15 April 23
Live on the homepage now!
Reader Supported News
Ron DeSantis, gearing up for a presidential bid, signed the six-week ban late Thursday night.
On Thursday, the state took even more aggressive action against reproductive freedom: Gov. Ron DeSantis signed a bill that would restrict abortion at six weeks of pregnancy. The bill will not take effect until after a court challenge to the 15-week ban is resolved.
In practical terms, this is a total ban: Many people do not even know they’re pregnant at six weeks. Even if they are aware, the Florida requirement to obtain an abortion — two in-person doctor visits with a 24-hour waiting period in between — is a challenging logistical burden at 15 weeks and would be nearly impossible at six.
The ban, if it takes effect, would not only decimate what’s left of abortion access for residents in Florida, but would also significantly curtail care for women across the South, who have been traveling to Florida from more restrictive states since Roe was overturned last summer. Annie Filkowski, the policy director of Florida Alliance of Planned Parenthood Affiliates, told Vox their clinics have seen nearly four times the patient volume since June, with people seeking abortions from “the surrounding states and the entire Southeast.”
The 15-week ban was already challenged in state court, and the six-week ban will not take effect until after the Florida Supreme Court rules on the legality of the earlier ban. While abortion rights advocates believe they have a strong case, they know their odds are long thanks to a politicized judiciary. DeSantis has stacked the state’s high court with conservative appointees, transforming the bench from a 5-2 liberal majority to a 6-1 conservative one.
Still, advocates say it is imperative that the public understand that, no matter what, abortion care will remain legal up to 15 weeks in Florida, at least until that decision comes down later this summer.
“Having an effective date tied to a Supreme Court decision is really hard for the public to understand, and it is intentionally confusing,” said Filkowski.
Florida’s 15-week abortion ban is already being challenged in court
Anabely Lopes was 15 weeks into her pregnancy when her doctors informed her that her fetus had a fatal congenital disorder that would kill the baby shortly after birth. Lopes was devastated, and then soon alarmed when she could find no doctor who would even give her a medically exempt abortion, as the providers all feared being sued. At 16 weeks and three days pregnant, Lopes traveled 1,000 miles to Washington, DC, to end her pregnancy. She later joined Rep. Debbie Wasserman Schultz (D-FL) in February as her guest at the State of the Union, serving as an example of someone denied critical treatment under extreme abortion laws.
Abortion rights advocates have been challenging the 15-week ban as illegal under Florida’s constitution, but the law that barred Lopes from receiving the procedure has remained in effect as the litigation plays out. A decision is expected sometime this summer.
In the meantime, though, the state is trying to go further. If the bill takes effect, as experts think is likely given the aggressive political climate in the Republican-controlled state, it would instantly catapult Florida into the ranks of the most restrictive states in the country on abortion access.
The new law not only bans abortion after six weeks but also bans abortion by telemedicine, and requires any medication abortion to be dispensed in person, which effectively outlaws mail orders of the pills. (Researchers have affirmed there is no medical need for abortion pills to be administered in the physical presence of a health care provider.) No other state has had a six-week ban with a requirement for two in-person doctors visits and no option for telehealth.
While the Florida law included exceptions for rape and incest, it requires anyone claiming those exceptions to provide a copy of a police report, medical record, or court order — even though victims often do not involve law enforcement. The executive director of the Florida Council Against Sexual Violence has called the exceptions “meaningless” and “harmful.”
Six weeks is simply not enough time for the vast majority of people to get abortion care, especially if remote options are off the table. As of 2017, nearly three-quarters of counties in Florida did not have any abortion clinics. In medical terms, pregnancy is measured from the date of the last menstrual period, not from the date of conception, and up to 25 percent of women don’t even have regular menstrual cycles, meaning a missed period wouldn’t signal anything unusual. It can take at least three weeks for a pregnancy hormone to appear on a home pregnancy test, and while blood tests can also confirm pregnancies, Florida health care professionals testified that it can take weeks to months to get an appointment with an OB-GYN, with wait times particularly long for low-income and Black Floridians.
Once a pregnancy is confirmed, a patient, under Florida law, would need to schedule an ultrasound with an abortion provider. Scheduling these appointments takes even more time. Filkowski told Vox that wait times at their clinics average about 20 days.
These barriers would prove virtually insurmountable for most people, and even harder for minors in Florida, who are required by law to either get parental consent to end a pregnancy or petition a judge to bypass their parents.
The Republican state senator who sponsored the six-week ban, Erin Grall, conceded a teenager would be unlikely to go through that legal process within six weeks. “I think the purpose of this bill is to say that when there is life, we are going to protect it,” Grall said.
The law also includes $25 million in new state funding for anti-abortion pregnancy centers, which are typically religiously affiliated clinics that provide women with items like diapers and baby clothes, and counsel them against getting abortions. This represents a more than fivefold increase from the $4.45 million in taxpayer funds Florida already allocates to such centers.
