.)

In 1985, President Ronald Reagan’s team made a conscious effort to bring evangelicals and social conservatives into the voting base of the Republican Party. The Republicans’ tax cuts and deregulation had not created the prosperity party leaders had promised, and they were keenly aware that their policies might well not survive the upcoming 1986 midterm elections. To find new voters, they turned to religious groups that had previously shunned politics.

“Traditional Republican business groups can provide the resources,” political operative Grover Norquist explained, “but these groups can provide the votes.” To keep that base riled up, the Republican Party swung behind efforts to take away women’s constitutional right to abortion, which the Supreme Court had recognized by a vote of 7–2 in its 1973 Roe v. Wade decision and then reaffirmed in 1992 in Planned Parenthood v. Casey.

Although even as recently as last week, only about 28% of Americans wanted Roe v. Wade overturned, Republicans continued to promise their base that they would see that decision destroyed. Indeed, the recognition that evangelical voters would turn out to win a Supreme Court seat might have been one of the reasons then–Senate majority leader Mitch McConnell refused to hold hearings for then-president Barack Obama’s nominee for the Supreme Court, Merrick Garland. Leaving that seat empty was a tangible prize to turn those voters out behind Donald Trump, whose personal history of divorces and sexual assault was not necessarily attractive to evangelicals, in 2016.

But, politically, the Republicans could not actually do what they promised: not only is Roe v. Wade popular, but also it recognizes a constitutional right that Americans have assumed for almost 50 years. The Supreme Court has never taken away a constitutional right, and politicians rightly feared what would happen if they attacked that fundamental right.

Last night, a leaked draft of a Supreme Court decision, written by Justice Samuel Alito, revealed that the court likely intends to overturn Roe v. Wade, taking away a woman’s constitutional right to reproductive choice. In the decision, Alito declared that what Americans want doesn’t matter: “We cannot allow our decisions to be affected by any extraneous influences such as concern about the public’s reaction to our work,” he wrote.

The dog has caught the car.

Democrats are outraged; so are the many Republican voters who dismissed Democratic alarms about the antiabortion justices Trump was putting on the court because they believed Republican assurances that the Supreme Court justices nominated by Republican presidents and confirmed with Republican votes would honor precedent and leave Roe v. Wade alone. Today, clips of nomination hearings circulated in which Justices Amy Coney Barrett, Brett Kavanaugh, Neil Gorsuch, Clarence Thomas, and even Samuel Alito–—the presumed majority in favor of overturning Roe v. Wade—assured the members of the Senate Judiciary Committee that they considered Roe v. Wade and the 1992 Planned Parenthood v. Casey decision upholding Roe settled law and had no agenda to challenge them.

Those statements were made under oath by those seeking confirmation to our highest judicial body, and they now appear to have been misleading, at best. In addition, the decision itself is full of right-wing talking points and such poor history that historians have spent the day explaining the actual history of abortion in the United States. This sloppiness suggests that the decision—should it be handed down in its current state—is politically motivated. And in a Pew poll conducted in February, 84% of Americans said they believed that justices should not bring their political views into their decision making.

Senator Susan Collins (R-ME) and Senator Lisa Murkowski (R-AK) provided key votes for Trump’s nominees and are now on the defensive. Collins publicly defended her votes for both Gorsuch and Kavanaugh around the time of their confirmation, saying she did not believe they would overturn Roe. She noted that Gorsuch was a co-author of “a whole book” on the importance of precedent, and that she had “full confidence” that Kavanaugh would not try to overturn Roe. Murkowski voted to confirm Gorsuch and Barrett.

Collins today said: “If this leaked draft opinion is the final decision and this reporting is accurate, it would be completely inconsistent with what Justice Gorsuch and Justice Kavanaugh said in their hearings and in our meetings in my office.” Like Collins, Murkowski noted that the final decision could change, but ‘if it goes in the direction that this leaked copy has indicated, I will just tell you that it rocks my confidence in the court right now.” The draft is not going in “the direction that I believed that the court would take based on statements that have been made about Roe being settled and being precedent.”

