The View From Your Window Contest

by Dish Staff

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You have until noon on Tuesday to guess it. City and/or state first, then country. Please put the location in the subject heading, along with any description within the email. If no one guesses the exact location, proximity counts. Be sure to email entries tocontest@andrewsullivan.com. Winner gets a free The View From Your Window book or two free gift subscriptions to the Dish. Have at it.

What Happens When You Like Absolutely Everything

by Dish Staff

Matt Honan went on a 48-hour “campaign of conscious liking, to see how it would affect what Facebook showed me”:

I liked one of my cousin’s updates, which he had re-shared from Joe Kennedy, and was subsequently beseiged with Kennedys to like (plus a Clinton and a Shriver). I liked Hootsuite. I liked The New York Times, I liked Coupon Clipinista. I liked something from a friend I haven’t spoken to in 20 years—something about her kid, camp and a snake. I liked Amazon. I liked fucking Kohl’s.

The results, he says, were “dramatic”:

My News Feed took on an entirely new character in a surprisingly short amount of time. After checking in and liking a bunch of stuff over the course of an hour, there were no human beings in my feed anymore. It became about brands and messaging, rather than humans with messages.

Likewise, content mills rose to the top. Nearly my entire feed was given over to Upworthy and the Huffington Post. As I went to bed that first night and scrolled through my News Feed, the updates I saw were (in order): Huffington Post, Upworthy, Huffington Post, Upworthy, a Levi’s ad, Space.com, Huffington Post, Upworthy, The Verge, Huffington Post, Space.com, Upworthy, Space.com.

Honan adds, “Eventually, I would hear from someone who worked at Facebook, who had noticed my activity and wanted to connect me with the company’s PR department.”

A Poem For Saturday

by Alice Quinn

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Vaness Vitiello Urguhart’s feature in Slate this week, Butch is Beautiful, put me in mind of a poem entitled “Old Friends”, written by Anne MacKay, who from childhood on—she was born in 1928 and died two years ago—had a home in Orient on the easternmost tip of the North Fork of Long Island. Anne was a graduate of Vassar College and was Drama Instructor and Theater Director at two distinguished New York schools, the Dalton School , from 1953-1972, and Horace Mann, from 1972-1992.

Later in life she devoted her energies to poetry and to preserving lesbian voices and experiences through her work with the Sophia Smith Collection at Smith College, where her own papers are now archived.

She is the author of Wolf Girls at Vassar: Lesbian and Gay Experiences 1930-1990 (St. Martin’s Press, 1993) and the poetry collections, Field Notes of a Lesbian Naturalist, Gifts, Salt Water Days, Fields, and Sailing the Edge, from which the poems we’ll post are drawn. (For a copy of Sailing the Edge or Field Notes of a Lesbian Naturalist, send a check or a money order for $20 to MG Soares for each book along with your address to PO Box 97, Orient, NY 11957.)

Anne’s snug cottage on the side of a hill overlooking Hallock’s Bay evoked Moley’s digs in The Wind and the Willows, its charm captured in her poem “Housemates”:

Silverfish along walls and ceilings,
sow bugs in the bathroom, mosquitoes, ants,
August flies—I share my house with one and all.
Spiders with soft pale webs, all sorts of hard
black bugs that creep or fly—mean-spirited biters,
moths who rush to the bed lamp, visiting wasps.
Most behave, rushing or crawling on separate rounds,
this old, warm home a perfect hunting ground.

“Old Friends” by Anne MacKay:

We saw an older girl
wearing a white, men’s
shirt at school—collar
open, sleeves folded up,
shoulders loose and free.
“Sexy!” we said—meaning
“cool!” Mother frowned,
“Don’t use that word!”
But it was handsome, and
looking back it was sexy,
a bridge between genders,
the comfort, the swagger
of the open-shirt sailor or
double-shirted woodsman.

It was the first present
I ever bought myself.
A dollar-fifty spent at
Lipton’s store set me free.
The colors, the makers,
changed and changed
but, loyal as a barnacle
on a wooden pier,
these comfortable shirts
remain my friends, still
with me, after sixty years.

