October 2013 – Page 8

Out And About

Rachel Cooke praises Out There, Stephen Fry’s two-part BBC documentary about gay life across the globe. She writes that “the films were moving, absorbing and often blackly funny, and all praise to Fry, who managed to stay calm during several encounters that would have left me punching the walls”:

Fry’s second film (16 October, 9pm) ventured into more upsetting territory: in Brazil, a gay person is murdered every 36 hours; in Russia, it is illegal to “promote” homosexuality, a law that has far-reaching and monstrous consequences for the parents and children of gay people (who are “promoting” homosexuality by being alive); in India, the hijras (men who, broadly speaking, identify as women) are forced to live on the outer margins of society. Fry proved a kind and thorough reporter on these matters – though I wish he had not cried so often, which I found self-indulgent. …

[He also traveled] to the US, the home of “reparative therapy”, which seeks to “cure” gay men of their urges.

In Los Angeles, Fry met Joseph Nicolosi, the psychologist who is one of the technique’s leading lights and who believes that homosexuality is the result of childhood trauma. For a while, they batted the arguments (I use the word loosely when it comes to Nicolosi) back and forth. It was all a bit desultory, and I was worried; Fry seemed to be losing heart. But then a coy look moved over his face. Taking in Nicolosi’s tanned visage, carefully trimmed beard and surprisingly dark hair, he told the good clinician that his appearance was distinctly metrosexual: he could very easily pass for a gay man. Nicolosi, silent now, looked stunned; his mouth actually fell open a little. Goal!

I’m joking around, but in fact Nicolosi’s “therapies” are at best cruel and at worst dangerous.

Watch for yourself:

Change We Can Believe In

Sides parses recent research indicating that the Obama administration is making young people less racist:

The distinctiveness of the Obama generation was most evident when asked questions designed to get at subtler forms of prejudice — such as how much individuals think racial inequality is due to the failings of African Americans. Thus the Obama generation was less likely than other generations to agree with statements like “It’s really a matter of some people not trying hard enough; if blacks would only try harder they could be just as well off as whites.” When asked questions designed to measure overt prejudice — such as approval of interracial marriage — the Obama generation was certainly unlikely to express such attitudes, but not necessarily more so than at least some earlier generations.

To be sure, it is difficult to prove that Obama’s ascendance caused these generational differences in racial attitudes. But [political scientists Tatishe Nteta and Jill] Greenlee’s findings dovetail with other research that documented a decline in racial prejudice during the 2008 presidential campaign — suggesting that Obama’s rise may really affect how people perceive African Americans. It is too soon to know whether any generational changes will stick, or what will be true for future generations. But at this moment, the available evidence suggests, as Nteta and Greenlee put it, “a change is gonna come.”

The Placebo Effect Has Its Place, Ctd

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Readers respond to a recent post:

One thing that’s often overlooked when talking about the placebo effect is that placebos can result in physical and measurable changes. In Parkinson’s, placebo doesn’t just affect the mind; it can affect the brain itself by increasing the release of dopamine, which can lead to the improvement of motor symptoms. I work in the Parkinson’s community and there is a strong interest among people living with the disease to harness placebo as a treatment in and of itself.

Of course that comes with significant ethical issues – the purposeful deception of patients as standard care is not an easy idea to swallow. However, there is perhaps one easy way around this quandary: tell patients they’re on a placebo. A study on irritable bowel syndrome published a few years ago found an improvement in symptoms when they did just that.

Another reader:

I think that Aidan O’Donnell has a skewed perspective on the placebo effect.

Rather than being “the added satisfaction patients derive from a treatment, over and above its actual benefits,” the placebo effect is in fact the baseline benefit against which the efficacy of medical treatments are measured. It does not refer to just a “feeling” of being better. It is a measure of actually being better in the same way as that achieved via medical treatment. In other words, our bodies are capable of some degree of healing without medical intervention, and our physiological processes are affected by our psychological state.

Another:

What Dr. O’Donnell seems to be missing is the fact that what people are looking for would be unethical for doctors to provide. People aren’t just looking to feel better; modern medicine does a pretty good job of managing pain. If all people wanted was more human contact and a small boost to overall well being and happiness, they could turn to a massage or some other spa treatment. What people want is an answer to their problems. They want to someone to tell them that it will be alright and that they can be fixed, and that the fix won’t be difficult or cause them pain. And so they turn to chiropractors and acupuncturists and homeopathic doctors. Because these people will tell them that they can make it better, even when they can’t (and they never can). Their success cases depend on the human body’s own recovery and the placebo effect. Their costs are small compared to real medical care, and they do no lasting harm, and you feel better when they are done. It’s easy to get sucked in.

Real medical doctors need to tell their patients the truth, that many times things look bad, and recovery may be long and painful. That isn’t to say that they don’t make mistakes, and that there are no improvements to be made. But it’s uncertainty that people are paying to get rid of, even if it’s a pleasant lie that they are buying.

