#like. did you know we did in fact have “the tools” to stop covid from becoming a pandemic?

[kabutone]

people are so shocked when they learn about the absolute depravity of the world thats right in front of them. not that its Good to be desensitized to horrific shit but like i am not surprised. every new bad news thing that comes out i am not surprised. yes, they will ignore death. they will let you die without a second thought. i'm sorry you are only just now learning this.

[thatdisasterauthor]

Delete your Threads account. You know what Meta as a company has done, you know the kind of person Mark Zuckerberg is. You've lived through Gamergate, the elections, covid, the fucking lot of it, and yet you're still willingly making an account on Threads. How can you possibly justify that?

Second ask: Scratch that, I hadn't read your most recent posts. Sorry for being so rude.

Third ask: "Still going to keep an eye on it" For what exactly? For it not to be as bad as it is? For it to get even worse before you decide it is wrong? You know who Mark Zuckerberg is. You know what Facebook is. Be up front: you don't actually care or stand for anything, you're only afraid of losing business. Have some dignity.

So you decided to be rude as fuck, "apologize," and then come back and be more rude?

I was incredibly clear in that post of why I am going to keep an eye on Threads, despite the concerns: Twitter was a valuable source of live news, especially during natural disasters, and Threads is the first potentially viable replacement for that. IDK if you actually follow me, but if you do you'll know I do a lot of work around natural disaster communication. Twitter was invaluable as a communication source during natural disasters. Full stop. It is not up for debate. But hey, if you want a source with more authority than a random tumblr blog, here, have a nice shiny research paper:

Mind you, that was written in 2010 and the importance of Twitter as a communications tool during natural disasters has only increased since then. There is no other tool out there, no other website--news or otherwise, that can provide such granular, specific updates when shit hits the fan as Twitter did. The only better, quicker source of information I have found during natural disasters is listening to actual radio chatter from the departments involved in whatever problem, and that can be very tricky to do if you don't know where to look or have the right equipment. There is no other site where I can go specifically follow so many of my local fire departments, my local emergency services, my local National Weather System stations, and get live pushed updates from them every single time they post.

When Twitter DDOSed itself last week and put a limit on the amount of tweets people could view and forced people to be logged in to view anything at all, the effect was immediate and BAD. People suddenly couldn't view things like missing person alerts, or weather alerts. I had people messaging me because they were trying to check the National Weather System autoalerts for their area on Twitter due to being caught in a sudden storm, but they couldn't get on to check.

Love it or hate it, Twitter had an immense amount of value and it got that value--at least in the case of natural disaster communication--because the stubborn ass government decided it was big enough to be trusted with official lines of information. Very, very few other social media sites have ever had that trust from the government. Look at how they banned TikTok on all government devices. But they DO trust Facebook, and Instagram, and Meta. Which means their chances of trusting Threads and migrating over there when Twitter finally takes its last breath are ASTRONOMICALLY higher than expecting them to go anywhere else.

We can debate the privacy and moral issues of the Metaverse and those involved until the cows come home, but it does not change the fact that if my mountain is on fire I'm gonna get information about where that fire is from wherever the fuck I can. I'm not going to wait around for it to maybe show up in a "live" updates news article from CNN from some reporter half a continent away in New York who doesn't know anything about where I live and gets the roads wrong because they just don't know. I'm going to go to the website full of my neighbors and local firefighters and see what's happening right that second.

Do we need to fix the privacy and moral issues? Yes. But we can't throw the baby out with the bathwater either. Not using Threads or any other Meta product isn't the answer here. Using them with extreme caution and only for very specific needs, for the time being, is. Long term, we need to be focusing on privacy based legislation that would finally put these companies in their place. But until then, again, I'm going to keep following my local fire departments wherever they go.

P.S.: If you're going to keep the shitty attitude, fuck right off and unfollow+block. You're not wanted here.

[zyxwl2015]

Excerpts from Lando Norris biography - part III

(There aren't too many behind-the-scenes stories anymore — mostly stating things everyone knows, F1 was postponed due to Covid, online racing happened, F1 resumed, Lando did this in this race, Lando had a new teammate, Lando moved to Monaco, etc etc)

Every one was extremely happy for Lando after his first podium at Austria 2020, including Trevor Carlin: "He is doing everything right and the results are coming and I am very proud of him" and "Lando is the nicest person you could ever meet"

Charlotte recalled in Eifel GP 2020, the marketing team's office was right next to the drivers' room and the walls were paper-thin, and —

We were working in the marketing office and we could hear this giggling from the drivers’ room next door… I went into their drivers’ room to speak to them and they were both lying on the massage bed watching YouTube or Instagram videos together. We all started pissing ourselves laughing at first, but I then said to them, “What the fuck are you doing? Why aren’t you in the garage? Everyone is looking for you!” I was like an ogre telling them off all the time. But that was the point where I and some others in the team realised that they actually enjoyed spending time together.

(Oh my Carlando heart 🥰)

Going into the 2021 season, he started to become more strict with certain things, especially diet and training: he stopped eating pizza, started to do more training and running (even though he "still hates it with a massive passion"), etc, to step up his performance. By summer break there's a noticeable change physically from when he first entered F1

Charlotte on Lando at that point:

When Carlos left, I think Lando got a bit nervous again, because he was a bit like, “Well, this guy’s obviously won seven races. He’s a known quantity, and he’s got a really good reputation.” I felt like Lando’s confidence had grown so much over the two years he had with Carlos. When Carlos left and we signed Daniel, Lando was a bit like, “I’ve really got to step up.” That was when I noticed that Mark, his manager, and Jon, his trainer, were building a positive environment by explaining that Norris had all the tools and experience and should not be putting pressure on himself… I used to call him kiddo, in fact I still do, but that was the time when I thought this guy actually could be really good and it will be really interesting to see the comparison. Some thought Dan would just come in and absolutely smash him, but he didn’t. You could certainly see a change in Lando, just the way he carried himself, the way he spoke, his whole demeanour. He was just so much more confident in himself while being self-deprecating.

(I love Charlotte 🥹)

Charlotte on Lando and Daniel's relationship:

At first, they were both definitely trying to suss each other out. We never thought they would not get on, but they just didn’t spend any time together… There was never any animosity between them, it was just they didn’t hang out. Andreas Seidl would have a meeting with both drivers before the race every Sunday. It’s called a “pre-race objectives meeting” and he would basically lay the law down and tell both drivers they are in it together. You drive for the team, no driver is better than the other, no one gets preferential treatment, you do what’s best for the team result, that kind of thing… Both drivers were team players and we needed that because we knew we were struggling and that Ferrari would be back up there again. Both of them then started spending more time together in engineering meetings and worked really hard on it. I can’t fault either of them. Both their work ethics are just unbelievable … but they started to work together quite a lot and from then, their relationship started to change and they started to get on really well.

McLaren keeps the Monaco 2021 trophy (as always), so Lando keeps the presentation box "because it is the coolest thing, a bespoke Louis Vuitton number" (😂)

Charlotte on Lando's relationship with McLaren team members:

He had worked with the boys for a long time by now, but he knew everyone, not just them by name, but their girlfriends, their wives, their kids, their families, their situation. He’d take the team out bowling or for dinner. I think he really understood the value of trying to galvanise people around him and that made him part of the furniture.

After the accident when he got mugged at Wembley Stadium, Charlotte messaged him saying she's so sorry. The whole McLaren team was being very supportive as well. When Lando went to the factory, he was really subdued, "he was worried because he thought he was going to be in trouble because of the watch getting stolen." Ofc Charlotte gave him a big hug

Charlotte described how different the mood was post Monza vs post Russia, especially during the last few laps, "It felt like the slowest time of my entire life, like watching a slow train crash."

[rumour] Ben Hunt says according to rumours, the contract he signed in mid-2021 (just before Monaco GP) was worth £6m a year, the one he signed beginning of 2022 (current one) was £50m for 4 years

[The End]

[fangirlwriting-stories]

Confrontation

Summary: No One Knows AU Part 27, Danny wants some answers.

Author's Note: Hey, sorry to leave you on the last one for so long, I honestly was planning on posting this one in like, two days, and then I got COVID. So uh, better late than never? Hope you enjoy!

...

Danny remembers where the training grounds are well enough to make it back there, which is good.  He doesn’t want to bother Tucker or Sam for directions, and he has a feeling Valerie and Jazz wouldn’t want to let him go alone.  But he needs one more answer than he currently has, and he doesn’t want to put anyone else at risk to get it.

He didn’t really get a good look at everything last time, since they’d all been such a desperate hurry, but Vlad really put a lot in the place.  The heavy duty ghost training set up is everywhere across the large space, from training bags to some kind of ceiling obstacle course to those dummies that do in fact look just like him.  (He really hadn’t noticed the human ones before.  He’s gonna try not to think about that.)

There’s also the fact that Vlad is sitting off to the side in ghost form, in one of two large plush chairs, sipping something from a mug and looking like he’s been waiting for him.  He smiles at Danny as he notices him.  “Daniel.”

Danny clenches his hands into fists.  “Vlad.”

Vlad gestures at the chair across from him with a smile.  Danny walks over and sits down, making sure his anger and determination both come across on his face.

“I was wondering when you’d stop by,” Vlad says.  “We have a lot to talk about.”

“No shit,” Danny snaps, crossing his arms.

“I think I’ll start,” Vlad says, and Danny grits his teeth.  “So, you held up remarkably well.  Much better than I’d have expected you to.  What didn’t I take into account?”

“My sister,” Danny spits.  “And I’m not here to answer all your questions.  You’re going to tell me something.”

Vlad gives a ‘go ahead’ gesture.  “Sure, Daniel.  A question for a question is fair enough.”

“Why Sam and Tucker?” Danny asks.  “Why them?  If you were just trying to get information, you could have just kept using the spy cameras in Valerie’s suit.  Why did it have to be them?”

Vlad gives him an almost disappointed look, like he expected more from him.  “Daniel, don’t be ridiculous,” Vlad says.  “It didn’t.”

Danny digs his nails into his hands.  “Then why—”

“They were simply the most effective tools to get the job done,” Vlad says with a shrug.

Danny feels an ectoblast start to build up around his hands, but Vlad keeps going.

“I was trying to break you down to a point where you’d accept my offer for a mentorship and we could start building our father-son bond,” he says.  “They were in a place to be easily manipulated as a means to that end.  If you wanted to avoid it, all you had to do was tell them sooner.”

Danny tries to take a breath in and mostly succeeds, but it comes out sharp and jagged.  He thinks of Sam’s desperate tears and panic when she told him what happened, of the lost guilt in Tucker’s face after they saved him.

“You,” he growls out, standing.  “You sick, callous, son of a bItCH—”

A scream comes out along with the last word, but along with it a huge burst of ectoplasmic energy that shoves Vlad suddenly across the room.  And, well.  He actually didn’t know he could do that.  But it works well enough for his end goal of ‘break every goddamn bone in Vlad’s body,’ so he keeps going.  Along with Vlad, he can see the equipment all throughout the room getting knocked over, torn to pieces, or disintegrated, which is also a nice bonus.  Vlad, after a couple seconds, is forced back into human form, which is helpful.

As tends to be the case with new powers, eventually Danny can’t quite keep going, but unlike what tends to be the case with new powers, this time the adrenaline gets him easily across the room and yanking Vlad up by the collar of his suit.

“Sam and Tucker are PEOPLE,” he screams right in his face.  “They’re not PLAYTHINGS for you to use just to get to me!”

Vlad stares at him for a moment, likely surprised at the power output he just witnessed, but seems to get over it quickly.  He chuckles, seeming wholly unbothered by Danny’s statement.  “On the contrary, Daniel, they served that function rather perfectly,” he says.

Danny’s certain his eyes are glowing bright green in rage.  He lets go of Vlad with one hand and summons a ball of ectoplasm, then fires it into the side of Vlad’s head, knocking him to the ground.  For good measure, he slams his foot onto his head to hold him in place.

“If you ever,” he growls, “EVER come near them again, I will shove you into a thermos and let you ROT IN IT.”

Vlad’s face has twisted up slightly in pain.  “And I’m sure your parents will wonder where their old college friend has gone,” he says.

“LOOK ME IN THE EYES,” Danny screams, leaning down into his face, “And see that I do not give a SINGLE SOLITARY FUCK.”

Vlad does, his eyes widen, seeming to finally understand that Danny’s being serious.

“Daniel, for heaven’s sake,” he says.  “You won the chess match.  Why are you so angry?”

Danny bends down and yanks Vlad up by his ponytail.  “I wasn’t PLAYING!  Believe it or not, I do not see what passes for our relationship as an all important chess match!”  Danny drops Vlad to the ground again, buries his head in his hands, and screams for a good couple seconds.  He pulls his head up finally, tries to calm down just a little.  “I was thinking about high school,” he says.  “And how to deal with my new powers.  And figuring out how to tell my friends that I died a couple months ago, and it really fucking sucked, and I wish they’d have been there.”  His voice cracks on the last word.  He shakes it off and turns his hate filled gaze back to Vlad.  “Newsflash, fruitloop, unless you show up to make yourself a nuisance, I don’t think about you.”

Vlad stares at him, clearly confused.  “But,” he says slowly, sitting up.  “I’m… I’m the only other being in existence that’s like you.  I’m the only one who could possibly understand.”

Danny laughs, because that’s hilarious, and what else is he supposed to do with this massively fucked up situation?

He glares at Vlad one last time, putting into his eyes all of his rage and hatred and a little bit of the grief he’s suffered at this fucker’s hands.

“If you ever come near Sam and Tucker again, I will make you regret it,” he says.  Then he turns and leaves Vlad in the ruined remains of his training grounds.  He slams the door on his way out.

[liesmyteachertoldme]

You are the hero you've been waiting for.

Like clockwork, the WHO has just declared Monkeypox a “public health emergency of international concern.”