(From Sailing the Edge © 2003 by Anne MacKay. Used by permission of the Estate of Anne MacKay, 2014. Photo by Flickr user Jackie)

The Fate Of The Syrian Rebellion

by Dish Staff

A view of a damaged buildings after barrel bomb was dropped

Robert Ford disputes the conventional wisdom that the non-jihadist rebels in Syria are more or less finished:

The death of moderate armed opposition elements has been greatly exaggerated. These groups — whom I define as fighters who are not seeking to impose an Islamic state, but rather leaving that to a popular decision after the war ends — have recently gained ground in Idlib province in northwestern Syria, and have nearly surrounded the provincial capital. If the rebels are ever to demonstrate military capacity, it should be in Idlib, where the supply lines from Turkey are easily accessible.

Their advances over the past month also extend beyond Idlib. Notably, moderate armed groups repelled regime attacks in the vicinity of the town of Morek, in west-central Hama province, and also advanced on the Hamidiyah air base there. They even damaged aircraft at the air base, with some reports claiming that they used surface-to-air missiles. Moreover, they launched renewed rebel incursions into Damascus from the nearby eastern suburb of Jobar on July 25 and 26.

But Charles Lister paints a very different picture of the rebels’ condition, warning that they appear to be losing the long battle for Aleppo and its environs to both the Assad regime and ISIS:

The military has followed air bombardment with methodical but effective ground incursions that, over time, have enabled it to re-capture territory and force a rebel retreat to the city’s northern districts. As such, the opposition is now in its weakest position in Aleppo city since mid-2012. … But although regime advances in Aleppo city are extremely significant, the most immediate threat comes from ISIS and its rapid advance north of the city.

Controlling Dabiq, one of the villages that AFP reported was seized Wednesday, is already extremely symbolic for ISIS, whose official magazine is named after the town for its role in the hadith — the teachings, deeds, and sayings of the Prophet Mohammed — as the site of a major battle before the end of the world. Abu Musab al-Zarqawi, who founded ISIS’ precursor group, once said the capture of Dabiq would represent the first step towards conquering “Constantinople” and “Rome.” With those villages in hand, ISIS now seems likely to move forward on two primary fronts — northwest towards Sawran and eventually Azaz and southwest to Liwa al-Tawhid’s stronghold in Marea.

Zaher Sahloul zooms in on the regime’s targeting of hospitals and health care workers:

According to Doctors Without Borders and other human rights organizations, the Syrian regime and some of the military groups have systematically targeted health care professionals, facilities, and ambulances. Physicians for Human Rights said government forces were responsible for 90 percent of the confirmed 150 attacks on 124 facilities between March 2011 and March 2014, which have devastated the country’s health care system. Of the more than 460 civilian health professionals killed across Syria, at least 157 were doctors, followed by 94 nurses, 84 medics, and 45 pharmacists. Approximately 41 percent of the deaths occurred during shelling and bombings, 31 percent were the result of shootings, and 13 percent were due to torture.

The crisis has forced many doctors to flee to neighboring countries. I heard of a doctor from Aleppo who decided to take the risky trip from Libya to Malta with his wife and three children by boat, trying to reach Europe, but they all died when the boat sank in the Mediterranean.

(Photo: A view of a damaged buildings after barrel bomb was dropped. At laest 17 people were killed and wounding dozen others after Syrian regime helicopters dropped barrel bombs on an opposition-controlled areas at Bab al-Nairab district in Aleppo, Syria. (Photo by Karam Almasri/Pacific Press/LightRocket via Getty Images)

Improving the FDA, Ctd

by Elizabeth Nolan Brown

Should the U.S. Food and Drug Administration inch closer to Europe’s drug approval model, in which certified, independent bodies can (and compete to) review new products? A Dish reader says, hey, it worked for the Federal Communications Commission:

The European system you describe has been in place for more than 15 years for much of the equipment that’s approved by the FCC.  Those of us who worked in the field at the time wondered if it really would be as reliable as the system the FCC used before, which required applications that were reviewed by the FCC and had to be approved before the equipment would be sold.  In practice, though, this system works much better than the old way – products come to market faster, the process is quicker and cheaper and, most important, there’s no evidence that there’s any more cheating than their used to be.  The FCC also has, as suggested, agreed that testing that meets European requirements also is good in the U.S., saving companies the trouble of re-testing equipment they know is compliant.  It’s a model the FDA definitely should consider.