Lacking enough votes to block the Senate bill, Democratic lawmakers tried and failed to amend it. Amendments included religious exemptions (two Jewish state senators argued Judaism encourages abortion to protect the health and safety of the mother, and other religions like Buddhism and Unitarianism allow abortions), an effort to eliminate the state’s 24-hour waiting period, and an exception for women facing mental health risk.
Florida provides critical reproductive health care for people throughout the South
While abortion banned after 15 weeks is far more restrictive than Floridians had to deal with prior to 2022, women in neighboring states like Louisiana, Mississippi, and Alabama have been contending with even stricter abortion rules since the overturn of Roe. As such, many have been traveling to Florida to end their pregnancies.
State data shows 82,192 people got abortions in Florida in 2022, compared to 79,817 in 2021. The increase was largely driven by those coming in from out of state. There were 6,708 non-Floridians who ended pregnancies in Florida in 2022, 38 percent more than the year prior.
If the ban goes into effect, people in the South will need to travel even farther for care, and many will likely turn to North Carolina, where it’s currently legal up to 20 weeks.
Stephanie Loraine Pineiro, who leads the reproductive justice group Florida Access Network, told Vox that if the ban takes effect, their work “will be focused on those needing to travel out of state, to wherever is safest and has the least amount of barriers.”
DeSantis is readying himself for the Republican presidential primary
The Republican governor is expected to announce his candidacy for the White House in the coming months, and no doubt expects signing a radically restrictive abortion law will help him in the competitive conservative primary. At least 13 GOP-controlled states have banned most abortions.
Among Florida voters, though, such restrictions are out of step with public opinion. One survey conducted by Florida Atlantic University last year found 67 percent of Floridians said abortion should be legal in all or most cases, while just 12 percent supported a total ban. Another recent survey, led by the Public Religion Research Institute, found 64 percent of Floridians backed abortion in all or most cases.
Abortion rights advocates say they are not surprised to see the aggressive enthusiasm for restricting reproductive rights from DeSantis, even as he worked to avoid commenting on abortion much last year during his campaign.
“This is Ron DeSantis seeing the success other states have had in implementing six-week bans on abortion care, like Texas, Alabama, and Georgia,” said Pineiro. “I’m sure those served as fuel and inspiration for him to say, ‘Oh, it’s already been litigated.’”
Filkowski, of Florida Alliance of Planned Parenthood Affiliates, agreed. “Ron DeSantis has shown from day one a perpetual thirst to have control over our bodies, our lives, our libraries,” she said. “I think we have seen his political maneuvering to give the answer that suits the crowd that’s in front of him. Like, when he was asked about abortion during his campaign, he’d practically run and never gave a full answer. But we are not surprised now.”
READ MORE 
Expelled state Rep. Justin J. Pearson speaks outside the Tennessee Capitol in Nashville. (photo: George Walker IV/AP)
Tennessee Rep. Justin Pearson honed his voice in college. I helped him. Here is what he taught me
The young man wearing a suit, not just that first day, but every day, was Justin J. Pearson, the Democratic House representative from the 86th District of Tennessee. We met in my first year as Director of Writing and Rhetoric at Bowdoin College, as he neared graduation. He wanted to be a better writer and a stronger speaker, he said. He wanted to hone his voice. So we made a plan. We met each week for a year, discussing current issues, and reading news articles. He wrote reactions and I responded with feedback and questions. But mostly, I held space for him. I affirmed that his ideas were worth reading and that his voice was worth hearing.
Over the past ten days, Justin's voice has garnered national attention—inspiring celebration and drawing criticism. His critics do not point to flaws in his argument. They do not call out his political objectives. Instead, he has been criticized for challenging the status quo. First for his appearance, and second for the way he used his voice.
At his swearing into office earlier this year, Justin proudly wore a dashiki in honor of his ancestors. Republican Representative David Hawk scolded him, alluding to a rule that male lawmakers must wear suits and ties.
There is no such rule.
There are, however, powerful unwritten rules about the status quo. And when Pearson, a young black man who is a powerful orator, wears his hair natural and chooses a formal dashiki over a western suit and tie, his very presence is a challenge. It's respectability politics.
On March 27, a mass shooting at Covenant School in Nashville left six people dead. When the Tennessee House of Representatives convened on March 30, Pearson and others walked past thousands of protestors as they entered the State House. Some held signs that read: "Do Something." Seeing that the House was not planning to address the mass shooting, Pearson joined with two other representatives—Justin Jones of Nashville and Gloria Johnson of Knoxville—to protest within the state house to call for gun laws.
The three were stripped of their committee assignments. On April 6, Pearson and Jones, both young Black men, were expelled from their positions by vote in the Republican-led House of Representatives. Gloria Johnson, a white woman, was not.
In a country founded on protest, when he took part in a peaceful protest to amplify the voices of his constituents begging for safer gun laws, Justin was silenced. It's respectability politics.