Anyone paying the slightest bit of attention to our rapidly declining world can see that we are headed for another (if not a series of) planned events. It will be fascinating to see how many Americans will submit this time around.

When we pulled back the curtain on COVID in 2020, few were ready to see what was being revealed. Today, most people have come to terms with the heartbreaking fact that we are the target of a very dark, anti-human, anti-nature, anti-family, and anti-God agenda. Those who have yet to see, don’t want to see. As they say, “ignorance is bliss.” What they don’t tell us is, blissful ignorance has an expiration date. Soon, even the mask wearers will be forced to see the harsh reality they’ve helped to create.

The question is, how bad does it have to get before we, the people, get off our asses and do something? Where are the men of this Nation? Where are the fathers? If you’re one of the few who have given your life to this historic moment, God bless you! If you’re one of the millions who have yet to stand up and speak out, what are you waiting for? Seriously. Gloves off. 

What we’re facing is nothing new. The masses have always been controlled by small groups of narcissistic tyrants. Go back as far as the cradle of civilization and ask yourself, “How did they do it? How did a few fat and flimsy royal types overpower thousands of behemoth slaves in an era prior to guns and surveillance?"

Answer: Mind control.

Not much has changed since then. However, what has changed is significant! Today, we have the ability to share information, person-to-person, on a global scale. The very technologies that are being used to destroy us can also be used to sustain us. What we have at our fingertips no people in history have ever had access to. We have the ability to be the first generation to stop history from repeating itself. Social media can be used as a weapon or as a tool. It is a bullhorn that can be used to amplify your voice or theirs. To spread your truth or their lies.

I’ve always found it fascinating that The Holy Bible states, “In the beginning was the word,” and that the very first amendment of the US Constitution is about the protection of free speech. Our voices matter. YOUR voice matters. Now more than ever! Are you going to allow another round of assaults against your civil and human rights, or this time will you say something? Will you allow the discomfort of disagreeing with your friends and family to stop you from doing what you know is right, or will you stand in the fire in the name of love and life? Contrary to the plot of every Marvel movie, there is no superhero coming to save us. For well over 30 years, I’ve been studying the work of Joseph Campbell, who dedicated his life to mapping what he called The Hero’s Journey. What Mr. Campbell discovered was that there’s a common thread within the stories humans have been sharing since the beginning of time. It goes something like this…

An everyday person is confronted by a challenge between life and death. A challenge far too big for them to handle… or so they think. They set out on a quest to find a hero with the strength to take on the challenge. Along the way, they endure trials and tribulations that push them beyond their personal boundaries of self-imposed limitations. What doesn’t kill them only makes them stronger. Ultimately, what they discover is, “the force is within. I am the one.”

This is your journey. Your story. You are the hero you've been waiting for.

Mikki Willis Father / Filmmaker  

[alyosiuscreightonward]

Dear Diary. Sigh. The voices inside my head.

I’ve been thinking and doing so very much over the past months since The Queen left the building. Apparently I was triggered by what others had commented online about her homecoming. Back then I was in a different state of mind. I was just so fucking stupid, ignorant and weak minded that I had been that fucking comatose to have even given it a second thought. I had to step away and just enjoy exactly how ill-informed I am about the world. The cacophony was just so brilliant that I couldn’t believe how I did not realize how desperate I was until I saw myself from a very different perspective: my head was so far up my ass. In that instance, it would have appeared to be that I was in a dryer at the laundromat. The clothes, like me, were going in a circle, around and around, and sitting on the other side in a plastic chair looking at it through the dryer window. It would’ve stopped eventually but I allowed it to go down into an abyss.

I’ve been trying not to self-flagellate and I’m still just beating myself up for being Sargent Skidmark, a true shit stain. You should ask, “How can you stand yourself? I mean, as a lint licker, you’re truly just eradicating your very existence.”

There are many moments when I feel like I’m nothing more than glioblastoma and I’ve metastasized into something so toxic that radiation can be welcoming. Imagining that the very first moment of an explosion is when destruction is inevitable but it’s considered a hug.

It’s almost as if I don’t care about the fact that I have been sober for 30+ years. It’s as if I have a deep desire to live in a cardboard condo underneath a highway overpass. Like I wanted Covid and I wanted to be infected with the virus. I am like my dog, Harry, starting shit and then when it hits the fan, I immediately cower in the darkest shadow pleading for the slightest hint of a sound to come out yet I recoil from the assumption that I could actually use the help.

Recently I’ve been using the tools available to me. I’ve been working with two different therapists. I’ve been taking medication. I’m learning how to use those tools to help me. Also I’m going through another phase in my life’s journey, I’m back in the vet tech field and during the process of this new job, I find myself in a position of being the smartest person in the room. I’m also petrified knowing that.

I can see that the other people I work with have had different experiences than I. Very simply, different universes. Now, they’re just coming together and not colliding into a supernova of “you’ve never been.” We’re going to find out where we stand and how we can contribute to each other’s success.

I laughed at that last sentence. Me and my self-deprecating behavior. I know I have to cope with my low self esteem because in the work environment, I appear to be the smartest person in the room and I’m not sure how to handle that.

Anyway, I am doing better than I had expected. I’m still learning how to take care of myself and realize that sometimes I need to do that.

…too funny…after all this bullshit, I’ve changed my mind and my attitude. See what a few days can do. Like Elsa, I let it go.

[aulunthe]

Reblogging this because sometimes, one person's truth is not the truth. A little critical thinking can often clear up outdated information and conspiracies. This video, even in its entirely has had a lot of traction from the duller tools in the tool shed on YouTube. This was posted on November 28th, 2022. It was 1:39 partial clip of a 7:36 Maddow Show segment. That's how pushers of disinformation work. They cherry pick bits and pieces of what will fit their narrative.

Rachel Maddow suggests, based on just published information from the CDC, that vaccines could stop COVID and prevent it from being spread from one person to another, but there is a lot more context to her statement than is captured in the above mini-clip.

That "The Rachel Maddow Show" segment was on March 30, 2021 when efficacy was not fully understood or known, and it was her understanding of what was just published and partially the belief at that time period. Today however we know that it can be contracted by a person vaccinated and spread to others as well. We also know that those who are vaccinated have a lesser chance of getting severely ill, having to be hospitalized, and less chance of death. This of course is dependent on whether a person has other underlying health issues. We also know that those who are not vaccinated have a greater chance of severe illness, hospitalization and death. And, those who spread disinformation which prevents others from getting vaccinated can lead to their hospitalization and/or death if they contract COVID. I also know this for a fact from personal experience. A cousin, and a long time friend and associate were both reluctant to get vaccinated due to conspiracy theorists, both contracted COVID, and both died. Another person living close by contracted COVID, had refused to get vaccinated, and wound up in the hospital for 2 weeks and was originally not expected to survive. He did recover but still has issues when exerting himself, months later. His wife who was vaccinated caught it from him and only had cold-like symptoms. Others living close by, husband and wife who were both vaccinated, wife contracted it during overseas travel, had cold-like symptoms. Her husband caught it from her when she returned home, no symptoms at all, 70 years old.

The first vaccines were administered in mid December 2020. First the Pfizer/BioNTech, and then the Moderna was given FDA emergency use authorization on Dec. 18, 2020.

That Maddow show episode is just a little over 3 months after the first vaccines were approved and administered, and 11 months after TFG suggested injecting disinfectants into the lungs; "And then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that. So, that, you’re going to have to use medical doctors with. But it sounds — it sounds interesting to me."

Trump suggests injecting disinfectants into the lungs on 4-23-2020 at a Coronavirus Task Force Press Briefing. Despite right wing disinformation (and his propaganda minister at the time) stating Trump was "musing", he was asking Bill Bryan, the head of the science and technology directorate at the Department of Homeland Security, the questions directly. Bryan had just completed a presentation and mentioned studies being done, and the effectiveness of disinfectants such as bleach and isopropyl alcohol on non-porous surfaces such as door knobs and stainless steel. Also the effectiveness of UV light (sunlight) in certain situations. Trump was not "musing", he was seriously asking the expert a question based on his thoughts. He first denied saying it when criticized, then admitted he said it by saying he was trying to trick the press in the room or some lame excuse like that.

* WARNING - THE FOLLOWING VIDEO CONTAINS MISINFORMATION *

RACHEL MADDOW - 29 MARCH 2021

[tanadrin]

TBH after reading the first paragraph of your latest post I thought the rest of it was going to be "and here's why all of that is laughably retarded and my take on how our institutions are captured by lysenkoists" - entire fields are badly wrong often, especially nutrition, why do you buy it?

I buy it because the science is reliable.

I don't know how you could characterize nutrition science as "captured by lysenkoists" in any form, unless by "lysenkoist" you just mean to generally disparage science you think is politically motivated. "X field is Lysenkoism" seems usually to be a lazy critique by people who want to dismiss politically inconvenient research without engaging with the substance of why they think a field or sub-field is wrong, which is the least interesting kind of critique.

The human body is complicated, so nutrition is hard to study. That sounds quite simple on its own, but it's very difficult to underrate the complexity of systems developed by random mutation and selection. I remember an anecdote I read once about circuits designed via genetic algorithm, which produced results that were difficult to understand. Individual elements usually had multiple overlapping functions, and there was one that had a closed loop totally unconnected to the rest of the device--but if you removed it it totally stopped functioning. Only after some serious investigation did the experimenters determine this was because of some kind of weak electrically-induced effect that this loop produced, which was nonetheless critical to the circuit's function. Most biological systems are designed in a similarly infuriating way, and the algorithms that produce them have been running for millions of years. On top of that, it's difficult to observe the human metabolism in action, and we're still not equal to the task of simulating it at any kind of realistic detail.

I think like a lot of biology, nutrition and food science has done quite a lot of impressive stuff given those restrictions, but "what are the causes of fatness in general, and the obesity epidemic in particular" are narrower questions that we've focused on intently only for a few decades. The obesity epidemic is recent, and for most of its history the science of food and nutrition has been concentrated on more pressing issues like how do we feed a rapidly growing world population, and prevent dietary diseases like rickets and pellagra, and not "what is the precise relationship of fatness to various health conditions, and what factors most directly control fatness."

The stuff you refer to as "laughably retarted" is what falls out of the evidence as soon as you start looking at it in any detail. These aren't controversial or difficult-to-replicate results--they're out of step with the common medical wisdom in some ways, but only because the common medical wisdom is often laughably retarded. Some doctors still get taught as fact that black people feel pain less acutely than white people, and until COVID hit and forced us to reexamine the evidence, common medical wisdom totally misunderstood how airborne particulates worked, based on a single totally misinterpreted study from a hundred years ago, even though any air pollution scientist could have set them straight. Because of a single anecdote by one researcher (I think Kinskey, but correct me if I'm wrong), a lot of gynecologists seem to think the cervix feels no pain at all, meaning IUDs are commonly inserted using sharp-tipped forceps to hold the cervix--and while this is fine for some, others find it excruciatingly painful, because it turns out that the sensitivity of the cervix to pain varies wildly among individuals. And these areas--pain, airborne disease, and gynecology--are comparatively tractable to study.

We have known since time immemorial that if you starve, you get thin and eventually die. Since 1761, we've had calorimeters that can give us a rough guess on the energy contained in food; and with those two tools you can rough out at basic CICO model. You could stop there, and treat all subsequent developments in the area as Lysenkoism because they didn't conform to your prior assumptions on what fatness is and means, but then you'd have no tools to understand questions like why obesity began rising toward the end of the 20th century, long after wealthy industrialized countries moved to a more sedentary lifestyle, how appetite relates to actual food consumption and exercise, what the metabolic effects of different foods are, the role of gut bacteria in health and how they're influenced by diet, and lots of other interesting questions. And, well, that would be laughably retarded.

[feelingbluepolitics]

We Must Handle the Truth

There's no question that the management of Donald trump will be an issue of on-going global importance. Knocking him from his (alleged) official perch is only the first step.

The more crucial steps must follow, because trump will retain his influence and his supporters, and they will do whatever he hints that he wants, even up to treasonous attacks, assassination attempts, and mass murders.

We must be clear. There is no cozy "look to the future and heal" pretence of an option in our present situation. This is aside from the fact that taking that Pollyanna path repeatedly --from Watergate to Reagan to Bush-- helped to criminalize and radicalize the Republicon Party into the danger they are today.

Shame, honor, and true patriotism have become vestigial on the Right. Their criminal administrations and elected representatives keep getting away with what they do because we embolden them each time with a blind eye.

That is not how justice works. The blind eye of justice means that no one, no matter how powerful, is exempt. The time to work on that is January 20, 2021, and we are far overdue. Politicians, corporations, tax cheats, polluters: we still have laws, for all of trump's and his administration's destructive efforts.

We sully our government offices and endanger our nation by not requiring accountability to the office and to the people, over and above any present occupant. Where we are blocked by pardons we must still have thorough public investigation. That is not a waste of time for lack of a prosecutorial path. It is existential. It's the accountability we cannot do without. It's the foundation of the future laws we need to draft and pass to safeguard this country.

Pardons become entirely corrupt when we acquiesce to them blocking investigation. Democracies survive on information and truth, combined. We are where we are now in part because we still have corrupt actors left-over from Watergate active in our politics.

What are we to do about trump? That isn't initially, or perhaps ever, all about pardons, or state versus federal charges, or orange jumpsuits. In this instance, ironically, the potential solution is all about trump. This is where an examination of how trump interacts with the rest of the human world can guide us.

He forms specific categories of relationships which are actually invariable, because he is permanently shallow and unperceptive. Because trump the consumate narcissist is always the center of every relationship, and because he is, without introspection, forever fixed in all his defects, all of his various relationships fall into the same patterns within their categories. Here they are:

1) The Strongmen. Shades of daddy Fred trump, these are aspirational relationships teaching the type of utter control the core pathetic trump would like to wield. But because of daddy, trump is conditioned to the "love me, admire me, and be useful and loyal or I will harm or destroy you" format, but on the weaker side.