Another Dish reader is more skeptical—but offers his own FDA improvement plan:

I’m the Director of Engineering at a small medical device company… While the European method of getting device/drug approval does seem attractive, I just wanted to clarify that the FDA does have an “independent reviewer” option that allows third party organizations that are certified by the FDA to perform the review for market clearance for many types of devices. The Catch-22 here is that the third party reviewers, while generally being more efficient than direct FDA review, are very expensive, certainly more expensive than a standard FDA 510(k) fee ($5,100 per device). So do we move to more third party review to expedite device approvals, and make medical device development more expensive, or do we bolster the FDA staff so review can be faster there?

One way the FDA could become more efficient is if they took a more libertarian approach to approval. Right now, a device/drug has to be proven “safe and effective” to get pre-market clearance. Why not have the FDA only concern itself with the “safe” part and let the market take care of the “effective” part? If a device or drug is ineffective, no one will buy it. That radically simplifies clinical trials as well, lowering the requirements for FDA approval while maintaining the safety of patients.

But another reader takes issue with the idea that Europe’s drug approval process is something to emulate:

I actually work in drug discovery and am currently working on a filing. But I don’t know where this animus is really coming from in terms of approval times. Consider this paper from the New England Journal of Medicine. In it they analyze the drug approval times for the FDA, the (European Medicines Agency) and Health Canada. There are a lot of statistics and different ways to look at the data, but these are the main conclusions:

For novel therapeutic agents approved between 2001 and 2010, the FDA reviewed applications involving novel therapeutics more quickly, on average, than did the EMA or Health Canada, and the vast majority of these new therapeutic agents were first approved for use in the United States.

In that study, a total of 289 unique novel therapeutic agents were approved, including 190 that earned approval in both the U.S. and Europe. Of this group, about 64 percent were first approved in the United States. Some 154 agents were approved in both Canada and the U.S., with us first 86 percent of the time.

The same reader points to another study, this one comparing the EMA, FDA and Japan’s Pharmaceutical and Medical Devices Agency (PMDA):

If you look at the first figure you’ll see the median values for the FDA are the best over the entire period. There is some variability, but I think that’s because of a couple outliers. Drugs are also generally submitted to the FDA first. So even thought submissions are completed by the FDA faster, the other agencies have more information from the drugs approved/being processed in the US.

I must say, all of the data I’ve seen says the FDA is doing a decent job in terms of approval times.

The researchers behind the New England Journal of Medicine paper, published in 2012, may provide some insight into mixed perceptions of the FDA’s approval process. Writing in Forbes, Joseph Ross and Nicholas Downing tease out some nuances in their findings:

… there was much more variation in time to approval among applications to the FDA. More than half of approvals were complete within one year, but there were many examples of the FDA requiring 800, 1000, even 1200 total days before approval. For instance, the well-known anti-cancer drugs Sanofi‘s Eloxatin and Novartis‘ Gleevec were both approved in less than 80 days, however it took more than 10 years from initial submission to approval for Sabril, and (sic) anti-seizure medication, and Asclera, a sclerosing agent to treat varicose veins.

A lot of the variation in FDA time to approval can be attributed to whether one or more cycles of review were required. Among the 62% of applications the FDA approved after a single review, the median time to approval was 278 days. In contrast, the median time to approval was 765 days among the 38% of applications that required multiple cycles of review.

Interestingly, applications within the hematology, oncology, and immune-modulating and anti-infective therapeutic classes were most likely to receive FDA approval after a single review. Applications within the musculoskeletal and pain and psychiatry and central nervous system therapeutic classes were most likely to require multiple cycles of review.

Okay, but can we all agree the FDA needs to hurry it up on the sunscreen already?