But for Justin J. Pearson to be successful at Bowdoin College, he learned how to deal with respectability politics. He knew how to code switch. He modulated to adapt to the rhetorical conventions of Government class discussions and commencement speech contests. As a Black man at a predominantly white institution, he was deeply aware of the expectations placed upon him as the son of two teenage parents who returned late to college and worked their way out of poverty through education. His mother is an educator currently pursuing her doctorate, his father is a minister who earned his Masters of Divinity when Justin was a child. He understood the opportunities education offers just as much as he understood how he was expected to behave. So he wore a suit. He wrote in a way that was legible in that setting and spoke with fluency in the language of that context.
Code switching is a practice of moving from one way of speaking to another. To be successful in the contemporary American system of education, one must navigate a colonial framework. One must use the language of the colonizer. Educator and scholar Vershawn Ashanti Young advocates for what he calls codemeshing, asserting that code-switching creates segregated codes that are separate but unequal. Instead, Young says, writing teachers should "teach how language functions within and from various cultural perspectives. And we should teach what it take to understand, listen, and write in multiple dialects simultaneously."
Some of the work that Justin and I engaged in had to do with understanding rhetorical contexts. Some of what we did together had to do with code switching and code meshing. The work of an educator—perhaps especially a teacher of writing and rhetoric—requires an understanding of systems of oppression and the needs of a student.
When I reached out to Justin this week after his expulsion, I asked how he was navigating these codes from within the institution. What does it mean to inhabit a rigid space like the legislature and does he feel that it is a productive space to bring about change? We discussed the foundational quote from Audre Lorde: "The Master's tools will never dismantle the master's house."
"It's true," he agreed.
"If we wanted to operate with the tools of white supremacy and patriarchy, or we were using the tools of hatred toward the poor. If we were using the tools of exploitative capitalism, of militarism… if we were using those tools, then no way that you could change the institution that you're a part of. Those tools will never dismantle the house because the house was built with those tools. And so you've got to come with new tools. Something entirely different that's not adjacent, not tangential to, but some tools that are entirely different than the ones that built the institutions."
Instead, he explained, "we are using a different set of tools to dismantle it. Brick by brick. Pillar by pillar. Piece by piece. And it is a painful, grueling process because these institutions are designed this way over centuries to be immovable. To be untouchable."
"Right?"
That's right, I nodded. Sitting in my office after a day of teaching composition and now being reminded by this former student about all the ways that change can happen. About all the tools we might use. We must use.
"I believe being within this institution but not being of this institution is quite important," Justin continued. "Institutions do not change because the people within them all suddenly get more courage. Rather what actually happens is that there are a few good folk within them that have some moral courage. And there is a mass movement of people outside of the building, outside of the institution, who push it to change. That actually leads to progress."
Raised in the black church and educated at an elite college, Pearson bridges worlds. He understands rhetorical situation and code meshing. In the wake of yet another school shooting, he responds with humanity to the families from Covenant School inside the building. He responds with compassion for the high schoolers who are pleading for their lives outside the building. And when it becomes clear that lawmakers will not address the issue, he and two others use their voices. Their voices are disruptive not because they know of no other way to speak, but because the situation called for disruption. Later, when offered an opportunity to speak before the vote for his expulsion, Pearson's voice is defiant and full of emotion because the situation calls for that. And when I sit down to talk with Pearson about all of this, he speaks quietly with reflection—calling me to see the situation in a new light. Because that is what was needed.
When I asked how he still felt optimistic despite the challenges, he said, "I don't believe [the challenges are] permanent. There's nothing in my body that says all the bad things that are happening are permanent. What I was getting to and what you helped me to get to, too, is that at minimum, you can say something."
Pearson feels empowered, despite all of the obstacles and silencing, because he so deeply believes in this truth. "The reason why it's worth it is that I'm assured that there is a victory date. I know it in my soul. And the reason I know it is because what we are fighting for is not because there is a financial interest associated with it. It's not because there's a lot of fame or recognition that comes with it. It's not that. It's that we believe in our hearts that this is true. And so, that cannot be taken. That cannot be easily lost or gained because of what the stock market is doing. Because of what people in power are doing. And the main thing is that we will never quit, so how can we lose? If you never quit, there is no way for you to lose."
When he was expelled from the House, though, did it not feel like a loss? I wonder.
Pearson leans back and smiles, taking in the question and shaking his head. "What I ask is 'What if we did give up?' Then what happens? What if we never fought back? The governor of Tennessee today wouldn't be talking about red flag laws as he is talking about in this red state where they have a super-majority Republican legislature. The governor of Tennessee said we need to pass red flag laws, which is what myself and my colleagues screamed about on the House floor."
"So it's a victory?" I ask.
"It's a victory." He pauses. "It's a start of a victory. But that doesn't happen without thousands of people marching. That doesn't happen without people having some courage."