This is why we have seen trump pushing the United States of America into eagerly obsequious deference with respect to Russia, North Korea, and Turkey, and also pandering to Saudi Arabia's power which is additionally derived through vast transactional wealth.

But we cannot and do not want to transform America or Biden into this Strongman mold, because then it will have been pointless to remove trump.

2) The Assets. This category comprises trump's immediate family members and all Republicons in office, from Mitch McConnell to Kevin McCarthy, and from Michigan’s Republicon Senate members to, potentially, Gorsuch, Kavanaugh, and Barrett. This category also extends to trump's supporters, mostly as a collective.

These are the flipside of the Strongman category, where trump gets to play the opposite role. These people are tools, who work constantly to remain in good standing with trump, rendering obsequious deference and servitude as a matter of advantage but also, essentially, as a matter of status survival.

trump is a horrible antagonist or enemy.

This, by the way, is exactly the relationship this country cannot continue to allow with trump, as a matter of national security.

3) The Targets. We know who they are. They caught trump's wrathful attention. Some of the targets are personal to trump to varying degrees, while some are a matter of expediency, or are demonstrated examples, or are, so far, peripheral.

But everybody knows trump will never stop -- that is the personna he cultivated-- unless a Target person has something of value to make them an Asset again. (This is why trump is called purely transactional, in combination with having no beliefs, no morality, and no honesty.)

Fauci, and Birx, (who for a while pulled off a mommy-style interaction with trump as he tried to impress her with nifty genius like injecting bleach), are in a no-man's land, transitional between Asset and Target, in part because trump doesn't like attention on covid if he can help it.

We don't know exactly what trump will try to inflict on Mary trump for writing her book, but we've already seen a variety of attacks against Bolton, Kelly, and Michael Cohen, along with innumerable others. (It isn't just books. It's that these people did not keep flattering, and obey.)

He ousted from political power Jeff Sessions, Jeff Flake, Bob Corker (White House as "an adult day care center"), and Mark Sanford, of "the Appalachian Trail." He can do the same to any other individual Republicon, because as a group, they are all too backstabbing, dishonorable, greedy, and cowardly to unite against him.

Certainty we have seen trump's behavior with respect to Fox Gnus, the Clintons, and Obama.

This is the relationship this country cannot allow itself to fall into with trump. But how possibly to prevent it?

For that, we look to another category of trump's relationships.

4) The Survivors. Of those not in the Strongman category, there are few people who have survived relationships with Donald trump and who can get trump to do favors for them -- to do what they want.

It is dangerous idiocy to call them trump's "friends," by way of explaining their leverage and longevity. The key is leverage.

Rudy Giuliani :

- A "very, very good relationship" with trump.

- "I've seen things written like he's going to throw me under the bus. When they say that, I say he isn't, but I have insurance."

- "I do have very, very good insurance."

Giuliani's insurance is knowledge; some knowledge about trump gives him leverage. The leverage has to represent knowledge that trump fears exposure of or consequences for. Giuliani doesn't fear being otherwise loose-lipped, or even crazy, and his relationship with trump is currently letting him pull in $20,000 a day for "legal work."

Roger Stone :

"[trump] knows I was under enormous pressure to turn on him. It would have eased my situation considerably. But I didn't."

This leverage allowed Stone to openly demand clemency from trump regardless of any amount of political capital it could potentially cost.

The succession of wives, too, possess whatever personal knowledge, likely far more powerful than negotiated pre-nups and settlements, which ensure the notorious litigious deadbeat abides willingly by contractual terms.

As a nation, we need to survive trump. We have observed what works. But as a nation, we must address the issue of trump just a bit differently. Unlike Giuliani, Stone, or even Putin’s special holds over trump, we must:

1) Investigate trump extensively. Entirely. Turn him inside-out. And then,

2) Make the findings public. This is where a nation, a government of, by, and for the people in a country ruled by law and not kingdoms or cults, differs from defensive black-mailers or manipulative foreign spies.

This part, making public everything that doesn't actually threaten our national security to reveal, is necessary to harden both our resolve and our democracy, and to peel off whatever of trump's support that we can, and to deter the next trumpian assaults, whether by trump or the people who will try to follow the path trump has scorched into the fabric of our nation.

Public reveals are also a safety measure. There is vast potential for corruption otherwise. But then,

3) Keep every single trump-related criminal prosecution -- legitimate, of course, because we are not trump -- on the table. That is the leverage.

That's how to survive trump. There must be no more talk of how investigating a former *resident will turn us into a "banana republic." In a so-called banana republic, powerful government officials pressure others, either to carry out vendettas, or favors of protection by "looking the other way". Government is bent toward personal exploitations. Been there. Done that these past four years under trump and Republicons.

They have actually installed what can be termed "a deep state," notably for the first time, and sane Americans must know its extant. Fcuk their cries of victimization and oppression of the Right. The only difference is, when we investigate, there are actual violations, crimes, and scandals, with evidentiary proofs; when conservatives investigate, it's fundamentally bullsh*t-and-paranoia based.

A "banana republic" is exactly what we are attempting to rescue our nation from. With all the recognition that the Right has systematically unmoored from truth, and the terrible dangers that threaten as a result, from a stupid civil war born of propaganda, to climate devastation, as much truth as we can discover is what we need.

Knowledge is power. With trump out of the White House, we can get it. We must have it.

[poedameronloverx]

Close To Home

Life In Lockdown Masterlist

Pairing - Poe Dameron x F! Solo Reader

Warnings - Massive amounts of Covid talk in this chapter as it starts to effect our lovely little squad, so if that upsets you please don’t read, I don’t want anyone to be triggered or upset by this content <3

Month 2 – April 2020

As the weeks went on, you found yourself getting more and more used to remote working. Your boss had made a lunch time finish on a Friday a weekly thing and you were grateful for it. Poe was getting every Friday off, and Rose got to finish at 3pm on a Friday. You and Poe were working round each other better, you’d gotten used to his singing and he got used to you getting up to wander round the room and stretch every hour or so. The novelty of having people around all day had worn off for BeeBee, he would choose to spend an entire day with either Poe or you and lie by your feet for the day. Rose’s idea of doing something each evening had stuck and you had set up a weekly plan of things to do. Movie nights became a Friday night tradition. Rose had ordered relaxation colouring books for each of you and that became your Monday night routine. There was a YouTube marathon on Tuesdays, you’d all found a series to binge together on Wednesdays and you played board games on Thursdays. Poe was teaching you to cook, you could make basic things but he was much better than you were and you’d asked him to help you learn. Rose loved teasing your about how cute you both looked and how domestic it was. Things were still strange but everyone was getting used to it.

Rose and Finn occasionally took walks after work, just the two of them. Poe had just arrived back home with BeeBee. He wandered into the living room and found you sitting on the sofa crying your eyes out. He was by your side in an instant, pulling you into his arms and rubbing your back.

“Sweetheart, what’s wrong?”

“My dad” you sobbed “He has the virus; he’s in the hospital on a ventilator”

“Oh sweetheart, I’m so sorry!” he pulled you tighter “He’ll be fine, I’ve never met a man as strong and stubborn as Han Solo!”

“Mum said he’s really ill, she’s not even allowed to go and see him”

“It’s not fair”

“I just want to go and see mum and hug her”

“I know sweetheart, I know”

Poe held you until you eventually cried yourself to sleep. He pulled you onto him, and grabbed the blanket from the back of the sofa and draped it over you. BeeBee jumped up onto the sofa and lay by your legs. Your body heat and the heat from the blanket lulled Poe to sleep. When Finn and Rose came back a little while later they eyed you suspiciously. The sound of Rose’s keys against the coffee table woke Poe.

“This looks romantic” Finn said

“Far from, I’ve just held her whilst she cried herself to sleep” Poe replied, glaring at his friend

“What’s wrong?” Rose asked

“Han’s got the virus; he’s in hospital on a ventilator”

“Oh my god, when did that happen, is he alright?”

“I don’t really know” Poe shrugged “She was really upset, I only got the basic information from her”

“I’ll phone Leia” Rose replied “To get more information but also to check on her”

Finn nodded “That's a good idea”

“I should text Ben.” Poe said “Then we need to work out what to do here. I don't want to put her to bed before dinner, I know she’s exhausted herself crying but she needs food in her system, as much as she probably won’t want it”

“We can make a start on dinner, wake her when it’s ready and make sure she eats at least a little then she can get some sleep” Finn said

Poe managed to lift you off him enough to move, he laid your head on a pillow and made sure the blanket still covered you. BeeBee got up and moved along the couch so he could snuggle against your stomach. Poe headed to the kitchen and made a start on dinner with Finn’s help. Rose sat on the bottom stair and called Leia. She was on the phone for 10 minutes before joining the guys in the kitchen.

“What did she say?” Finn asked

“He had a few symptoms so they called the doctor yesterday and he was told to go in and get checked out, they didn't want to worry Y/N and Ben so they just kept it between them at that point, the hospital got him tested and obviously he had it so they said he would get kept in overnight but he started to struggle to breathe so they put him on the machine. They don’t know when or if he’ll come back around”

“Oh god” Finn replied

“We just have to take care of her” Rose said “We know how close she is to her parents and not being able to be with them is going to be so hard for her”

“She has us” Poe replied “And we’ll be here for her day and night, no matter what time”

“Absolutely” Rose nodded “I’ll wake her for dinner”

The next week was difficult, you’d asked for some time away from work as you knew you would never be able to concentrate whilst your thoughts were all about your father. He hadn’t been getting better but he also hadn’t gotten any worse, which the doctors said was a really good thing. Poe and Rose had both taken a few days off to make sure someone was with you and helping keep your mind off things. You and Poe were on a walk with BeeBee one afternoon when your phone rang.

“It’s mum” you said to Poe before answering the phone. He gently took hold of your arm and led you over to a wall where you could sit. He could only hear your side of the conversation but the fact you hadn’t burst into tears yet made him feel more positive. “I’ll speak to you later mum, love you. Bye”

“How’s things?”

“Dad came off the ventilator this morning” you replied, happy tears appearing in your eyes “He’s breathing on his own and the doctors are really happy with his progress”

“That’s great news sweetheart. And it’ll be a load off your mind knowing he’s doing okay”

“Yeah, it really is” you replied “Thank you, you’ve helped keep me going this last week or so. I really appreciate it”

“I’m here for you anytime sweetheart” Poe replied

“I appreciate it more than you'll ever know. It's been so scary seeing all the stuff on the news, I guess I just didn't think it would end up so close to home”

Poe held his arms open and you fell into his hug gratefully. Poe gave the best hugs in the entire world. He hugged tightly and it made anyone he hugged feel secure and content.

Easter was very much a non event, the weather wasn't great so you were inside all day. Poe cooked a nice meal for everyone and you sat and watched a lot of TV whilst eating all of the Easter snacks you'd ordered in with the food shop. You were all happy to have a few days off work, Finn had a few weeks off whilst the schools were closed for the spring break. A few days after Easter, your father was released from the hospital. He still wasn't 100% back to his normal self but he was really glad to be back in his own home. You face-timed with him and your mother every day, just to check up on how they were both doing. You knew it wasn't easy on Leia either. She had to take care of Han plus do everything herself at home, whilst trying to work. Finn decided to take up gardening whilst he had free time, he ordered loads of plants and gardening tools online and got to work as soon as they arrived. Your garden had never really been full of plants because you and Rose were always too busy and neither of you were that into gardening. Finn cut down all the bushes, planted loads of flowers and painted the fences. The small fence that separated the patio from the grass was painted a sky blue and all of the surrounding fences were white. Poe helped Finn with the painting, whilst you and Rose cleaned up all the garden furniture. Once you were done, it looked like a whole new garden.

As the month went on, things with everyone's work got quieter. You were no longer working full days, Monday to Wednesday you only worked from 11am until 3pm, Thursday you worked 9am-12pm and Friday was a day off. Rose only had to work Mondays, Wednesdays and Fridays. Poe no longer had to do any work. He was luckily still getting paid but his work just didn't have anything else they could do remotely. They told him to keep checking his work emails just incase anything did come in. It took a while to adjust to all of the free time. Working from home had been strange anyway but only working for part of the time made it even weirder. Finn was still working his normal hours after the school break. Friday became a cooking day. Poe continued to teach you how to make meals, and sometimes the pair of you would bake.

Rose liked to come on walks with BeeBee when she had the spare time, the park was everyone's favourite place to go. It became a lifeline to everyone. The stay at home order still said you were only able to go out once a day for some exercise. You all began to look forward to walk time so you could get to your park. You could walk all the way round it twice before BeeBee got bored. You would always stop at the kiosk and get a coffee or an ice cream, whilst the dog ran after his ball.

“This is his dream” Poe chuckled as he watched Rose throwing the ball “He's getting to spend time with people he loves, he's getting much longer walks than normal and he gets to run after his ball a lot”

You smiled “Animals must be loving this lockdown thing, they get to spend so much time with their humans and don't have to stay home alone all day”

“Bee is loving living with you and Rose. He's always really happy when you guys come to visit us so all of us living together is great for him”

“I'm actually really enjoying it too, I had my reservations at first. Especially when Rose just mentioned Finn moving in. I didn't want to be the third wheel in my own home. And even when she said you were coming too, I wasn't sure we'd all manage to work around each other but thankfully we have and I couldn't be happier to be spending this lockdown with you guys. Especially with how much you helped me when my dad was ill”

“I'm glad we're all together too. It's made things feel so much better knowing that anytime I have a bad day I get to spend it with my best friends. Living with Finn is great but sometimes when him and Rose are all loved up it gets a bit annoying. I mean not that I'm not happy for them because I absolutely am, they're a great couple but yeah”

“No, I totally get that. Being the 3rd wheel isn't easy” you nodded “They're adorable, but sometimes it sucks to be left out so I'm glad we have each other during this lockdown”

“Me too, I think you're the only one that gets what it's like to be 3rd wheel to them” Poe chuckled

The final few days of the month were difficult, Rose fell ill with suspected Covid. She had all of the symptoms but she didn't feel overly ill. Finn moved into the spare room with Poe, he didn't want to get ill whilst he was still so busy with work. You looked after Rose, bringing her food and plenty of fluids to keep her going. You were glad that she didn't have a really bad case of it, but you worried for the rest of you.