The Past Wasn’t More Innocent, You Were

Waldman axes nostalgia:

I’m not the first person to say this … but when you’re a child the world is simple and innocent. Your parents take care of feeding and clothing and housing you, and if you’re lucky the biggest problem you have is what you’re going to get for your birthday. But your world only looked like the the world because children are naive. That’s part of what makes childhood wonderful, but once you grow up you should come to an understanding of what it was and what it wasn’t. You can use your memory of the emotions that characterized your childhood to create good art, or crappy art (although I haven’t seen the show, from the reviews I gather The Goldbergs is the latter).

That isn’t to say cultures don’t change, and American culture changes faster than most. But any time you’re tempted to say something like “The world was a more innocent place when I was a kid,” try to remember that that’s kind of like believing as an adult that your dog really did go to live on a farm upstate.

Update from a reader:

The Daily Show absolutely checkmated this idea a few years ago.

The Best Of The Dish Today

First up: some late night links. Ezra uses a triangle to explain the debate over the ACA. And Benen gets some great quotes from Republicans when Medicare D was underwater in its first few months. To wit:

Rep. Kevin Brady (R-Texas): “I think it needs to be understood that in a major reform, an improvement of a program like this, there are bound to be glitches.”

Rep. Tom Price (R-Ga.): “Kinks” in Part D got “worked out.”

Rep. Sam Johnson (R-Texas) to CMS official: “You guys have done a super job.”

Fmr. Rep. Nancy Johnson (R-Conn.): “This is a major change in the Medicare program and it is not surprising that there have been implementation pitfalls along the way.”

Heh. But back to today. Dude, we blogged a lot about conservatism – its deepening class divide; Lowry and Ponnuru’s gentle attempt at channeling Tea Party rage; and Thatcher’s unpleasant side. I wrote a post on what the ideas of my mentor, Michael Oakeshott, could contribute to the current travails of the GOP.

I remained unfazed by the Saudis’ fuming over a potential transactional relationship between Washington and Tehran; and made the case for Obama finally getting to grips with the out-of-control NSA. As for the president’s foolishly broad statement that “if you like your plan, you can keep it,” I sadly inferred that the president was either lying or willfully uninformed. I keep remembering Obama’s own description of his core weakness: deep laziness. Is that what’s behind his going on auto-pilot for the NSA and the ACA? Are we seeing in policy terms the results of the phoned-in failure of his first presidential debate last year?

Kids with tablets; kids with cannabis; a face of pellucid underwater stillness.

The most popular post of the day was still this (a surprise to me); and the second was this post naming the man who deserves to be fired for the Obamacare website fiasco.

The map seen above charts the Dish’s popularity around the world for as long as WordPress VIP has been watching. Only two countries that I can see have had no Dish readers. The six most popular Dish-hubs, after the US, are, in descending order, Canada, the UK, Australia, Germany, Ireland and France. But we’ve only had one page-view from Tuvalu.

See you later this evening on AC360 Later and in the morning, when, with any luck, this nasty cold I’ve gotten will have abated a little.

Your Biological Clock Has No Snooze Button

Before you set your alarm tonight, read Casey N. Cep on the perils of hitting snooze:

Since 1956, we have been confusing snooze for sleep, sacrificing our waking life nine minutes at a time. Not only do we delay the start of our days, but we compromise the very sleep we are trying to steal. The healthy, continuous sleep cycles we need are thoroughly disrupted by the snooze. When we hear the first sound of the alarm, our bodies release adrenaline and cortisol, hormones that wake us, interrupting our natural sleep cycle to make us alert.

Surrendering to the temptation of the snooze erases that hormonal surge: our bodies try to reenter the deeper periods of sleep. Only those restorative levels of sleep take a lot longer than nine minutes to enter, so every snooze confuses our bodies even more. We think three or four snoozes are the equivalent of an extra 30 or 40 minutes of rest, but the patchy, interrupted sleep of snooze is worse than no sleep at all. Instead of the natural sleeping then waking, the snooze drags us into unhealthy, unsatisfying fits of trying to sleep and trying to rise, but failing to do either.

Quotidian Sex

Stephen Marche praises David Tod Roy’s translation of the fifth volume of The Plum in the Golden Vase, or the Chin Ping Mei. “The book is 400 years old, but its moment is right now,” says Marche, who illustrates that claim by quoting a sex scene “enfolded into domestic and even Imperial politics in a fascinating way”:

She pumped it in and out of her mouth unceasingly, until white saliva overflowed from her lips, and rouge stains appeared on the stem of his organ. Just as he was about to ejaculate, the woman questions Hsi-men Ch’ing, saying, “Ying the Second has sent invitations inviting us to his place on the twenty-eighth. Are we going to go, or not?”