It took courage for Pearson to move to Maine from Memphis. It took courage for him to ask for help—to share his messy drafts and take the feedback. It took courage for Pearson to put on a suit at Bowdoin. And it takes courage for Pearson to wear a dashiki and to pick out his hair each day that he walks into that white-dominated space not built for him. It takes courage for Pearson to evoke the rhythms of Black vernacular and the images of the black church on the floor of the House.
When Pearson was reinstated by a unanimous vote on Wednesday, the day after we spoke, he wore a dashiki with a suit. From the clothes that he wears to the tones he uses, to the spaces he inhabits, Justin J. Pearson is drawing from his various lived experiences. He is claiming his multiple ways of being. He is codemeshing and bridge-building as he claims his space among the next generation of leaders.
"We've got to be the folks who say, this is not something we want to preserve. We need a new status quo, we need a new South, a new Tennessee, a new country."
As he looks ahead, Pearson is inspired by the young people he sees. "This is a generational awakening that is going to demand solutions. And they not going nowhere. They're only growing up. They're only becoming more voters."
And as I look ahead, I am inspired by this young man. Following his lead, I am eager to use new tools to build a house worth inhabiting, and grateful that he determined to hone his voice and to use it for good.
READ MORE 
Russian soldiers. (photo: Creative Commons)
Rescue workers dig for survivors after Russian missile attack on a block of apartments in Sloviansk, Donetsk region.
The attack on the quiet neighbourhood on Friday came as Russian President Vladimir Putin signed a bill that will make it easier to mobilise citizens into the army, and block them from fleeing the country if drafted.
The governor of the Donetsk region Pavlo Kyrylenko told national television that seven Russian S-300 missiles had been fired at Sloviansk, west of the city Bakhmut, the site of the heaviest fighting on the Ukrainian front line.
“As of now, casualties at all sites – 21 people were injured and eight people have died,” Kyrylenko said on national television.
Kyrylenko said there were “no fewer than seven spots hit” in Sloviansk, west of the city Bakhmut, the site of the heaviest fighting on the Ukrainian front line.
Ukrainian police said on Twitter that a child died in an ambulance after being pulled out from the rubble.
Ukraine’s First Lady Olena Zelenska said the child was a two-year-old boy and sent her condolences to the family during this “indescribable grief”.
“The evil state once again demonstrates its essence,” President Volodymyr Zelenskyy wrote in a post accompanied by footage of a damaged building.
“Just killing people in broad daylight. Ruining, destroying all life.”
Shocked residents
Ukrainian police said 10 buildings were damaged in the assault. They said the two top floors of a five-storey building had collapsed after the attack and a fire had broken out opposite the site.
Rescue teams were combing through the affected area.
“I live on the opposite side of the street and I was sleeping a little when I heard this huge boom and I ran out from my flat,” 59-year-old resident Larisa told the AFP news agency.
“I was really scared and in a state of shock,” she said, adding the impact of the shelling had broken her windows and sent shards of glass flying throughout her home.
“I heard a woman screaming, ‘There’s a child here, there’s a child here.’ She was screaming so much.”
Putin signs conscription bill
More than a year after Moscow launched its offensive in Ukraine, fears were high in Russia that the government was planning a new mobilisation drive after a bill was rushed through parliament this week to create a digital draft system.
Under the legislation, which Putin signed Friday, a draftee would be banned from travelling abroad and would have to report to an enlistment office once electronic call-up papers are received.
Tens of thousands of men fled Russia last year after Putin announced a mobilisation to prop up the forces in Ukraine.
The attack on Sloviansk, which many residents have fled since Russia invaded, came as Moscow said it was pushing to take more districts of ravaged Bakhmut.
Despite having little strategic value, the town has become a fixation of military commanders, leading to a brutal nine-month war of attrition.
“Wagner assault units are conducting high-intensity combat operations to conquer the western districts of the city,” the Russian army said in a statement, referring to the private paramilitary group.
Russian airborne troops were “providing support to assault squads and halting the enemy’s attempts to deliver ammunition to the city and bring in reserves”, it added.
On Thursday, Moscow claimed to have cut off Ukrainian forces in Bakhmut. Kyiv denied the claim, saying it had access to its troops and was able to send in munitions. Ukraine has pledged to continue defending Bakhmut.
READ MORE 
Police cars block Maple Street in North Dighton, Mass., half a mile from the house where Air National Guard member Jack Teixeira was arrested Thursday in a leak case. (photo: Kylie Cooper/WP)
President Biden, high-profile Department of Defense officials and members of Congress have called into question the clearance process and security protocols that they say gave Teixeira access to the leaked documents.
In Ireland on Friday, Biden said he has asked to “make sure they get to the root of why he had access in the first place.” While there may have been failures that allowed Teixeira allegedly to view and take home such a large volume of national secrets, it is not out of the norm for a young person in the military to be entrusted with such responsibilities, experts say.
Here’s what to know about that process and how Teixeira fits into the larger system.
Why did Jack Teixeira have a top-secret security clearance?