So here’s the next part. I hope if you read this far that you enjoyed it and you’re still enjoying the series. Your comments would mean the world to me <3 Have a lovely weekend!

[dornish-queen]

Pedro Pascal on Fame and ‘The Mandalorian’: ‘Can We Cut the S— and Talk About the Child?’

By Adam B. Vary

Photographs by Beau Grealy

When Pedro Pascal was roughly 4 years old, he and his family went to see the 1978 hit movie “Superman,” starring Christopher Reeve. Pascal’s young parents had come to live in San Antonio after fleeing their native Chile during the rise of dictator Augusto Pinochet in the mid-1970s. Taking Pascal and his older sister to the movies — sometimes more than once a week — had become a kind of family ritual, a way to soak up as much American pop culture as possible.

At some point during this particular visit, Pascal needed to go to the bathroom, and his parents let him go by himself. “I didn’t really know how to read yet,” Pascal says with the same Cheshire grin that dazzled “Game of Thrones” fans during his run as the wily (and doomed) Oberyn Martel. “I did not find my way back to ‘Superman.'”

Instead, Pascal wandered into a different theater (he thinks it was showing the 1979 domestic drama “Kramer vs. Kramer,” but, again, he was 4). In his shock and bewilderment at being lost, he curled up into an open seat and fell asleep. When he woke up, the movie was over, the theater was empty, and his parents were standing over him. To his surprise, they seemed rather calm, but another detail sticks out even more.

“I know that they finished their movie,” he says, bending over in laughter. “My sister was trying to get a rise out of me by telling me, ‘This happened and that happened and then Superman did this and then, you know, the earthquake and spinning around the planet.'” In the face of such relentless sibling mockery, Pascal did the only logical thing: “I said, ‘All that happened in my movie too.'”

He had no way of knowing it at the time, of course, but some 40 years later, Pascal would in fact get the chance to star in a movie alongside a DC Comics superhero — not to mention battle Stormtroopers and, er, face off against the most formidable warrior in Westeros. After his breakout on “Game of Thrones,” he became an instant get-me-that-guy sensation, mostly as headstrong, taciturn men of action — from chasing drug traffickers in Colombia for three seasons on Netflix’s “Narcos” to squaring off against Denzel Washington in “The Equalizer 2.”

This year, though, Pascal finds himself poised for the kind of marquee career he’s spent a lifetime dreaming about. On Oct. 30, he’ll return for Season 2 as the title star of “The Mandalorian,” Lucasfilm’s light-speed hit “Star Wars” series for Disney Plus that earned 15 Emmy nominations, including best drama, in its first season. And then on Dec. 25 — COVID-19 depending — he’ll play the slippery comic book villain Maxwell Lord opposite Gal Gadot, Chris Pine and Kristen Wiig in “Wonder Woman 1984.”

The roles are at once wildly divergent and the best showcase yet for Pascal’s elastic talents. In “The Mandalorian,” he must hide his face — and, in some episodes, his whole body — in a performance that pushes minimalism and restraint to an almost ascetic ideal. In “Wonder Woman 1984,” by stark contrast, he is delivering the kind of big, broad bad-guy character that populated the 1980s popcorn spectaculars of his youth.

“I continually am so surprised when everybody pegs him as such a serious guy,” says “Wonder Woman 1984” director Patty Jenkins. “I have to say, Pedro is one of the most appealing people I have known. He instantly becomes someone that everybody invites over and you want to have around and you want to talk to.”

Talk with Pascal for just five minutes — even when he’s stuck in his car because he ran out of time running errands before his flight to make it to the set of a Nicolas Cage movie in Budapest — and you get an immediate sense of what Jenkins is talking about. Before our interview really starts, Pascal points out, via Zoom, that my dog is licking his nether regions in the background. “Don’t stop him!” he says with an almost naughty reproach. “Let him live his life!”

Over our three such conversations, it’s also clear that Pascal’s great good humor and charm have been at once ballast for a number of striking hardships, and a bulwark that makes his hard-won success a challenge for him to fully accept.

Before Pascal knew anything about “The Mandalorian,” its showrunner and executive producer Jon Favreau knew he wanted Pascal to star in it.

“He feels very much like a classic movie star in his charm and his delivery,” says Favreau. “And he’s somebody who takes his craft very seriously.” Favreau felt Pascal had the presence and skill essential to deliver a character — named Din Djarin, but mostly called Mando — who spends virtually every second of his time on screen wearing a helmet, part of the sacrosanct creed of the Mandalorian order.

Convincing any actor to hide their face for the run of a series can be as precarious as escaping a Sarlacc pit. To win Pascal over in their initial meeting, Favreau brought him behind the “Mandalorian” curtain, into a conference room papered with storyboards covering the arc of the first season. “When he walked in, it must have felt a little surreal,” Favreau says. “You know, most of your experiences as an actor, people are kicking the tires to see if it’s a good fit. But in this case, everything was locked and loaded.”

Needless to say, it worked. “I hope this doesn’t sound like me fashioning myself like I’m, you know, so smart, but I agreed to do this [show] because the impression I had when I had my first meeting was that this is the next big s—,” Pascal says with a laugh.

Favreau’s determination to cast Pascal, however, put the actor in a tricky situation: Pascal’s own commitments to make “Wonder Woman 1984” in London and to perform in a Broadway run of “King Lear” with Glenda Jackson barreled right into the production schedule for “The Mandalorian.” Some scenes on the show, and in at least one case a full episode, would need to lean on the anonymity of the title character more than anyone had quite planned, with two stunt performers — Brendan Wayne and Lateef Crowder — playing Mando on set and Pascal dubbing in the dialogue months later.

Pascal was already being asked to smother one of his best tools as an actor, extraordinarily uncommon for anyone shouldering the newest iteration of a global live-action franchise. (Imagine Robert Downey Jr. only playing Iron Man while wearing a mask — you can’t!) Now he had to hand over control of Mando’s body to other performers too. Some actors would have walked away. Pascal didn’t.

“If there were more than just a couple of pages of a one-on-one scene, I did feel uneasy about not, in some instances, being able to totally author that,” he says. “But it was so easy in such a sort of practical and unexciting way for it to be up to them. When you’re dealing with a franchise as large as this, you are such a passenger to however they’re going to carve it out. It’s just so specific. It’s ‘Star Wars.'” (For Season 2, Pascal says he was on the set far more, though he still sat out many of Mando’s stunts.)

“The Mandalorian” was indeed the next big s—, helping to catapult the launch of Disney Plus to 26.5 million subscribers in its first six weeks. With the “Star Wars” movies frozen in carbonite until 2023 (at least), I noted offhand that he’s now effectively the face of one of the biggest pop-culture franchises in the world. Pascal could barely suppress rolling his eyes.

“I mean, come on, there isn’t a face!” he says with a laugh that feels maybe a little forced. “If you want to say, ‘You’re the silhouette’ — which is also a team effort — then, yeah.” He pauses. “Can we just cut the s— and talk about the Child?”

Yes, of course, the Child — or, as the rest of the galaxy calls it, Baby Yoda. Pascal first saw the incandescently cute creature during his download of “Mandalorian” storyboards in that initial meeting with Favreau. “Literally, my eyes following left to right, up and down, and, boom, Baby Yoda close to the end of the first episode,” he says. “That was when I was like, ‘Oh, yep, that’s a winner!'”

Baby Yoda is undeniably the breakout star of “The Mandalorian,” inspiring infinite memes and apocryphal basketball game sightings. But the show wouldn’t work if audiences weren’t invested in Mando’s evolving emotional connection to the wee scene stealer, something Favreau says Pascal understood from the jump. “He’s tracking the arc of that relationship,” says the showrunner. “His insight has made us rethink moments over the course of the show.” (As with all things “Star Wars,” questions about specifics are deflected in deference to the all-powerful Galactic Order of Spoilers.)

Even if Pascal couldn’t always be inside Mando’s body, he never left the character’s head, always aware of how this orphaned bounty hunter who caroms from planet to planet would look askance at anything that felt too good (or too adorable) to be true.

“The transience is something that I’m incredibly familiar with, you know?” Pascal says. “Understanding the opportunity for complexity under all of the armor was not hard for me.”

When Pascal was 4 months old, his parents had to leave him and his sister with their aunt, so they could go into hiding to avoid capture during Pinochet’s crackdown against his opposition. After six months, they finally managed to climb the walls of the Venezuelan embassy during a shift change and claim asylum; from there, the family relocated, first to Denmark, then to San Antonio, where Pascal’s father got a job as a physician.

Pascal was too young to remember any of this, and for a healthy stretch of his childhood, his complicated Chilean heritage sat in parallel to his life in the U.S. — separate tracks, equally important, never quite intersecting. By the time Pascal was 8, his family was able to take regular trips back to Chile to visit with his 34 first cousins. But he doesn’t remember really talking about any of his time there all that much with his American friends.

“I remember at one point not even realizing that my parents had accents until a friend was like, ‘Why does your mom talk like that?'” Pascal says. “And I remember thinking, like what?”

Besides, he loved his life in San Antonio. His father took him and his sister to Spurs basketball games during the week if their homework was done. He hoodwinked his mother into letting him see “Poltergeist” at the local multiplex. He watched just about anything on cable; the HBO special of Whoopi Goldberg’s one-woman Broadway show knocked him flat. He remembers seeing Henry Thomas in “E.T.” and Christian Bale in “Empire of the Sun” and wishing ardently, urgently, I want to live those stories too.

Then his father got a job in Orange County, Calif. After Pascal finished the fifth grade, they moved there. It was a shock. “There were two really, really rough years,” he says. “A lot of bullying.”

His mother found him a nascent performing arts high school in the area, and Pascal burrowed even further into his obsessions, devouring any play or movie he could get his hands on. His senior year, a friend of his mother’s gave Pascal her ticket to a long two-part play running in downtown Los Angeles that her bad back couldn’t withstand. He got out of school early to drive there by himself. It was the pre-Broadway run of “Angels in America.”

“And it changed me,” he says with almost religious awe. “It changed me.”

After studying acting at NYU’s Tisch School of the Arts, Pascal booked a succession of solid gigs, like MTV’s “Undressed” and “Buffy the Vampire Slayer.” But the sudden death of his mother — who’d only just been permitted to move back to Chile a few years earlier — took the wind right from Pascal’s sails. He lost his agent, and his career stalled almost completely.

As a tribute to her, he decided to change his professional last name from Balmaceda, his father’s, to Pascal, his mother’s. “And also, because Americans had such a hard time pronouncing Balmaceda,” he says. “It was exhausting.”

Pascal even tried swapping out Pedro for Alexander (an homage to Ingmar Bergman’s “Fanny and Alexander,” one of the formative films of his youth). “I was willing to do absolutely anything to work more,” he says. “And that meant if people felt confused by who they were looking at in the casting room because his first name was Pedro, then I’ll change that. It didn’t work.”

It was a desperately lean time for Pascal. He booked an occasional “Law & Order” episode, but mostly he was pounding the pavement along with his other New York theater friends — like Oscar Isaac, who met Pascal doing an Off Broadway play. They became fast, lifelong friends, bonding over their shared passions and frustrations as actors.

“It’s gotten better, but at that point, it was so easy to be pigeonholed in very specific roles because we’re Latinos,” says Isaac. “It’s like, how many gang member roles am I going to be sent?” As with so many actors, the dream Pascal and Isaac shared to live the stories of their childhoods had been stripped down to its most basic utility. “The dream was to be able to pay rent,” says Isaac. “There wasn’t a strategy. We were just struggling. It was talking about how to do this thing that we both love but seems kind of insurmountable.”

As with so few actors, that dream was finally rekindled through sheer nerve and the luck of who you know, when another lifelong friend, actor Sarah Paulson, agreed to pass along Pascal’s audition for Oberyn Martell to her best friend Amanda Peet, who is married to “Game of Thrones” co-showrunner David Benioff.

“First of all, it was an iPhone selfie audition, which was unusual,” Benioff remembers over email. “And this wasn’t one of the new-fangled iPhones with the fancy cameras. It looked like s—; it was shot vertical; the whole thing was very amateurish. Except for the performance, which was intense and believable and just right.”

Before Pascal knew it, he found himself in Belfast, sitting inside the Great Hall of the Red Keep as one of the judges at Tyrion Lannister’s trial for the murder of King Joffrey. “I was between Charles Dance and Lena Headey, with a view of the entire f—ing set,” Pascal says, his eyes wide and astonished still at the memory. “I couldn’t believe I didn’t have an uncomfortable costume on. You know, I got to sit — and with this view.” He sighs. “It strangely aligned itself with the kind of thinking I was developing as a child that, at that point, I was convinced was not happening.”

And then it all started to happen.

In early 2018, while Pascal was in Hawaii preparing to make the Netflix thriller “Triple Frontier” — opposite his old friend Isaac — he got a call from the film’s producer Charles Roven, who told him Patty Jenkins wanted to meet with him in London to discuss a role in another film Roven was producing, “Wonder Woman 1984.”

“It was a f—ing offer,” Pascal says in an incredulous whisper. “I wasn’t really grasping that Patty wanted to talk to me about a part that I was going to play, not a part that I needed to get. I wasn’t able to totally accept that.”