Your Saturday Morning Cartoon

by Dish Staff

Jonathan Crow heaps praise on Astro Boy, the early ’60s cartoon developed by Japan’s “god of manga,” Osamu Tezuka, who counted Stanley Kubrick among his fans. Crow describes the first episode, “Birth of Astro Boy,” seen above:

After his son dies in a freak car accident, scientist Dr. Astor Boynton is driven mad by grief. He develops an insane laugh and, with it, an equally insane plan to build a robot who looks just like his dead son. After a Frankenstein-esque montage, Astro Boy is born. All seems well for the adorable, sweet-natured robot, until Boynton freaks out over Astro Boy’s lack of growth. “I’ve been a good father to you, haven’t I?” he whines. “Well then, why can’t you be a good son to me and grow up to be a normal human adult?” How’s that for a parental guilt trip?

So Dr. Boynton casts Astro Boy out, selling him into slavery to The Great Cacciatore, an evil circus ringleader who forces him to be the world’s cutest robot gladiator. Fortunately, Dr. Elefun, a colleague of Dr. Boynton, takes pity on Astro Boy and works to free him from his bondage.

The whole story plays out as if Mary Shelley and Fritz Lang collaborated to make Dumbo. Tezuka throws in a lot of wacky slapstick comedy, which just barely takes the edge off the story’s Dickensian melodrama, which relentlessly mines all those primal fears you thought you got over. In short, it’s brilliant.

Enjoy The Silence?

by Phoebe Maltz Bovy

Separate from all of the other debates raging online is the question of whether you are, in fact, a terrible person if you’re steering clear. Or, conversely, if you’re joining in. Which is it? First, the counterpoint:

Nick Bilton is also skeptical (NYT):

Trying to discuss an even remotely contentious topic with someone on social media is a fool’s errand. Yet still we do it. My Twitter and Facebook feeds over the last month have been filled with vulgar discourse about Israel and Gaza. For example, someone posts a link saying Hamas hailed rockets upon Israel, someone else responds by accusing Israel of killing hundreds of civilians, and next thing you know it’s chaos on social media. A link quickly devolves into vicious and personal attacks.

Been there, done that. While I do scan Twitter and Facebook to see what others have linked to or are discussing (and, ahem, linking to the things I’ve written), when it comes to actually posting things myself, I’m ever more drawn to Pinterest, Instagram, and the upbeat, apolitical world of adorable pets, space-age fashion, and from-scratch yuba preparation. (No, that was not a gratuitous link to a Saveur article that, yes, happens to include a photo of a fit, shirtless man. That was just the best explanation of yuba I could find!)

But there’s also a strong case that social-media silence is itself unethical. Writes Janee Woods:

For the first couple of days, almost all of the status updates expressing anger and grief about yet another extrajudicial killing of an unarmed black boy, the news articles about the militarized police altercations with community members and the horrifying pictures of his dead body on the city concrete were posted by people of color. … And almost nothing, silence practically, by the majority of my nonactivist, nonacademic white friends – those same people who gleefully jumped on the bandwagon to dump buckets of ice over their heads to raise money for ALS and those same people who immediately wrote heartfelt messages about reaching out to loved ones suffering from depression following the suicide of the extraordinary Robin Williams, may he rest in peace. But an unarmed black teenager minding his own business walking down the street in broad daylight gets harassed and murdered by a white police officer and those same people seem to have nothing urgent to say about pervasive, systemic, deadly racism in America?

They have nothing to say?

Why? The simplest explanation is because Facebook is, well, Facebook. It’s not the New York Times or a town hall meeting or the current events class at your high school. It’s the internet playground for sharing cat videos, cheeky status updates about the joys and tribulations of living with toddlers, and humble bragging about your fabulous European vacation. Some people don’t think Facebook is the forum for serious conversations. Okay, that’s fine if you fall into that category and your wall is nothing but rainbows and happy talk about how much you love your life.