In his role as a “Cyber Transport Systems Journeyman,” Teixeira managed computers and communications systems, a function similar to providing tech support. To do that job, he had maintained a top-secret clearance since 2021, a federal complaint notes, and could view a smaller category of highly classified material called sensitive compartmented information.
Teixeira also had access to a Defense Department computer network called the Joint Worldwide Intelligence Communications System, a U.S. official familiar with the matter told The Washington Post. That could have allowed the 21-year-old to read and potentially to print documents with the same level of classification as many of the ones leaked.
In response to questions from reporters, Pentagon spokesman Patrick S. Ryder, a brigadier general, said Thursday that the military regularly entrusts young people with classified information, that Teixeira’s having that level of clearance was normal and that scores of other young workers have that type of access.
Experts in national security and clearance law agreed.
“For someone in his particular position and his responsibilities, it’s not unusual that he would have that kind of access,” said Bradley Moss, a lawyer who works in security clearance law. Because Teixeira worked in a space where those documents existed, he needed that clearance, Moss added.
Teixeira was serving in a National Guard unit that has large responsibilities. The 102nd Intelligence Wing runs an around-the-clock operation that distills intelligence for senior military leaders, a defense official told CNN.
Because of the large amount of classified information, more information technology workers who might not otherwise need clearances must get them to manage the systems, said Amy Jeffress, a lawyer who specializes in national defense matters and served in the Justice Department.
What is the process for getting a top-secret security clearance?
More than a million people have top-secret security clearance. To get it, a candidate must fill out an exhaustive form called the SF86, which asks for information including any foreign contacts, places of residence and work history. Some positions also require applicants to take a polygraph exam.
Candidates also submit to investigative interviews, and background checkers question friends, family members and colleagues to obtain a broader picture of each person. The government runs criminal and financial checks in a process that can take months or longer.
Moss explained that investigators are looking for potential risks of reliability such as financial problems, drug or alcohol abuse, questionable foreign connections and professional misconduct.
Finding someone reliable and not a security risk, though, is a determination made about a moment in time, said Kenneth Gray, a retired FBI special agent and lecturer at the University of New Haven.
“The clearance process shows you are a reliable person, that you are not going to commit espionage against the federal government,” Gray said. “That’s only a snapshot in time, though. It doesn’t mean you are necessarily reliable in three years.”
How effective are background checks, and what measures are taken at secure facilities?
Security experts said the background checks are largely effective in determining whether someone has been approached by foreign agents or governments but are not infallible. Some people can beat polygraphs and, as Gray noted, the clearances show someone is reliable only at a moment in time.
But 18- or 19-year-olds who receive clearances could undergo significant changes in maturity or ideology before follow-up clearance checks, which often are conducted every five years.
“When you are granting access to a person with classified documents, you always have the possibility that that person is not going to be trustworthy,” Gray said. “There are effective safeguards in audits, but there’s always risks. If you want to lock it down totally and grant very limited access, it makes it very difficult to do your job.”
Guardrails do exist once someone starts working with classified materials. Certain documents can be viewed only inside Sensitive Compartmented Information Facilities (SCIFs) and officials use access cards that leave a digital trail of what someone has downloaded and printed.
But, Moss said, an element of “honor and trust” is placed in individuals who have been cleared that relies on their adhering to security protocols.
“Security officials don’t have the time to check every person as they exit the building,” Moss said. “They do random inspections, but it would too significantly disrupt work operations to inspect everyone every day.”
Could this leak affect the clearance and security process?
After Teixeira’s arrest Thursday, high-level officials across the U.S. government called for a review of the security and clearance processes surrounding classified documents.
Secretary of Defense Lloyd Austin said in a statement that he was directing the undersecretary of defense for intelligence and security to review intelligence access, accountability and control procedures to “prevent this kind of incident from happening again.”
Sen. Jack Reed (D-R.I.), the chairman of the Senate Armed Services Committee, said in a statement Thursday that Congress must address “protocols for how intelligence is handled, the security clearance process, and how officials can prevent intelligence leaks like this.”
What exactly those changes would be is not clear. After Edward Snowden used a thumb drive to transfer classified material out of secure facilities, that type of hardware was prohibited. Moss suggested a review of physical security procedures and a possible increase in random inspections of clearance-holding people in offices is needed.
Gray said there should be an in-depth study and probably changes in how documents will be handled.
READ MORE
A patient undergoing chemotherapy. (photo: Cochise)
In 2013, I had great health insurance, and it probably saved my life.
Early in 2013, I looked at the back of my right calf and thought, “Huh. That looks weird. Has that always looked like that?”
At the time, I didn’t spend a lot of time looking at the back of my calves. I’m sure you don’t spend a lot looking at yours. Kind of like the dark side of the moon, they’re on the dark side of your body. And they’re not interesting enough to make a special effort. What do the backs of our calves do all day long? Who knows, they could be plotting to overthrow the government and we’d never notice.