This is the Chin Ping Mei’s gift to the literature of the world. It shows, better than any other novel, the integration of sex into the quotidian. Erotica tends to focus exclusively on one dimension of the human experience. But the thing about sex is that it happens in ordinary life; just like the scene above, sex happens while working out the family schedule. The Hollywood summary of Chin Ping Mei might well be Jane Austen meets hardcore pornography.

Street Sermons

B.M.I. acknowledges that “no, hip-hop is not perfect, nor is it outright ‘redemptive,’ but it speaks truth to a society that has, historically, ignored the laments of sufferers”:

The easiest connection to make between Christianity and hip-hop is its prophetic voice. The prophets in the Old Testament were sent by God to speak to his people and tell them how it was, show them with vivid language the reality of their plight. It was always descriptive long before it was prescriptive. Prophecy was not some futuristic sightseeing, but truth telling so that they may see the future. Ralph Basui Watkins has been a central figure in the discussion of hip-hop and Christianity for years and he expands on the nature of that voice:

“Like Jeremiah, hip-hop is crying out as it critiques and engages the plight of those it speaks for and to. Hip-hop is looking at the political centers and religious leaders, critiquing them while crying out for help. The question is, will the leaders hear hip-hop? Will they listen to the cry? Will they come alongside hip-hop and help, or will they condemn the screaming voice from within?” – Hip-Hop Redemption, pg. 49

If you remember, the prophets, too, turned toward the political and religious leaders of their day and described the very sins that infected the cities and altars. The prophets spoke with the very word of God passing through their teeth to accuse and condemn. I can only imagine the harshness of the language that they used to fill their listener’s ears with descriptive force. Hip-hop employs the same format as emcees see and report the way things are and shout out about the way things ought to be. They speak to the beat in hopes that the political machine and church will see the reality of what is going on in the culture, especially in the inner cities. Making a call for them to turn and repent of their part in the fracturing of those very communities and work towards restoration.

Previous Dish on hip-hop and religion here.

Is Obamacare Politically Unstable?

In a post linked to earlier, Douthat noted that the Obamcare “subsidy cut-off creates a chasm between winners and losers right in the middle of the middle class, which is not a normal way for social insurance to be subsidized”:

Now an effective levy of several thousand dollars on the small fraction of middle class Americans who buy on the individual market is not history’s great injustice. But neither does it seem like the soundest or most politically stable public policy arrangement.

Ezra imagines various ways the law could develop. One scenario:

The law could fail relative to expectations and prove a political disaster for Democrats, but still be delivering insurance to more than 10 million Americans come 2017. As a result, President Chris Christie could find himself with a mandate to make changes but no earthly way to pass full repeal. Obamacare thus becomes the platform for a far-reaching set of Republican health-care reforms.

Cowen foresees something similar:

Chris Christie will campaign against ACA and beat Hillary Clinton in the general election. Upon assuming office he will place price controls on the insurance plans in the individual market, repeal much but not all of the federal financial support for the Medicaid expansion, and keep many other parts of ACA, while claiming to have repealed the whole thing. Enough Democrats will go along with this, as public opinion will have shifted toward the Republican side on this issue. The individual market still won’t be working very well. The exchanges will be working fine in the technical sense, but skittishness, political risk, and the adverse selection death spiral will have led the insurance companies to withhold high quality policies from that side of the market.

Meanwhile, McArdle wonders whether the limited networks many exchange plans use will face a political backlash:

Nineteen million people were buying insurance on the individual market; an estimated 16 million of them will need to switch to policies on the exchanges or Medicaid. Those policies may end up costing them less, after subsidies (especially if they go on Medicaid). But they will also force them to go to cheaper doctors and hospitals. The young won’t care, but the middle-aged will chafe at the loss of freedom. Especially because the expensive doctors and hospitals are often the ones most in demand — the ones with cutting-edge technologies and skills. Cost is not a perfect proxy for quality, of course. But it is not unrelated, either.

Now, maybe that’s all they do: chafe and complain. But maybe they contact their state or federal legislators and demand that carriers be required to cover all the expensive doctors and hospitals. This is basically what happened in the 1990s: Health maintenance organizations achieved significant cost controls by limiting patient choices, and patients got their legislators to put a stop to it. With so many people being affected, it would be surprising if that didn’t happen again.

Face Of The Day

Katie Hosmer praises photographer Todd Bretl:

From sharks and marine mammals to critters, and corals, Bretl is not afraid to get right in there and swim alongside the rare and stunning animals. As a result of his adventurous spirit, he is able to capture the playful essence of daily activities that generally take place in an underwater world. Bretl captures such incredible details in crystal clear waters that viewers will feel like they are nose to nose with a toothy, grinning shark or staring into the glowing orange eyes of a rare little fish.

(Photo by Todd Bretl)