Pascal had actually shot a TV pilot with Jenkins that wasn’t picked up, made right before his life-changing run on “Game of Thrones” aired. “I got to work with Patty for three days or something and then thought I’d never see her again,” he says. “I didn’t even know she remembered me from that.”

She did. “I worked with him, so I knew him,” she says. “I didn’t need him to prove anything for me. I just loved the idea of him, and I thought he would be kind of unexpected, because he doesn’t scream ‘villain.'”

In Jenkins’ vision, Max Lord — a longstanding DC Comics rogue who shares a particularly tangled history with Wonder Woman — is a slick, self-styled tycoon with a knack for manipulation and an undercurrent of genuine pathos. It was the kind of larger-than-life character Pascal had never been asked to tackle before, so he did something equally unorthodox: He transformed his script into a kind of pop-art scrapbook, filled with blown-up photocopies of Max Lord from the comic books that Pascal then manipulated through his lens on the character.

Even the few pages Pascal flashes to me over Zoom are quite revealing. One, featuring Max sporting a power suit and a smarmy grin, has several burned-out holes, including through the character’s eye. Another page features Max surrounded by text bubbles into which Pascal has written, over and over and over again in itty-bitty lettering, “You are a f—ing piece of s—.”

“I felt like I had wake myself up again in a big way,” he says. “This was just a practical way of, like, instead of going home tired and putting Netflix on, [I would] actually deal with this physical thing, doodle and think about it and run it.”

Jenkins is so bullish on Pascal’s performance that she thinks it could explode his career in the same way her 2003 film “Monster” forever changed how the industry saw Charlize Theron. “I would never cast him as just the stoic, quiet guy,” Jenkins says. “I almost think he’s unrecognizable from ‘Narcos’ to ‘Wonder Woman.’ Wouldn’t even know that was the same guy. But I think that may change.”

When people can see “Wonder Woman 1984” remains caught in the chaos the pandemic has wreaked on the industry; both Pascal and Jenkins are hopeful the Dec. 25 release date will stick, but neither is terribly sure it will. Perhaps it’s because of that uncertainty, perhaps it’s because he’s spent his life on the outside of a dream he’s now suddenly living, but Pascal does not share Jenkins’ optimism that his experience making “Wonder Woman 1984” will open doors to more opportunities like it.

“It will never happen again,” Pascal says, once more in that incredulous whisper. “It felt so special.”

After all he’s done in a few short years, why wouldn’t Pascal think more roles like this are on his horizon?

“I don’t know!” he finally says with a playful — and pointed — howl. “I’m protecting myself psychologically! It’s just all too good to be true! How dare I!”

[dreaminginthedeepsouth]

LETTERS FROM AN AMERICAN

September 9, 2021

Heather Cox Richardson

After weeks of pleading with Americans to get vaccinated as Republican governors opposed mask mandates, ICUs filled up, and people died, today President Joe Biden went on the offensive.

Saying, “My job as President is to protect all Americans,” he announced that he was imposing new vaccination or testing requirements on the unvaccinated. The U.S. government will require all federal employees, as well as any federal contractors, to be vaccinated. The government already requires that all nursing home workers who treat patients on Medicare and Medicaid have to be vaccinated; Biden is expanding that to cover hospital workers, home healthcare aides, and those who work in other medical facilities. “If you’re seeking care at a health facility, you should be able to know that the people treating you are vaccinated.”

Using the Department of Labor’s Occupational Safety and Health Administration (OSHA), Biden will also make employers with 100 or more employees require that their employees either be vaccinated or show a negative coronavirus test at least once a week. He pointed out that big companies already are doing this, including United Airlines, Disney… and the Fox News Channel.

Together, the new vaccine requirements will affect about 100 million Americans, making up two thirds of all U.S. workers.

Biden also urged those who run large entertainment venues to require vaccines or show a recent negative test for entry. He has already required teachers at the schools run by the Defense Department to get vaccinated, and today he announced that the government will require teachers in the Head Start program, which is federally funded, to be vaccinated. He called on governors to require that all teachers and staff be vaccinated for coronavirus, as their states already require a wide range of vaccinations for other diseases.

Calling out those like Florida governor Ron DeSantis, who has taken a stand against mask mandates and is threatening to withhold the salaries of school officials who defy him, Biden said that “if these governors won’t help us beat the pandemic, I’ll use my power as President to get them out of the way.”

He is using the Defense Production Act to increase production of rapid tests and has worked with major retailers to sell those tests at cost for the next three months. The government has also expanded free testing at 10,000 pharmacies and will spend $2 billion to distribute nearly 300 million rapid tests to community health centers, food banks, and schools. He has ordered the Transportation Safety Administration to double the fines on travelers that refuse to mask.

After deploying nearly 1000 healthcare workers to address this summer’s surges in 18 states, the president is now sending in military health teams from the Defense Department. Meanwhile, he said, the U.S. continues to donate vaccines to the rest of the world, “nearly 140 million vaccines over 90 countries so far, more than all other countries combined, including Europe, China, and Russia.... That’s American leadership on a global stage, and that’s just the beginning.” The U.S. is now shipping 500 million more Pfizer vaccines to 100 lower-income countries.

“Many of us are frustrated with the nearly 80 million Americans who are still not vaccinated, even though the vaccine is safe, effective, and free,” Biden said. More than 175 million Americans are fully vaccinated, and for the past three months we have created 700,000 new jobs a month. But while nearly three quarters of those eligible have gotten at least one shot, the highly contagious Delta variant has ripped through the unvaccinated, who are overcrowding our hospitals, threatening the health of our children, and weakening our economic recovery.

“[D]espite America having an unprecedented and successful vaccination program, despite the fact that for almost five months free vaccines have been available in 80,000 different locations, we still have nearly 80 million Americans who have failed to get the shot…. And to make matters worse, there are elected officials actively working to undermine the fight against COVID-19,” Biden said. “Instead of encouraging people to get vaccinated and mask up, they’re ordering mobile morgues for the unvaccinated dying from COVID in their communities. This is totally unacceptable.”

“[W]e have the tools to combat COVID-19, and a distinct minority of Americans—supported by a distinct minority of elected officials—are keeping us from turning the corner…. We cannot allow these actions to stand in the way of protecting the large majority of Americans who have done their part and want to get back to life as normal.”

“We’ve been patient, but our patience is wearing thin. And your refusal has cost all of us,” he said. “So, please, do the right thing.”

The Biden administration is pushing back, too, on Texas’s Senate Bill 8, which prohibits abortion after 6 weeks and thus outlaws 85% of abortions in the state. Today, the United States of America sued the state of Texas for acting “in open defiance of the Constitution” when it passed S. B. 8 and deprived “individuals of their constitutional rights.” The United States has a “profound sovereign interest” in making sure that individuals’ constitutional rights can be protected by the federal government, the lawsuit declares. "The act is clearly unconstitutional under longstanding Supreme Court precedent,” Attorney General Merrick Garland said.

What is at stake in this case is the ability of the federal government to defend Americans’ constitutional rights against local vigilantes, a power Americans gave to the federal government in 1868 by ratifying the Fourteenth Amendment to the Constitution after white former Confederates in southern states refused to accept the idea that their Black neighbors should have rights.

Since the 1950s, the Supreme Court has used federal power to protect the rights of minorities and women when state laws discriminated against them. S. B. 8 would strip the government of that power, leaving individuals at the mercy of their neighbors’ prejudices. The government has asked the U.S. district court for the western district of Texas to declare the law “invalid, null, and void,” and to stop the state from enforcing it.

This issue of federal supremacy is not limited to Texas. Glenn Thrush of the New York Times today called out that in June, Missouri governor Mike Parson signed the Second Amendment Preservation Act, which declares federal laws—including taxes—that govern the use of firearms “invalid in this state.” Like the Texas abortion law, the Second Amendment Preservation Act allows individuals to sue state officials who work with federal officials to deprive Missourians of what they consider to be their Second Amendment rights. “Obviously, it’s about far more than simply gun rights,” one of the chief proponents of the bill, far-right activist Aaron Dorr, said to Thrush about his involvement.

There were other wins today for the Biden administration. Today was the deadline for federal agencies to produce a wide range of records surrounding the events of January 6 to the House Select Committee to Investigate the January 6th Attack on the United States Capitol, and according to the committee’s Twitter feed, those records have, in fact, been forthcoming.

And Taliban officials did allow a plane carrying about 115 Americans and other nationals to leave Afghanistan.

Biden’s new approach to the pandemic is, as Josh Marshall of Talking Points Memo points out, good politics as well as good for public health. About 65% of the voting age population is already vaccinated, and older people are both more likely to be vaccinated and more likely to vote. With most Americans vaccinated and increasingly frustrated with those who refuse, there is little political risk to requiring vaccines, while Republicans standing in the way of public health measures are increasingly unpopular. Florida, where deaths from coronavirus soared to more than 300 a day in late August, has begun to limit the information about deaths it releases.

If Biden’s new vaccine requirements slow or halt the spread of the coronavirus, the economic recovery that had been taking off before the Delta variant hit will resume its speed, strengthening his popularity. Those Republican lawmakers furious at the new vaccine requirements are possibly less worried that they won’t work than that they will.

Notes:

https://www.justsecurity.org/wp-content/uploads/2021/09/lawsuit-doj.pdf

https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/09/09/remarks-by-president-biden-on-fighting-the-covid-19-pandemic-3/

https://www.cnn.com/2021/09/09/politics/biden-administration-texas-abortion-law/index.html

https://january6th.house.gov/news/press-releases/select-committee-issues-sweeping-demand-executive-branch-records

https://www.nytimes.com/live/2021/09/09/business/economy-stock-market-news

https://docs.google.com/document/d/1b3CD2rFn105IQ7ziTfcTT5m8bzv1gBXE5-RXEV0phMM/edit

https://www.nytimes.com/2021/09/09/us/politics/missouri-gun-law.html

https://www.cbsnews.com/news/afghanistan-news-taliban-to-let-americans-evacuate-flights-from-kabul-airport/

https://www.nbcmiami.com/news/local/as-covid-deaths-soar-florida-curtails-public-records-on-which-counties-hit-hardest/2547538/

Josh Marshall @joshtpmThe vax mandate is good public health. It’s also good politics. A big majority of the voting age population is already vaxed. About 65%. Propensity to vote and likelihood of being vaxed both rise with age. The vaxed are losing patience w the voluntarily unvaxed who …

288 Retweets1,742 Likes

September 10th 2021

LETTERS FROM AN AMERICAN

HEATHER COX RICHARDSON

[yourdailykitsch]

Taylor Kitsch, an actor known for his roles in such Hollywood productions as "Battleship: Battle for Earth" and "X-Men Origins: Wolverine", is starring in the new Canal + series "Defeated". In an interview, the actor reveals what he remembers from history lessons, what connects the series' story with the modern world. He also explains why, according to him, every person should visit the former concentration camp of Auschwitz-Birkenau.

Taylor Kitsch started his adventure in Hollywood as a "hottie" - an actor associated with a great body and beautiful face. All because the first role that brought the popularity of the former model Abercrombie and Fitch was the character of naughty lover Tim Riggins in the cult series "Friday Night Lights".

Kitsch did not avoid tough moments in his career - for example, when the $ 250 million John Carter, his first such big role, suffered a disgusting box office failure. But the Canadian knew this taste already - after coming to the USA, he was homeless for some time before finding a job.

For years, he has been successfully playing in big titles and alongside big names. Oliver Stone ("Savages"), Ryan Murphy ("Heart Reflex"), roles alongside Chadwick Boseman ("21 Bridges"), Michael Shannon ("Waco"), Michael Keaton ("American Assassin") and Rihanna ("Battlefield ), the HBO series "Detective," starring Vince Vaughn and Rachel McAdams. Meanwhile, Kitsch finds his way to charity, especially for children.

From 1 January 2021, we will watch him in  "Defeated" . There he plays the role of Brooklyn policeman Max McLoughlin, who in the summer of 1946 is sent to Berlin, which is divided into four spheres of influence. Its task is to support the emerging police structures in the rubble. But upholding order in a space of brutality and lawlessness and clashing political forces - French, American, British and Soviet - will not be easy. Especially since Max does not know that he is used as a pawn in the game to open the Cold War, and somewhere in the maze of Berlin rubble lurks his brother Moritz, a self-proclaimed Nazi hunter who will stop at nothing ...

In addition to Kitsch, the main roles will be: Nina Hoss (local policewoman Elsie Garten), Sebastian Koch (criminal known as Engelmacher, Al Capone of post-war Berlin), Logan Marshall-Green (Max's missing brother, Moritz) and Michael C. Hall (consul Tom Franklin ).

The "Defeated" takes place in Berlin, right after the war. When you decided to play Max McLoughlin, did you have any knowledge of what the situation in Germany was like then?

The seres begins six months after the end of the war. I have the impression that this is a moment that is missing in the educational process - we learn a lot about the war itself, but about what happened immediately after it, for example, I had no idea. The plot of "Defeated" is made up, but our director Måns Mårlind (co-creator of the hit series "Bridge over the Sund") constructed it on the basis of many true stories. I have the impression that fact and fiction are perfectly balanced here. In the process of preparation, he gave us many documentaries and articles that helped to build an idea about the climate of the city from 1946. Discovering the next details of the story was fascinating for me.

Your work gives him a chance to get to know the world, its history, extraordinary places and people. Do you appreciate it?

This is the best part of my job! With each new production, I have a chance to immerse myself in its world and get to know it thoroughly. It could be a war movie like "Survivor", a story about a cult leader ("Waco"), the world of a detective ("Detective") or the beginning of the AIDS epidemic, as in "Heart Reflex". When I was an aspiring actor learning to act in New York, I never imagined that I would be able to live and work like this. Train with Navy Seals or meet Larry Kramer [American playwright, writer and activist for LGBT rights - ed.]. I am very lucky!