But for some reason, I did look at the back of my right calf. And I noticed that a mole I’d had there for my whole life looked slightly different. Or did it? I wasn’t sure. In fact, I wasn’t sure I’d looked at this mole since the Clinton administration. But whatever it used to look like, now it looked sort of … like it was splitting in half. Like one side was making a break for it and heading around my leg toward my shin.
Or maybe not. Maybe what I’d thought was one mole had always been two overlapping moles and I hadn’t ever noticed. Maybe?
Then I thought, “Maybe I should go to a dermatologist.”
So I eventually made a dermatologist appointment, an appointment 10 years ago right now. And the most important thing about the way I made that decision, which plausibly saved my life, is that I wasn’t worried at all. I wasn’t worried enough to hurry; it took me six weeks to get around to it. I wasn’t worried when the dermatologist looked at it and said he’d go ahead and slice it off. I wasn’t worried when the phone rang a week later and it was the dermatologist, calling me directly.
What I’d always heard about waiting for results from medical tests is that you want a nurse or receptionist to call you. You definitely don’t want to hear from the doctor themselves. Yet I was so totally unworried that when I heard the doctor’s voice, that never crossed my mind. To the degree I thought anything, I thought, “Wow, this guy is such a caring physician that he makes a point of calling patients to tell them that they’re perfectly fine.”
That was not why he was calling. He was calling to tell me that my weird-looking mole was malignant melanoma, i.e., the type of skin cancer that kills you. Unless it’s caught at the very beginning, which mine was. Then (if you’re lucky like me) they send you to have a big chunk cut out of the site of the melanoma to make sure they got it all, and you look like you got bitten by a shark, and then the receptionist calls to say there were no malignant cells in the chunk, and doctors tell you, “You need to come get looked at even three months, and wear a lot of sunscreen.”
And that’s the thing about melanoma, which you probably don’t know unless you’ve spent many bleary nights reading every single website on the internet that mentions it. It’s not just that it’s the most dangerous of the three kinds of skin cancer, causing 80 percent of skin cancer deaths. It’s that if it escapes from your skin into your lymph nodes, it’s sometimes more dangerous than many other types of cancer. For instance, the survival rates for stage II melanoma are the same or worse than for stage III breast cancer.
But on the other hand, survival rates in its earliest forms are very high. In my case, I learned, there was only a 7 percent chance it would kill me in the next 10 years. Now those 10 years are up, and I’m extremely happy to have not beaten the odds.
So if ever there were a cancer where early detection makes all the difference, it’s melanoma. If I hadn’t gone to have my weird-looking mole examined, eventually one day, a clump of malignant cells would have migrated from my skin to elsewhere in my body and quietly begun multiplying. Would that have taken six months, three years, five years? There’s no way to know. But then I would have been looking at prognosis charts with survival numbers like 67 percent, or 49 percent, or 34 percent. The difference between that and being cancer-free was a five-minute procedure in a suburban office building on a Monday.
That’s why it’s so important to understand how unworried I was. I wasn’t $400 worth of worried, or $100 worth of worried, or even $20 worth. I wouldn’t have gone to the dermatologist if I didn’t have health insurance. I probably wouldn’t have gone if I had insurance but it had a big deductible or even any real copay. The only reason I went to have my life saved is because it cost me zero dollars.
And the reason it cost me nothing is because I was then working for Dog Eat Dog Films, Michael Moore’s production company, and had America’s best health insurance. Moore didn’t just make an entire documentary, “SiCKO,” about our disastrous health insurance system, he did his best to make sure his employees didn’t experience it. My coverage had no deductible, and most doctor’s visits had no copay. (The dental coverage was great too — I had three wisdom teeth removed for a total cost to me of $242.) I’d never had insurance like this before in my life and probably never will again unless I move to Ontario.
So you can understand why ever since, I’ve closely followed the GOP’s attempts to destroy the Affordable Care Act, aka Obamacare. With my melanoma diagnosis, I suddenly became much more interested in everything about health care policy, in the same way you’re suddenly much more interested in the safety instructions in the seat back in front of you when the pilot announces you’re ditching in Lake Superior. And every time Republicans have gone on TV to talk about this subject, what I’ve heard them say is, “We very much want to kill you, Jon Schwarz.”
That’s because Obamacare required insurance companies for the first time to cover everyone, regardless of any preexisting conditions. There’s no more disqualifying condition than cancer; without Obamacare, I would now likely be essentially uninsurable if someday in the future I need to get insurance on the individual market. And we know what happens to people without health insurance in the United States: they die.
This doesn’t mean that I don’t understand Obamacare’s many grievous flaws. But they’re not flaws of going too far; they’re flaws of not going nearly far enough.