Washington Post columnist Jennifer Rubin suggested that the Senate Judiciary Committee should hold hearings on whether the justices lied in their confirmation hearings, and call Senators Collins and Murkowski as witnesses.

This apparent shift from what they had promised is a searing blow at the legitimacy of the Supreme Court, which was already staggering under the reality that three of the current justices were nominated by Donald Trump, who lost the popular vote and then tried to destroy our democracy; two were nominated by George W. Bush, who also lost the popular vote in his first term; and one other is married to someone who supported the January 6 insurrection and yet refused to recuse himself from at least one case in which she might be implicated.

Today, Republicans tried to turn this story into one about the leak of the draft document, which is indeed a rare occurrence (although not unprecedented), rather than the decision itself. Senate minority leader Mitch McConnell (R-KY) blamed the leaker for attacking the legitimacy of the court, although McConnell’s refusal in 2016 to hold hearings for Obama’s Supreme Court nominee on the grounds that eight months was too close to an election to confirm a justice before shoving Barrett through in October 2020 when balloting was already underway arguably did more to undermine the court’s legitimacy. Echoing him, one commentator said the draft leak was worse than the January 6 insurrection.

But while McConnell and the right wing are implying that a liberal justice’s office leaked the draft, there is no evidence either way. Observers note, in fact, that the leak would help the right wing more than the dissenters, since it would likely lock in votes. Those trying to blame the liberal justices did not comment on an apparent leak from Chief Justice Roberts’s office that suggested he wanted a more moderate decision. Jennifer Rubin suggested calling the bluff of those blaming the liberal justices: she proposed agreeing that whichever office leaked the draft ought to recuse from the final decision.

Republican politicians have largely stayed silent on the draft decision itself today, but the reaction of Nevada Republican Adam Laxalt, who is running for Senate, suggested the pretzel Republican politicians are going to tie themselves into in order to play to the base without alienating the majority. Laxalt issued a statement on Twitter that said the leaked draft represented a “historic victory for the sanctity of life,” but also said that since abortion is legal in Nevada, “no matter the Court’s ultimate decision on Roe, it is currently settled law in our state.”

Democrats, though, are not only defending the constitutional right recognized by Roe v. Wade, but also calling attention to the draft’s statement that the Fourteenth Amendment under which the Supreme Court has protected civil rights since the 1950s can cover only rights that are “deeply rooted in this Nation’s history and tradition.”

It seems likely that the right-wing justices, who are demonstrating their radicalism by overturning a 50-year precedent, are prepared to undermine a wide range of constitutional rights on the grounds—however inaccurate—that those rights are not deeply rooted in the justices’ own version of this nation’s history and tradition.

Protesters turned out in front of the Supreme Court and across the country today vowing that women will not go backward. As actress Ashley Nicole Black tweeted: “There's a particular slap to the face of being told we can vote for abortion rights, by the court that gutted voting rights.”

—

Notes:

https://www.washingtonpost.com/politics/2022/05/03/most-americans-say-supreme-court-should-uphold-roe-post-abc-poll-finds/

https://www.pewresearch.org/politics/2022/02/02/publics-views-of-supreme-court-turned-more-negative-before-news-of-breyers-retirement/

https://nymag.com/intelligencer/2022/05/the-scotus-leak-is-good-actually.html

https://www.washingtonpost.com/politics/2022/05/03/murkowski-collins-roe-abortion-opinion/

https://www.washingtonpost.com/opinions/2021/12/03/supreme-court-conservatives-lied/

https://www.washingtonpost.com/outlook/2022/05/03/originalists-misreading-constitution-silence-abortion/

https://www.bloomberg.com/news/articles/2022-05-03/mcconnell-calls-leaked-abortion-draft-decision-stunning-breach

https://www.politico.com/news/2022/05/02/supreme-court-abortion-draft-opinion-00029473

https://www.npr.org/sections/pictureshow/2022/05/04/1096525936/see-protests-grow-across-the-country-as-the-supreme-court-deals-with-roe-v-wade

Share