Prague, where you shot "Defeated", is a cult city for many Polish filmmakers, due to the famous FAMU school, but also a popular, atmospheric excursion destination. How was your time there?

Lovely. He will refer again to the privilege of working like this: six months in such a wonderful place, it is almost immoral! The only downside was the tight schedule so I didn't discover all the nooks and crannies that I had on the agenda. Fortunately, my driver, a guy in his fifties, was a great-grandfather from Prague, very talkative, and from him I learned the most interesting things - stories about the adventures of my ancestors and friends! Besides, in Prague, if you want to take a history lesson, you go out twenty meters in front of the front door - and it's already getting started. We shot in the summer, before Covid. We had an international team - Czechs, Swedes, Russians, Germans, French ... In use - not only behind the scenes, but also on the set - several languages ​​simultaneously. Really, the only problem for me was my diet. Flour, red meat, stews ... I don't really like to eat like that. At least the beer was delicious, really amazing! In general, I really liked the culture of drinking and eating outside, these gardens, the community ... wonderful thing.

Due to the fact that the film was made in Europe, you had the opportunity to see places related to the war with your own eyes. What made the greatest impression on you? I was lucky, although it is not quite an adequate term that during the shooting we managed to visit the site of the former Auschwitz camp. Of course I knew, I had read about concentration camps before, but this direct contact with the site was invaluable, it gave me a clear idea of ​​what happened. It is difficult for a man to believe what he sees around him. He's standing right next to him, yet he doesn't quite believe it. The space made a huge impression on me. I did not realize how huge Birkenau was, how perfectly organized the entire extermination was. This architecture, the surrounding houses, barracks. Someone designed it, thought over the function down to the smallest detail, and during my visit, I had the chance to trace how and where the whole process took place, step by step. I was standing there and it felt like I was choking, my whole body ached. Such experiences helped me a lot to bring my character to life. Max did not survive the camp himself, but he appears in a place marked by this tragedy, the tragedy of World War II, it affects him. I wish everyone could visit this place because it is a life changing experience.

Movies set in the past can be a perfect mirror for what is here and now. What analogies do you see between that reality and today's world? - Division, the dictate of fear, fear of the unknown, of otherness. Different ways to work through your trauma. These are all threads that connect the "Defeated" space with our reality. For my character, especially the experience of trauma resulting from family history, from the relationship with my brother, becomes the key. They both underwent a similar shock, but their reactions were completely different. I found it very interesting. Max is still hoping for a change, Moritz, as the saying goes, "the platform is gone". They have a completely different perception of one and the same event. Again, it is also a very contemporary thread - one event, situation, and extreme different opinions about it.

Your hero comes from Brooklyn, after you came from Canada, you spent a lot of time in New York. What is so special about the atmosphere of this city that gives it such a "mythical" status? For me, it has always been, I fully agree! Scorsese's "Streets of Poverty" has always been such a cinematic quintessence of New York, with its excellent Keitel and DeNiro. This film is set in the 1940s, which is the present day of Max. He was my point of reference in terms of the accent. Those years were difficult, the inhabitants struggled to make ends meet, and that also had to affect my character's character. Besides, New York has a chic character, New Yorkers feel proud of their roots. It's also something that Max defines.

And you had to transfer this New York feeling to Berlin ... ... to the razed Berlin, which for Max becomes, in a way, another space of trauma, personal again, but this time much more intense.

For this role, you had to master not only a Brooklyn accent, but also the German language. It was difficult?

I had an amazing accent teacher from Berlin, Simone. My rock! Fortunately, Max is an American who speaks German poorly and not a German, because if I had to play a German, I would have had a nervous breakdown! German is a damn hard language, especially for someone who wasn't exposed to such sounds when growing up. I learned everything phonetically. Sometimes I was "suspended" during the scene and then I was saved by Nina [Hoss, a great German acting and screen partner of Kitsch - ed.]. In my career, I have had to play with a South African, Texas, New York accent ... I've learned that there is no such thing as an optimal effect, someone is always dissatisfied. I focus on the vision agreed with the creators and I stick to it. Language is an amazing link between the actor and the protagonist, gives a unique insight into his state of mind and view of the world. I definitely prefer to play the character with an accent than to speak as usual. It's a great transformation tool. The arrangement of the lips, the appearance of the face, and the term are changing. In "Waco" my character, the guru of the sect David Koresh, had an unnaturally high, soft voice, which immediately made the viewer feel differently.

We associate you with American hits, but you are, like Ryan Reynolds or Ryan Gosling, Canadian. Do you feel like an American, or is Canada a state of mind after all?

I started my adventure with the USA when I was 20, I came to school. Now I'm forty, so I've spent half my life here. Madness! Over time, I have grown into this space, I have settled down and I feel at home. I'm talking to you from my home in Austin, Texas. But at the same time, I'll always be Canadian. I go there often, visiting my family and familiar places. Maybe I'll go back one day, who knows?

You've had moments in your career that turned from a promise of triumph to failure, such as the high-budget John Carter, who failed at the box office. Do you have something that you already know: "I'm avoiding this"? I don't have things that, as a rule, I don't do or know that I will never do. But there are some that I don't like. These include radical weight changes. My dear friend must have gained twenty-five kilos for a small, independent film. The first week was great because you eat what you want, then depression started, joint problems, sugar jumping ... I never put my back, but I lost weight. I lost a dozen kilos for the role in "Waco", before that for the "Bang Bang Club". It's fucking hard and very exhausting, especially the older I get. My body and head hate it! Also, until Scorsese calls with some great proposal, I say: enough.

[sciencespies]

This clever game 'microdoses' people with the manipulation used to spread fake facts

https://sciencespies.com/tech/this-clever-game-microdoses-people-with-the-manipulation-used-to-spread-fake-facts/

This clever game 'microdoses' people with the manipulation used to spread fake facts

An online game developed by a team of social psychologists could be a useful tool in the fight against misinformation, helping internet users spot misinformation and call it out for what it is: manipulative.

Misinformation – often spread by automated bots, but also unsuspecting people – worms its way into our heads by appealing to a sense of injustice or distrust and by using emotionally charged language to stoke fear and anger among social media users.

And sadly, as we’ve seen during the COVID-19 pandemic, it can have very real and sometimes lethal consequences.

But just like a vaccine stimulates an immune response to protect against disease, this new game – called GoViral! – aims to give people a taste of the tactics used to spread misinformation and conspiracy theories, so they can combat falsehoods online. 

“COVID-19 falsehoods and conspiracies pose a real threat to vaccination programs in almost every nation,” says social psychologist and co-author Jon Roozenbeek.

“Every weapon in our arsenal should be used to fight the fake news that poses a threat to herd immunity.”

In two studies, players of the game were more likely to rate misinformation as manipulative, compared to genuine news, after just 5 minutes of game time. They also had more confidence in their ability to spot misinformation, even one week later, and said they were less likely to spread misinformation with others. 

The game hinges on the idea that it might be more effective to stop misinformation from spreading than counter each specific falsehood with factual content from reputable sources after the misinformation has been posted online.

“While fact-checking is vital work, it can come too late. Trying to debunk misinformation after it spreads is often a difficult if not impossible task,” University of Cambridge social psychologist Sander van der Linden explains. 

Instead, GoViral! is designed to prevent false narratives from taking root in the first place by building people’s confidence and ability to recognize misinformation when they see it.

“By pre-emptively exposing people to a microdose of the methods used to disseminate fake news, we can help them identify and ignore it in the future,” van der Linden says.

The worry is, as research shows, that few adults actually know how to identify misinformation – with less than half of Australian adults in one survey reporting they could confidently do so. Other studies have also shown that the inaction of silent bystanders helps fake news spread.

“The aim of countering misinformation is not to change the opinions of the people posting it, but to reduce misperceptions among the often-silent audience,” says biomedical informatics researcher Adam Dunn at the University of Sydney, who was not involved in the study.

So how does the game work? Players are tasked with promoting noxious posts about COVID-19 to create public panic in a virtual game scenario using deceptive techniques, such as citing fraudulent ‘experts’.

This creates awareness amongst players of how misinformation works and how people can help stop it – which is a kind of ‘psychological resistance’ to future falsehoods, the researchers say.

Their analysis involved a total of 3,548 players in two separate studies. The first study collected data from real-world users who were surveyed before and after they played the game and shown 18 social media posts each time. Half were credible, half were not.

Immediately after playing, these GoViral! players were better able to distinguish real news about COVID-19 from convincing conspiracies than they could before gameplay. 

In the second study, the researchers compared the game to a set of infographics from UNESCO’s #ThinkBeforeSharing campaign and a control group of gamers who just played Tetris.

UNESCO infographic (Basol et al. 2021)

Roughly two-thirds of GoViral! players said they felt less likely to get duped in the future; a week later, GoViral! players still rated misinformation as more manipulative than credible news, more so than the Tetris players or infographic readers.

It’s also worth noting that the infographics did help people recognize misinformation, just not as much or for as long.

“Interestingly, our findings also show that the active inoculation of playing the game may have more longevity than passive inoculations such as reading the infographics,” Roozenbeek says.

Although the results may be encouraging, the game – which is backed by the UK Cabinet Office, WHO, and UNESCO – is not getting all that much traction online. It’s available in lots of languages but has only been played about 400,000 times since its launch last October.

But whether you’re a gamer or not, remember there are a number of ways we can stop misinformation in its tracks – if you stop and think about it.

The research was published in Big Data & Society. If you want to try the game for yourself, it’s freely available here.

#Tech

[didanawisgi]

Medicine’s Fundamentalists

The randomized control trial controversy: Why one size doesn’t fit all and why we need observational studies, case histories, and even anecdotes if we are to have personalized medicine

BY NORMAN DOIDGE

AUGUST 14, 2020

If the study was not randomized, we would suggest that you stop reading it and go on to the next article. —Quote from Evidence-Based Medicine: How to Practice and Teach EBM

Why is it we increasingly hear that we can only know that a new treatment is useful if we have a large randomized control trial, or “RCT,” that has positive results? Why is it so commonly said that individual case histories are “mere anecdotes” and count for nothing, even if a patient, who has had a chronic disease, suddenly gets better with a new treatment after all others failed for years—an assertion that seems, to many people, to run counter to common sense?

Indeed, some version of the statement, “only randomized control trials are useful” has become boilerplate during the COVID-19 crisis. It is uttered as though it is self-evidently the mainstream medical position. When other kinds of studies come out, we are told they are “flawed,” or “fatally flawed,” if not RCTs (especially if the commentator doesn’t like the result; if they like the result, not so often). The implication is that the RCT is the sole reliable methodological machine that can uncover truths in medicine, or expose untruths. But if this is so self-evident, why then, do major medical journals continue to publish other study designs, and often praise them as good studies, and why do medical schools teach other methods?

They do because, as extraordinary an invention as the RCT is, RCTs are not superior in all situations, and are inferior in many. The assertion that “only the RCTs matter” is not the mainstream position in practice, and if it ever was, it is fading fast, because, increasingly, the limits of RCTs are being more clearly understood. Here is Thomas R. Frieden, M.D., former head of the CDC, writing in the New England Journal of Medicine, in 2017, in an article on the kind of thinking about evidence that normally goes into public health policy now:

Although randomized, controlled trials (RCTs) have long been presumed to be the ideal source for data on the effects of treatment, other methods of obtaining evidence for decisive action are receiving increased interest, prompting new approaches to leverage the strengths and overcome the limitations of different data sources. In this article, I describe the use of RCTs and alternative (and sometimes superior) data sources from the vantage point of public health, illustrate key limitations of RCTs, and suggest ways to improve the use of multiple data sources for health decision making. … Despite their strengths, RCTs have substantial limitations.

That, in fact, is the “mainstream” position now, and it is a case where the mainstream position makes very good sense. The head of the CDC is about as “mainstream” as it gets.

The idea that “only RCTs can decide,” is still the defining attitude, though, of what I shall describe as the RCT fundamentalist. By fundamentalist I here mean someone evincing an unwavering attachment to a set of beliefs and a kind of literal mindedness that lacks nuance—and that, in this case, sees the RCT as the sole source of objective truth in medicine (as fundamentalists often see their own core belief). Like many a fundamentalist, this often involves posing as a purveyor of the authoritative position, but in fact their position may not be. As well, the core belief is repeated, like a catechism, at times ad nauseum, and contrasting beliefs are treated like heresies. What the RCT fundamentalist is peddling is not a scientific attitude, but rather forcing a tool, the RCT, which was designed for a particular kind of problem to become the only tool we use. In this case, RCT is best understood as standing not for Randomized Control Trials, but rather “Rigidly Constrained Thinking” (a phrase coined by the statistician David Streiner in the 1990s).

Studies ask questions. Understanding the question, and its context, is always essential in determining what kind of study, or tool, to use to answer those questions. In the “RCT controversy,” to coin a phrase, neither side is dismissive of the virtues of the RCT; but one side, the fundamentalists, are dismissive of the virtues of other studies, for reasons to be explained. The RCT fundamentalist is the classic case of the person who has a hammer, and thinks that everything must therefore be a nail. The nonfundamentalist position is that RCTs are a precious addition to the researcher’s toolkit, but just because you have a wonderful new hammer doesn’t mean you should throw out your electric drill, screwdriver, or saw.

So let’s begin with a quick review of the rationale for the “randomized” control trial, and their very real strengths, as originally understood. It’s best illustrated by what happens without randomization.

Say you want to assess the impact of a drug or other treatment on an illness. Before the invention of RCTs, scientists might take a group of people with the illness, and give them the drug, and then find another group of people, with the same illness, say, at another hospital, who didn’t get the drug, and then compare the outcome, and observe which group did better. These are called “observational studies,” and they come in different versions.