To this day, I often think about the thousands of Americans walking around with undiagnosed, early melanomas who could be cured in five minutes. Some of them think something might be wrong but aren’t doing anything because they have no insurance or bad insurance. Is it you, 28-year-old woman in jeggings who’s clearly spent too much time at a tanning salon? Or maybe it’s you, middle-aged dad I saw carting around three kids at the grocery store while getting instructions on your cellphone on what brand of spaghetti to buy. Or you, the 60-year-old cashier at the Indian restaurant who gave me the extra order that someone else never picked up. These thoughts about this unnecessary suffering torment me. If that sounds overwrought to you, I’m guessing you’ve never looked at a pathology report with your name on it that says “diagnosis: malignant.”
And the awful truth is that while Obamacare may save some of those people, it won’t save them all — because although it will help nearly everyone get some kind of insurance, it won’t help everyone get good insurance, the kind that saved me. Some of them will look at their strange asymmetric mole and their $2,000 deductible and won’t be $2,100 worth of worried until it’s too late.
The U.S. right has a phrase they like to use about health care, which is that Americans need more “skin in the game.” This means that the real problem with our system is that regular people don’t have to pay enough, that we “buy” health care like we do clothes or cars, and we’ve been getting too much because insurance makes it seem so cheap. But as someone with some nonmetaphorical skin in the game, I can tell you this isn’t just wrong, it couldn’t possibly be wronger. People don’t want to go to the doctor. They don’t go get pointless chemotherapy instead of going to Six Flags, because chemotherapy and Six Flags are both the same amount of fun but chemotherapy’s cheaper. I didn’t have to pay anything to see a doctor, and because of that, it cost the health care system about $5,000 to treat me. If I’d delayed because I had to pay, it easily could have ended up costing the system $500,000 worth of interferon, CT scans, and radioimmunotherapy, plus the additional downside of me being dead. Multiply that by millions of people and you’ll understand why the right’s crusade against health insurance is more than just evil and cruel, it’s evil, cruel, and incredibly stupid.
The U.S. right has momentarily given up on killing Obamacare all at once and is now attempting to kill it off in pieces. Meanwhile, there’s little interest from Democrats in improving it.
That means it’s up to us. We have to keep fighting, to get rid of the bad parts of Obamacare and keep and improve the good parts, so the Affordable Care Act is just the first step to the only system that’s ever worked anywhere on Earth: universal, high-quality health insurance and health care for everyone. And while we’re working on this, seriously, please, please use lots of sunscreen and don’t skimp on dermatologist appointments.
READ MORE 
Sudan's paramilitary Rapid Support Forces in Khartoum. (photo: Umit Bektas/Reuters)
Explosions and gunfire reverberate throughout the city of 10 million people as Rapid Support Forces battle military troops.
Shooting and blasts took place on Saturday in the vicinity of Sudan’s army headquarters and the defence ministry in central Khartoum, as well as the presidential palace and airport.
Columns of smoke emanated from various places in the city of 10 million people and soldiers were deployed on the streets. Civilians were seen running for cover as artillery exchanges rocked Khartoum.
Witnesses reported “confrontations”, loud explosions, and gunfire near a base held by the paramilitary Rapid Support Forces (RSF) in south Khartoum.
“The Rapid Support Forces were surprised Saturday with a large force from the army entering camps in Soba in Khartoum and laying siege to paramilitaries there,” the RSF said in a statement.
The army “launched a sweeping attack with all kinds of heavy and light weapons”, it said.
However, a spokesman for Sudan’s army said paramilitary troops attacked military bases.
“Fighters from the Rapid Support Forces attacked several army camps in Khartoum and elsewhere around Sudan,” said Brigadier-General Nabil Abdallah.
“Clashes are ongoing and the army is carrying out its duty to safeguard the country.”
‘A criminal’
Smoke was seen rising from the airport and RSF said its forces had taken control of the facility. RSF said it also had taken over two other airports – in the northern city of Merowe and El-Obeid in the south – and “full control” of the presidential palace.
Sudan’s General Intelligence Service denied the presidential palace had been seized, and the military said other RSF claims were untrue.
The Sudanese air force was conducting operations against the paramilitary fighters, the army said, with footage showing military aircraft in the sky.
A doctors’ association urged physicians to head to hospitals as casualties mounted.
General Abdel Fattah al-Burhan, head of the ruling Sovereign Council, was reportedly safe.
In a phone interview with Al Jazeera, the commander of the Rapid Support Forces – General Mohamed Hamdan Dagalo, better known as Hemedti – called army chief al-Burhan “a criminal” and accused the military of carrying out a coup.
‘People are terrified’
Al Jazeera’s Hiba Morgan, reporting from Khartoum, said fighting was ongoing.
“We are hearing gunfire in the capital near the vicinity of the presidential palace in the northern part of the capital,” said Morgan. “Lots of confusion here with regard to what is happening at the moment. People are terrified.”
The rift between the forces came to the surface on Thursday when the army said recent movements by RSF – a powerful paramilitary group – had happened without coordination and were illegal.
The heads of the army and the RSF earlier told mediators they were ready to take steps to de-escalate the situation.