Woods goes on to discuss factors beyond social media pertaining to what she sees as white silence regarding Ferguson (worth reading), but let’s pause on her analysis of what it means to remain silent on social media. Woods is ostensibly referring to two different phenomena: First, to the people who are very much part of the conversation, but who’ve skipped a particular topic, and next, to those who have active social-media accounts but tune out. These are, however, two sides of the same coin. If someone’s weighing in, but only in uncontroversial cases (does anyone support depression or ALS?), they may be making the world a better place, but they’re not risking anything.

But! Before weighing in, there’s something to be said for knowing a little bit about what you’re talking about. Like Woods, I found that a disproportionate amount of my social-media reading material (links and commentary) on Michael Brown has come from non-white (specifically: black) Facebook friends and Twitter users, but… I’m actually fine with that. Listening-to rather than speaking-for, you know? Everyone should be upset about what’s happening, and it relates to all Americans, but when it comes to figuring out what’s going on and what to do about it, I would, all things equal, rather hear what black people have to say. I’m not sure what’s added if white people, responding principally to an “in case you missed it” social-media environment, start holding forth before… well, before doing what Woods advises later in her post: “Diversify your media.”

Is abstaining from these squabbles a noble way of focusing on more serious debate (or of leaving important problems to the experts)? Or is engaging what it means to be an informed citizen? It’s hard to avoid the sense that some of the weighing-in is see-I-care posturing. An appropriately-timed status update that hits just the right notes garners “likes”; is the warm feeling that ensues about what those “likes” say about how one’s friends stand on this key issue, or is it maybe just the teensiest bit personal? But it’s also hard to hear justifications of prolonged silence on certain issues as anything other than defensiveness.

Do you battle it out on social media? Email dish@andrewsullivan.com to let us know.

A Legal Nightmare

by Dish Staff

In a long and compelling article, Paul Campos presents the for-profit Florida Coastal School of Law as a microcosm of the problems afflicting higher education in America:

Florida Coastal is one of three law schools owned by the InfiLaw System, a corporate entity created in 2004 by Sterling Partners, a Chicago-based private-equity firm. InfiLaw purchased Florida Coastal in 2004, and then established Arizona Summit Law School (originally known as Phoenix School of Law) in 2005 and Charlotte School of Law in 2006.

These investments were made around the same time that a set of changes in federal loan programs for financing graduate and professional education made for-profit law schools tempting opportunities. Perhaps the most important such change was an extension, in 2006, of the Federal Direct PLUS Loan program, which allowed any graduate student admitted to an accredited program to borrow the full cost of attendance – tuition plus living expenses, less any other aid – directly from the federal government. The most striking feature of the Direct PLUS Loan program is that it limits neither the amount that a school can charge for attendance nor the amount that can be borrowed in federal loans. … This is, for a private-equity firm, a remarkably attractive arrangement: the investors get their money up front, in the form of the tuition paid for by student loans. Meanwhile, any subsequent default on those loans is somebody else’s problem – in this case, the federal government’s.

He adds, “From the perspective of graduates who can’t pay back their loans, however, this dream is very much a nightmare”:

How much debt do graduates of the three InfiLaw schools incur? The numbers are startling. According to data from the schools themselves, more than 90 percent of the 1,191 students who graduated from InfiLaw schools in 2013 carried educational debt, with a median amount, by my calculation, of approximately $204,000, when accounting for interest accrued within six months of graduation – meaning that a single year’s graduating class from these three schools was likely carrying about a quarter of a billion dollars of high-interest, non-dischargeable, taxpayer-backed debt.

And what sort of employment outcomes are these staggering debt totals producing? According to mandatory reports that the schools filed with the ABA, of those 1,191 InfiLaw graduates, 270 – nearly one-quarter – were unemployed in February of this year, nine months after graduation. And even this figure is, as a practical matter, an understatement: approximately one in eight of their putatively employed graduates were in temporary jobs created by the schools and usually funded by tuition from current students.

Every Sex Worker Is Somebody’s Daughter

by Elizabeth Nolan Brown

knox

Last night, a close friend told me he had been reading my posts about decriminalizing sex work. “I’m sympathetic,” he said, “and I want to agree with you. But I just keep thinking, ‘what if it were my daughter?’ That’s, like, every father’s worst nightmare.”