But scientists soon realized that these results would only be meaningful if those two groups were well matched in terms of illness severity and on a number of other factors that affect the unfolding of the illness.

If the two groups were different, it would be impossible to tell if the group that did better did so because of the medication, or perhaps because of something about that group that gave it an advantage and better outcome. For instance, we know that age is a huge risk factor for COVID-19 death, probably because the immune system declines as we age, and the elderly often already have other illnesses to contend with, even before COVID-19 afflicts them. Say one group was, on average, 60 years old, and all the members got the drug, and the other group was on average 75 years old, and they were the ones that didn’t get the drug. Say that when results were analyzed and compared, they showed the younger group had a higher survival rate.

A naive researcher might think that he or she was measuring “the power of the medication to protect patients from COVID-19 death” but may actually have also been measuring the relative role of youth, in protecting the patients. Scientists soon concluded there was a flaw in that design, because we do not know, with any reasonable degree of confidence, whether the better outcomes were due to age or the medication.

Age, here, is considered a “confounding factor.” It is called a confounding factor, because it causes confusion, because age can also influence the outcome of the study in the group as a whole. Other confounding factors we know about in COVID-19 now include how advanced the illness is at the time of the study, diabetes, obesity, heart disease, and probably the person’s vitamin D levels. But there could easily be, and probably are, many other confounding factors we don’t know, as of yet. There are even potential confounding factors that we suspect play a role, but are not quite certain about: the person’s general physical fitness, the ventilation in their home, and so on.

This is where randomization is helpful. In a randomized control trial, one takes a sufficiently large group of patients and randomly assigns them to either the treatment group, or the nontreatment (“placebo” or sugar pill) control group, for instance. Efforts are made to make sure that apart from the treatment, everything else remains the same in the lives of the two groups. It is hoped that by randomly assigning this large number of patients to either the treatment or nontreatment condition, that each of the confounding factors will have an equal chance of appearing in both groups—the factors we know, such as age, but also mysterious ones we don’t yet understand. While observational studies can, with some effort, match at least some confounding factors we do understand in a “group matched design” (and, for instance, make sure both groups are the same age, or disease severity), what they can’t do is match confounding factors we don’t understand. It is here, that RCTs are generally thought to have an advantage.

With such a good technique as RCTs, one might wonder, why do we ever bother with observational studies?

There are a number of situations in medicine in which observational studies are obviously superior to randomized control trials (RCTs), such as when we want to identify the risk factors for an illness. If we suspected that using crack cocaine was bad for the developing brains of children, it would not be acceptable to do an RCT (which would take a large group of kids, and randomly prescribe half of them crack cocaine and the other half a placebo and then see which group did better on tests of brain function). We would instead follow kids who had previously taken crack, and those who never had, in an observational study, and see which group did better. All studies ask questions, and exist in a context, and the moral context is relevant to the choice of the tool you use to answer the question. That is Hippocrates 101: Do no harm.

Now, you might say that a study of risk factors is very different from the study of a treatment. But it is not that different. There can be very similar moral and even methodological issues.

In the 1980s, quite suddenly, clinicians became aware that infants were dying, in large numbers, in their cribs, for reasons that couldn’t be explained, and a new disorder was discovered, sudden infant death syndrome, or SIDS, or “crib death.” Some people wondered if parents were murdering their children, or if it was infectious, and many theories abounded. A large observational study was done in New Zealand that observed and compared factors in the lives of the infants who died and those who didn’t. The study showed that the infants who died were frequently put to sleep on their tummies. It was “just” an observation. But on that basis alone, it was suggested that having infants sleep on their backs might be helpful, and that parents should avoid putting their infants on their fronts in their cribs. Lo and behold, the rates of infant death radically diminished—not completely, but radically. No sane caring person said: “We should really do an RCT, rule out confounding factors, and settle this with greater certainty, once and for all: All we have to do is randomly assign half the kids to be put to bed on their tummies and the other half on their backs.” That would have been unconscionable. The evidence provided by the observational study was good enough.

Again, all studies have a context and are a means to answering questions. The pressing question with SIDS was not: How can we have absolute certainty about all the causes of SIDS? It was: How can we save infant lives, as soon as possible? In this case, the observational study answered it well.

The SIDS story is a case where we can see how close, in moral terms, a study of risk factors and a study of a new treatment can be in a case where the treatment might be lifesaving. Putting children on their tummies is a risk factorfor SIDS. Putting them on their backs is a treatment for it. The moral issue of not harming research subjects by subjecting them to a likely risk is clear.

Similarly, withholding the most promising treatment we have for a lethal illness is also a moral matter. That is precisely the position taken by the French researchers who thought that hydroxychloroquine plus azithromycin was the most promising treatment known for seriously ill COVID-19 patients, and who argued that doing an RCT (which meant withholding the drug from half the patients) was unconscionable. RCT fundamentalists called their study “flawed” and “sloppy,” implying it had a weak methodology. The French researchers responded, in effect saying, we are physicians first; these people are coming to us to help them survive a lethal illness, not to be research subjects. We can’t randomize them and say to half, sorry, this isn’t your lucky day today, you are in the nontreatment group.

There are other advantages to observational studies in assessing new treatments. They are generally lower in cost than RCTs, and can often be started more quickly, and published more rapidly, which helps when information is needed urgently, as in a novel pandemic when little is understood about the illness. (RCTs, in part because of the moral issues, take longer to get ethics approval.) Observational studies are also easier to conduct at a time when patients are dying in high numbers, and hospital staff is overwhelmed, trying to keep people alive. They can involve looking back in time, to make use of observations in the medical chart. In such cases, it is crucial that the initial observations about how patients responded to the medications and treatments that the staff had on hand is documented, in as systematic as way as is possible, because there might be clues and nuggets as to what worked.

Exclusion Criteria: Do RCTs Study Real-World Patients?

But there are also problems at the conceptual heart of the RCT. Often the RCT design sees “confounding factors” not simply as something that has to be balanced between the treatment and no-treatment groups by randomization, but eliminated at the outset. For a variety of reasons, includinga wish to make interpretation of final results more certain, they aggressively eliminate known confounding factors before the study starts, by not letting patients with certain confounding factors get into the study in the first place. They do this by often having a lot of what are called “exclusion criteria,” i.e., reasons to exclude or disqualify people from entering the study.

Thus, RCTs for depression typically study patients who only have depression and no other mental disorders, which might be confounding factors. So, they usually study people who are depressed but who are not also alcoholic, not on illicit drugs, and who don’t have personality disorders. They also tend to exclude people who are actively suicidal (because if they are, they might not complete the expensive study, and some people think it is unethical to give a placebo to a person in acute risk of killing themselves). There are many other reasons given for different exclusions, such as a known allergy to a medication in the study.

But here’s the problem. These exclusions often add up until many, maybe even most, real-world depressives get excluded from such a study. So, the study sample is not representative of real-world patients. Yet this undermines the whole purpose of a research study “sample” in the first place, which is to test a small number of people (which is economical to do), and then extrapolate from them on to the rest of the population. As well, many studies of depression and drugs end up looking at people who are about as depressed as a college student who just got a B+ and not an A on a term paper. This is why many medications (or short-term therapies) end up doing well in short-term studies, but the patients relapse.

If you are a drug company (which pay for most of these studies) and you’re testing your new drug, exclusion criteria can be made to work in favor of making your drug appear more powerful than it really is, if sicker patients are eliminated. (This is a good trick, especially if your goal of making money from the drug is your first priority.)

This isn’t a matter of conjecture. This question of whether RCTs, in general, are made up of representative samples has been studied. An important review of RCTs found that 71.2% were not representative of what patients are actually like in real-world clinical practice, and many of the patients studied were less sick than real-world patients. That, combined with the fact that many of the so-called finest RCTs, in the most respected and cited journals, can’t be replicated 35% of the time when their raw data is turned over to another group that is asked to reconfirm the findings, shows that in practice they are far from perfect. That finding—that something as simple as the reanalysis of the numbers and measurements in the study can’t be replicated—doesn’t even begin to deal with other potential problems in the studies: Did the author ask the right questions, collect appropriate data, have reliable tests, diagnose patients properly, use the proper medication dose, for long enough, and were their enough patients in it? And did they, as do so many RCTs, exclude the most typical and the sickest patients?

Note, other study designs also have exclusion criteria, but they often are less problematic than in RCTs for reasons to be explained below.

The Gold Standard and the Hierarchy of Evidence

So, why is it we also hear that “RCTs are the gold standard,” and the highest form of evidence in the “hierarchy of evidence,” with observational studies beneath them, and case histories, at the bottom, and anecdotes beneath contempt?

There are several main reasons.

The first you just learned. It had been believed that RCTs were a completely reliable way to study a treatment given to a small sample of people in a population, see how they did, and then one could extrapolate those findings to the larger population. But that was just an assumption, and now that we have learned the patients studied are too often atypical, we have to be very careful about generalizing from an RCT. This embarrassment is a fairly recent finding that has yet to be taken fully into account by those who say RCTs are the gold standard.

The second reason has to do with the fundamentalists relying on outdated science, which argued that RCTs are more reliable in their quantitative estimates of how effective treatments are because they randomize and rule out confounding factors.

But a scientist who wanted to know if RCTs, as a group, were universally better and more reliable than observational studies at truth-finding would actually study the question scientifically, and not just assert it. And, in the 1980s, Chalmers and others did just that, examining studies from the 1960s and 1970s. They found that in the cases where both RCTs and observational studies had been done on the same treatment, the observational studies yielded positive results 56% of the time, whereas blinded RCTs did so only 30% of the time. It thus seemed that observational studies probably exaggerated how effective new treatments were.

Three other reviews of comparisons of observational and RCT study outcomes showed this same difference, and so researchers concluded that RCTs really were likely better at detecting an investigator’s bias for the treatment being studied, and hence more reliable. Since many scientific studies of drugs were paid for by drug companies that manufactured those drugs, it was not a surprise that the studies would have biases. These reviews formed much of the basis for RCT fundamentalism.

Just because an RCT is performed and published is no reason to assume it doesn’t exaggerate efficacy.

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But here’s the problem: These were reviews of studies that were done in the 1960s and 1970s. Once the observational study researchers became aware of the problem, they upped their game, and improved safeguards.

In 2000, new reviews comparing the results from hundreds of RCTs and observational studies in medicine that had been conducted in the 1990s were conducted by scientists from Yale and Iowa College of Medicine. They found that the tendency of observational studies to suggest better results in treatments had now disappeared. They now got similar results to RCTs. This was an important finding, but it has not been sufficiently integrated into the medical curriculum.

There is another reason we hear about RCTs. As RCTs became the type of study favored by regulatory bodies to test new drugs, they rose to prominence, and drug companies upped their game and learned many ingenious ways to make RCTs exaggerate the effectiveness of the drugs they are testing.

Entire books have been written on this subject, an excellent one being Ben Goldacre’s Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients.Since, to bring a drug to market requires only two RCTs showing the drug works, these techniques include doing many studies but not publishing the ones that don’t show good results. But there are sneakier techniques than making whole studies with negative outcomes go missing. There are ways to publish studies but hide embarrassing data; publish the good data in well-known journals and the negative findings in obscure journals; not study short-term side effects; almost never study, or ask about, long-term side effects; or play with measuring scales, so that patients appear to achieve statistically meaningful benefits which make no clinical difference. If you do a study that gives you a bad outcome on your key measure, don’t report that, just find some small outcome that was in your favor and retroactively change the goal of the study, to report that benefit and that alone. Make researchers and subjects sign gag clauses and nondisclosures. Have the drug companies ghostwrite the papers, make up the tables, and get academics, who never see the raw data sign them. This is routine.

The list goes on, and those tricks have often been used, successfully, to gain approval for drugs. Becoming very familiar with these ruses can save lives, because in a pandemic, new drugs will earn Big Pharma billions because the illness is so widespread, and they have a large playbook to draw from. Once two RCTs are selected from the many done to take the drug forward, the propaganda campaign begins, and as Goldacre shows, drug companies spend twice as much on marketing as they do on research. So, to repeat, just because an RCT is performed and published is no reason to assume it doesn’t exaggerate efficacy.

One group of studies, though, that don’t often play by these corrupt rules are RCTs done on already generic drugs, because they are off-patent, and there is really very little money to be made in them. In these cases, when a drug company has a generic rival to what might be a big money maker, there are ways of making that generic look bad. If the generic takes four weeks to work, test your drug against it, in a three-week study (the placebo effect for your drug won’t have worn off yet). If a vitamin is threatening your drug, test your drug against it, but use the cheapest version, in a dose that is too low. It’s an RCT, that’s all that matters.

Despite all this, advocates of RCTs still teach that, all else being equal, RCTs are always more reliable, and teach this by cherry-picking well-known cases where RCTs were superior to observational studies, and ignore cases where observational studies have been superior, or at least the better tool for the situation. They take the blunt position that “RCTs are better than observational studies,” and not, the more reasonable, accurate, and moderate, “All else being equal, in many, but not all situations, RCTs are better than observational studies.”

The phrase, “all else being equal,” is crucial, because so often all else is not equal. Simply repeating “RCTs are the gold standard of evidence-based medicine” implies to the naive listener that if it is an RCT then it must be a good study, and reliable, and replicable. It leaves out that most studies have many steps in them, and even if they have a randomization component, they can be badly designed in a step or two, and then lead to misinformation. Then there is the very uncomfortable fact that, so often, RCTs can’t even be replicated, and so often contradict each other, as anyone who has followed RCTs done on their own medical condition often sadly finds out. A lot of this turns out to be because they have many steps, and because Big Pharma is so adept now at gaming the system. Like gold, they turn out to be valuable but also malleable. A lot of the problem is that patients differ far more than these studies concede, and these complexities are not well addressed in the study design.