A confrontation between them could spell prolonged strife across a vast country already dealing with economic breakdown and flare-ups of tribal violence.
Current tensions stem from a disagreement over how the RSF should be integrated into the military and what authority should oversee the process. The merger is a key condition of Sudan’s unsigned transition agreement.
However, the army-RSF rivalry dates back to the rule of autocratic President Omar al-Bashir, who was removed in 2019.
Under the former president, the paramilitary force, led by powerful General Mohammed Hamdan Dagalo, grew out of government-backed former militias known as the Janjaweed that carried out a brutal crackdown in Sudan’s Darfur region during the decades of conflict there.
Sudan conflict zone analyst Mohammed Alamin Ahmed said: “It’s a power struggle that began a long time ago and it has escalated to direct clashes today. There is an exchange of accusations on who started this, and the fighting has extended, not just in Khartoum, but also in the strategic city of Merowe where the Sudanese armed forces have a strong air force there.
“And it looks like the RSF is trying to neutralise the capacity of Sudanese army [and] air force there to pull them towards a ground battle.”
READ MORE 
Firefighters respond to the industrial fire in Richmond, Indiana. (photo: Michael Conroy/AP)
Hydrogen cyanide gas can be fatal depending on the dose and length of exposure. Benzene can cause various types of cancer among those with long-term exposure.
Officials said Friday that air monitors detected hydrogen cyanide, benzene, chlorine, carbon monoxide and volatile organic compounds in the ground-level smoke.
“We detected some new contaminants right at the incident command post, which is, again, at the center of the evacuation zone," Jason Sewell, the EPA's on-scene coordinator, said at a news conference in Richmond, Indiana.
"The two new contaminants we detected were hydrogen cyanide and benzene. We had not detected those before last night. The fire department jumped on extinguishing the hot spot and that abated," he said.
The EPA said it notified the Richmond Fire Department that it had detected the two dangerous compounds out of concern for firefighters’ safety.
The blaze was first reported on Tuesday afternoon, and soon after, the Wayne County Emergency Management Agency told residents within half a mile to evacuate. That order is still in place.
The warehouse where the fire started contained large amounts of shredded and bulk recycled plastic, and it sent ominous black smoke over Richmond and surrounding towns in eastern Indiana and western Ohio. Local and federal officials warned area residents on Wednesday that smoke from burning plastic could contain cancer-causing toxins.
Hydrogen cyanide, a highly toxic gas, can be fatal depending on the dose and length of exposure.
Benzene is known to cause cancers such as leukemia, multiple myeloma and non-Hodgkin lymphoma in some people with long-term exposure. The World Health Organization has said there’s no safe level of benzene exposure when it comes to cancer risk.
“What we don’t know is the levels and where did they measure them?” said Dr. Arthur Frank, an environmental and occupational health professor at Drexel University.
Christine Stinson, executive director of Wayne County Health Department, said her analysts need time to go over the test results from both air and water samples to understand the long-term health threats people living near the fire site could face.
"We certainly are going to get that information out to the public — what are the risks you have been exposed to if you didn’t honor that evacuation zone," she said, adding, "I don't want to frighten anybody, but this was a plastics fire. There was particulate matter up in the air."
The EPA said Thursday that it also found asbestos in samples of debris that fell in surrounding neighborhoods up to 1.5 miles from the fire. Asbestos can cause several types of cancer, including mesothelioma and lung, laryngeal and ovarian cancer. No amount of exposure is considered safe, according to the Occupational Safety and Health Administration.
Frank said the fire may have spewed additional chemicals that the EPA has not tested for yet.
By Friday afternoon, no flames or smoke were visible, but firefighters will remain at the scene this weekend in case any hot spots reignite, city officials said.
“Stay away from the site,” Richmond fire chief Tim Brown said in a news conference. “Let us take care of it, let us take care of the flare ups and everyone will be safe.”
Environmental health experts said they worry that acute exposure to the chemicals the EPA has identified so far could lead to breathing problems in the short term or cancer in the long term.
“If you think back 20 years ago to the World Trade Center, remember that stuff there burned for days and smoke was coming up and we’re still seeing now disease from people who worked on that pile. This has got a lot of the same stuff,” Frank said.
Andrea De Vizcaya Ruiz, an associate professor of environmental and occupational health at the University of California, Irvine, said that judging by the size of the plume, "this is not something that is going to disperse in a short period."
"It’s going to take a long time for those concentrations to come down," she said.
Area residents have been instructed not to touch debris that has landed in their yards, and especially not use lawnmowers, which could kick up dangerous material and make it easy to inhale.
Ash debris from the fire was all over the farm of Lynn Childers in New Paris, Ohio, 6 miles away. Childers told NBC News on Thursday that he felt irritation in his throat and nose.
"My throat was burning," he said. "I didn't pay any attention to it because I didn't know the severity."
Follow us on facebook and twitter!
PO Box 2043 / Citrus Heights, CA 95611
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.