My friend doesn’t have a daughter, to be clear. He’s also one of the most sexually liberal people I know. But while his attitude does discourage me, it doesn’t surprise me. This is the sexist culture we live in—one where a man who I know has had sex with at least three different women in the past week can literally imagine nothing worse for his hypothetical daughter than getting paid to have sex.

Damon Linker trots out similar sentiment at The Week today. Using his apparent mind-reading powers, he asserts that no one could honestly be okay with having a child in porn:

People may say they see nothing wrong with or even admire (Miriam Weeks’) decision to become a porn actress, but it isn’t unambiguously true. And our ease of self-deception on the matter tells us something important about the superficiality of the moral libertarianism sweeping the nation.

How do I know that nearly everyone who claims moral indifference or admiration for Weeks is engaging in self-deception? Because I conducted a little thought experiment. I urge you to try it. Ask yourself how you would feel if Weeks — porn star Belle Knox — was your daughter.

I submit that virtually every honest person — those with children of their own, as well as those who merely possess a functional moral imagination — will admit to being appalled at the thought.

Linker knows that nearly everyone must feel appalled because… he thought about it and was appalled? That’s some pretty shaky logic. (By the reverse, I conducted a thought experiment and am not appalled ergo everyone wants porn star daughters!) It also preemptively dismisses disagreement—anyone who says they are not appalled is just not being honest.

Under that rubric, I’m not even sure what sense it makes to argue, but nonetheless: I would not be appalled to have Weeks as my daughter. I would be proud to have raised a young woman of intelligence, confidence, academic commitment, libertarian leanings, a strong feminist streak, and a way with words. I would worry about a daughter doing porn—but not because of the porn itself. I would worry about the way she might be treated by people outside the industry. I would worry that she might experience sexual violence not on set, but at the hands of people who think porn stars and prostitutes don’t deserve the same bodily integrity as “good” women. And my heart would break to think of her other accomplishments being dismissed by people intent on defining a women’s worth by how many people with which she’s had sex.

I would sure as shit rather have a porn star daughter (or son) than one who thinks, as Linker does, that being in porn makes someone “low, base, and degraded.”

I think I get this viewpoint from my very Catholic, sex-negative, virgin-until-marriage mother. She taught me that we’re all created equal, that only God can judge, and everyone, everyone, is deserving of charity and respect. (The God part didn’t resonate so much with me, but you win some, you lose some.) I’m also reminded of one of my favorite quotes, from a book called Das Energi:

Don’t ever think you know what’s right for the other person. He might start thinking he knows what’s right for you

There’s nothing wrong with having certain expectations for your children—most parents want to see their kids live up to their fullest potential and achieve certain markers of normative success. All else being equal, I’d rather my own hypothetical daughter choose, say, engineering over becoming a Burger King cashier or a brothel worker, because the former seems to offer more security and room for advancement. But here’s the crux of the matter: Our best laid plans mean jack.

“It’s fine that you wouldn’t want your daughter having sex for money,” I told my friend yesterday, “but say she does anyway, and there’s nothing you can do about it. Would you want her to have to stand out on the street, get in cars with totally unvetted strangers, be arrested, get a criminal record? Or would you want her to be able to work in a safe environment? And go to the police if something bad happened? And not get thrown in jail?”

Decriminalizing prostitution is a means of harm reduction.

It’s the same argument people make about marijuana: You don’t have to get high, or even approve of people getting high, to think we shouldn’t be locking people for up it. Proponents of decriminalization aren’t asking you to become pro prostitution, to encourage your kids to go into sex work, or even to abandon thinking it’s morally wrong, if that’s what you think. Plenty of people think premarital sex in general is wrong, but they probably don’t think it should be illegal. All we’re asking is for you to consider that criminalizing prostitution does more harm than good. If — gasp! horror! disgust! — your daughter did happen to become a sex worker, wouldn’t you want to make it as safe and non-ruinous for her as possible?

Thoughts? Email dish@andrewsullivan.com.

(Photo: @belle_knox/Twitter)