The Hierarchy-of-Evidence Notion Does Harm, Even to RCTs

One of the peculiar things about current evidence-based medicine’s love affair with its “hierarchy of evidence” is that it is still proceeding along, ignoring the implications of the scientifically documented replication crisis. True, the fact there is a replication crisis is now widely taught, and known about, but to the fundamentalists, it is as though that “crisis” doesn’t require that they reexamine basic assumptions. The replication crisis is compartmentalized off from business as usual and replaced with RCT hubris.

The irony is that the beauty of the RCT is that it’s a technique designed to neutralize the effects of confounding factors that we don’t understand on a study’s outcome, and thus it begins in epistemological humility. The RCT, as a discovery, is one of humanity’s wonderful epistemological achievements, a kind of statistical Socrates, which finds that wisdom begins with the idea, “whatever I do not know, I do not even suppose I know” (Apology, 21d).

But that beautiful idea, captured by a fundamentalist movement, has been turned on its head. The way the RCT fundamentalist demeans other study designs is to judge all those designs by the very real strengths of RCTs. This exaggeration is implicit in the tiresome language they use to discuss them: The RCTs are the “gold standard,” i.e., against which all else is measured, and the true source of value. Can these other designs equal the RCT in eliminating confounders? No. So, they are inferior. This works, as long as one pretends there are no epistemological limitations on RCTs. The problem with that attitude is, it virtually guarantees that the RCT design will not be improved, alas, because improved RCTs would benefit everyone. In fact, RCTs would be most quickly improved if the fundamentalists thought more carefully about the benefits of other studies, and tried to incorporate them, or work alongside them in a more sophisticated way. That is another way of saying we need the “all available evidence” approach.

The Case History and Anecdotes

Also disturbing, and, odd, actually, is the belittling of the case history as a mode of making discoveries, or what it has to offer science as a form of evidence. In neurology, for instance, it was the individual cases, such as the case of Phineas Gage, that taught us about the frontal lobes, and the case of H.M., that taught us about the role of memory, two of the most important discoveries ever made in brain science.

Here’s how the belittlement goes. “Case histories are anecdotes, and the plural of anecdote is not data, it is just lots of anecdotes.”

First of all, case histories are not anecdotes. An anecdote, in a medical text, is usually several sentences, at most a paragraph, stripped of many essential details, usually to make a single point, such as “a 50-year-old woman presented with X disease, and was treated with Y medication, for 10 days, and Figure 7 shows her before and after X-rays, and the dramatic improvement.” In that sense, an anecdote is actually the opposite of a case history, which depends on a multiplicity of concrete, vivid details.

A case history (particularly in classic neurology or psychiatry) can run for many pages. It is so elaborated because it understands, as the Canadian physician William Osler pointed out: “The good physician treats the disease; the great physician treats the patient who has the disease.” And who that patient is—their strengths, weaknesses, their other illnesses, other medications, emotional supports, diet, exercise habits, bad habits, genetics, previous treatment histories, all factor into the result. To practice good medicine, you must take it all into account, understanding that the patient is not any one of these details, but a whole who is more than the sum of the parts. Thus, true patient-centered medicine necessarily aspires toward a holistic approach. So, a case history is a concrete portrait of a real person, not an anecdote; and it is vivid, and the furthest thing possible from an abstract data set.

A typical RCT describes several data points about hundreds of patients. A typical case history describes perhaps hundreds of data points about a single patient. It’s not inferior, it’s different. The case history is, in fact, a technology, albeit an old one, set in language (another invention, we forget) and its structure (what is included in the case history, such as descriptions of the patient’s symptoms, objective signs, their subjective experiences, detailed life history, what makes the illness better, what worse, etc.) was developed over centuries.

Even anecdotes have their place. We often hear methodologists say, when a physician claims he or she gave a patient a particular medication, or supplement, or treatments, and they got better, “that that proves nothing. It is just an anecdote.” The problem is in the word “just.” Something doesn’t become meaningless, or a nonevent because a scientist adds the word “just” before it. That word really says nothing about the anecdote and a lot about the speaker’s preference for large number sets.

But anecdotes are very meaningful, too, and not just when lives are changed by a new treatment for the first time. This dismissive indifference to anecdotes turns out to be very convenient, for instance, for drug companies. If you are a physician, and you give a patient who had perfectly good balance an antibiotic, like gentamicin, and she suddenly loses all sense of balance because it injured her balance apparatus, the drug maker can say that is “just” an anecdote. It doesn’t count. And in fact, it is a fairly rare event. But it is by just such anecdotes that we learn of side effects, in part because (as I said above) most RCTs for new drugs don’t ask about those kinds of things, because they don’t want to hear the answer.

If we are to be honest, evidence-based medicine is, in large part, still aspirational. It is an ideal.

That’s why the approach I take—and I think most trained physicians with any amount of experience and investment in their patients’ well-being also take—might be called the all-available-evidence approach. This means, one has to get to know each of the study designs, their strengths, and their weaknesses, and then put it all together with what one is seeing, with one’s own eyes, and hearing from the particular patient who is seeking your care. There are no shortcuts.

One of the implications of this approach in the current COVID-19 situation is that we cannot simply, as so many are insisting, rely only on the long-awaited RCTs to decide how to treat COVID-19. That is because physicians in the end don’t treat illnesses, they treat patients with illnesses, and these patients differ.

The RCTs that are on the way may recommend, in the end, one medication as “best” for COVID-19. What does that mean? That it is best for everyone? No, just that in a large group, it helped more people than other approaches.

That information—which medication is best for most people, is very useful if you are in charge of public health for a poor country and can only afford one medication. Then you want the one that will help most people.

But if you are ordering for a community that has sufficient funds for a variety of medications, you are interested in a different question: What do I need on hand to cover as many sick people as possible, and not just those who benefit from medication X which helps most, but not all people? Even if a medication helps, say, only 10% of people, those will be lives saved, and it should be on hand. A medication that helped so few might not even have been studied, but if the others failed, it should be tried.

A physician on the frontline wants, and needs, access to those medications. He or she asks, “What if my patient is allergic to the medication that helps most people? Then, what others might I try?” Or, “What if the recommended medication is one that interacts negatively with a medication that my patient needs to stay alive for their non-COVID-19 condition?”

There are so many different combinations and permutations of such problems—and hardly any of them are ever studied—that only the physician who knows the patient has even a chance of making an informed decision. They are the kinds of things that arise on physician chat lines, that ask questions to 1,000 online peers like, “I have a patient with heart disease, on A, B, and C meds, and kidney disease on D, who was allergic to the COVID-19 med E. Has anyone tried med F, and if so, given their kidney function, should I halve the dose?”

Evidence-based medicine hasn’t studied some of the most basic treatments with RCTs or observational studies, never mind these kinds of individual complexities. So, the most prudent option is to allow the professional who knows the patient to have as much flexibility as possible and access to as many medications as possible. If we are to be honest, evidence-based medicine is, in large part, still aspirational. It is an ideal. Clinicians need latitude, and patients assume they have it. But now the RCT fundamentalists are using the absence of RCTs for some drugs to restrict access to them. They have gone too far. This is epistemological hubris, at the expense of lives, and brings to mind the old adage, “Absence of evidence is not evidence of absence.” As long as we’ve not got the best studies for all conceivable permutations, medicine will remain both an art and a science.

So, does conceding as much and giving the clinician latitude mean I don’t believe in science?

“Believe,” you say?

That is not a scientific word. Science is a tool. I don’t worship tools. Rather, I try to find the right one for the job. Or, for a complex task, which is usually the case in medicine—especially since we are all different, and all complex—the right ones, plural.

[gaiapaia]

Kermit and Friends: Unhappily Vaxxed

Kermit and Friends is a show that welcomes everyone. It doesn’t matter what race you are, what culture you come from, what religion you believe in, what sexual preferences you have, or what political party you’re aligned with. That’s just one of the many things that makes KAF so special.

However, it doesn’t stop at Kermit and Friends... the show’s host, Elisa Jordana, pretty much carries this mindset into her real life. She’s willing to be friends with ANYONE as long as they’re nice, funny, or interesting. Nothing else matters outside of having just one of those qualities. Bless her beautiful heart.

Unfortunately, not surrounding yourself with a likeminded bubble can lead to some annoyances, to put it lightly.

Everything in America is politicized right now. It’s been that way since a celebrity became President and the media started obsessing over him. Instead of COVID-19 being a health crisis, it became a political tool used by both parties to cater to their voters beliefs.

Since Elisa has friends on both sides of the political spectrum, she was hearing about it from every angle regarding the vaccine. From her Democratic friends, COVID-19 is the scariest disease in human history despite none of them actually knowing anyone who died from it. From her Republican friends, the vaccination was created to kill off the population despite none of them actually knowing anyone who died after taking the vaccine.

So when it came time for Elisa to make a choice whether or not she should get vaccinated... she had friends/family members telling her she was going to die with either choice she made. Imagine how nerve wracking that must be for someone who already has severe anxiety issues? It broke my heart to see Elisa so stressed out over this.

Elisa ended up getting vaccinated. I saw on her Facebook she was STILL being criticized by her liberal friends for waiting this long... it’s so ridiculous. Thankfully though, Elisa is perfectly fine. If you give 100 million people a Tylenol pill, a very small percentage of them will get sick from it and possibly even die. The odds of that happening though are about the same as winning the lottery (that also goes for the odds of dying from COVID). The coronavirus situation is a very serious issue since a small percentage of people dying or becoming seriously ill is nothing to take lightly, but it’s so silly how political everything revolving around it has become. Thankfully Elisa can put it all behind her now and not worry about it any longer.

Claire from New Jersey called into the show to announce he was converting to Christianity and accepting Jesus Christ as his Lord and Savior. Claire even said he was getting baptized Sunday night. I’m personally all for this, I think there’s a lot of good that can be learned from Jesus’s teachings and being a believer in Him. However, Claire took it a step further and said he’s joining a sanctuary of some kind and won’t be allowed back on the internet for the next few months.

This to me is taking it a tad bit far. You don’t need a community to be a believer in Jesus Christ. I also find the internet very helpful when learning about the Bible and Christianity as a whole. To eliminate it and instead go with a group led by some pastor or two is a mistake in my opinion, but hey... maybe this will lead Claire to happiness and fulfillment. I certainly hope so. His calls and presence in chat will be certainly missed.

Claire claims the place he’s going to is like a rehab facility so he can overcome his addictions to food and porn. Elisa hilariously took intrigue in Claire’s porn viewing habits... her questions made me laugh hard. Elisa also shared that Claire was the reason Sugar didn’t co-host the show this week. I know Claire had some critical comments about Sugar in the chat last week, but I was surprised to hear it had that kind of negative impact on her. Hopefully Claire will find it in his heart to apologize and sweet Sugar will return to her Kermit and Friends family very soon. We all love you Sugar and we missed you on yesterday’s show!

T-Bob and Kleenex had a spat on a livestream earlier this week and decided to continue it on Kermit and Friends. The fight on the livestream had to do with political stuff, and the fight yesterday was just them name calling one another. It was entertaining but nothing substantial I could break down and explain.

Their fight did lead to a guy named Mark Connors calling into the show. Referred to as Mark Cruz by T-Bob, this Mark dude claims to be a multi-millionaire and a former country music star who’s friends with Dolly Parton. How someone of this status can be so obsessed with T-Bob is baffling to me. He ranted about Bob in two separate calls for what had to be 15 minutes combined. Mark even brought his wife on the line to talk about a time when Bob supposedly threatened to skull f*** her, whatever that means.

According to T-Bob, Mark “Cruz” is a statutory rapist that got off because he was friends with the judge or something like that. Bob has made it one of his life missions to expose Mark’s allegations to the World, claiming he had news vans sent to Mark’s house in Tennessee to ask him about his legal troubles. 

Who knows what’s true and what’s false with these guys. All I know is that it has to be unbelievably tiresome to carry so much hatred for another human being. There aren’t many things I like about myself, but one thing I would never change is the fact that I obsess over things/people I love, not over things/people I hate. 

Kermit made 3 new awesome friends yesterday. The first was a very nice man by the name of Chip Baker. Chip is another one of Coach Love’s associates. He is the author of The Formula Chart For Life and he specializes in positive inspiration and motivation. Chip brought that positive energy to Kermit and Friends with a glorious smile and fun attitude, not letting the T-Bob/Kleenex stuff bother him at all, even offering advice to both men.

Laura Meadows and her handsome son Culver also made their KAF debuts yesterday. Laura is an actress that’s had roles in over 80 movies/television shows ranging from Law and Order, Any Given Sunday, and lots of horror stuff. Her son Culver was singing in the background when she first joined the show and later Laura brought him on to perform in front of the camera, but he was a bit too shy. I would absolutely love to see more of Laura and Culver on KAF in the future... both seem like extremely sweet people that exemplify the spirit of Kermit.

Sigmond returned to the show to give the greatest Rhianna cover you’ll ever hear when he sung her song, Stay. Wappy also beautifully performed Lady Picture Show by Stone Temple Pilots and Easy by The Commodores. Kermit and Friends is really blessed to have these two gentlemen and their amazing musical talent on the show every week.

To end the episode, Elisa played a phone recording of her final conversation with Andy Dick. It started with Andy mad at Elisa for the publicity he received over his arrest being covered on Kermit and Friends; then when Elisa defended herself, Andy went on this self-loathing tangent saying he doesn’t deserve her or anyone else. Andy then promptly hung up on Elisa when his friends started calling for him, pretty much summing their entire relationship up in 2 seconds.

What a jam packed show it was this week. There was a little bit of everything. I’m very proud of Elisa for both facing her fears head-on regarding the vaccination shot and for doing the show even though her anxiety/stress levels had been through the roof the previous 24 hours. That took a lot of fortitude and strength, and Elisa was rewarded with an awesome episode of Kermit and Friends that everyone enjoyed.