Archive for the ‘Things that actually matter’ category

Pick Up The Damn Phone

August 11, 2015

I just got off the phone to my Congresscritturs:  Elizabeth Warren, Ed Markey, and Joe Kennedy.  I spoke to aides at each place, thanking Senator Warren for her support for the Iran deal, and urging in the strongest possible terms that Senator Markey and Rep. Kennedy pull their fingers out and do the same.

The bad guys are hitting the airwaves, the junkets, the phones hard on this one.  President Obama got this one right: the anti-deal folks include all those who screwed up the Iraq call.  We shouldn’t — we must not — let the nation listen to them again.

Joseph_Hauber_(attr)_Falter_Pilz_Schlange

To that end: aeons ago I did a summer’s worth of answering the phone on Capitol Hill for a congressman.  I’ve asked, and what was true then is still true: phone calls make a difference to these people — and you’d be surprised how few calls can make a difference.

So get on the phone.  Call your representatives.

House of Representatives numbers.

Senate numbers.

Thank your peeps if they’ve already got this one right:  affirmation matters a lot to them.  If they are still thinking, urge them POLITELY to come out in favor of the deal.  Tell them how disappointed you are, how angry, how motivated for change you have become if they tell you that they’re going to try to block the deal.  (Again — do so politely, but firmly.  That’s vastly more scary to them than bluster.)

If you want a great quick review of the arguments for the deal, there’s no better place to start that James Fallows. This post and this one will put you ahead of the entire neo-con policy apparat.*

In any event.  Call. Call now. Get your friends to get on the horn. It matters.

*This one opens with a longer list of Fallows’ arguments for the deal in the context of an opponents view.  The asymmetry of intellectual power will, I think, speak for itself.

Image:  attibuted to Joseph Hauber, Unsterblichkeit – Falter, Knollenblätterpilz und Schlange,** before 1834.

**translation help, anyone?

 

Some Damn Foolish Thing In The Balkans

June 4, 2015

It’s getting interesting* down Athens’ way:

ATHENS — Greece on Thursday told the International Monetary Fund it would not make a $335 million payment due Friday, taking a little-used option to defer that payment and three others until the end of the month.

Coming amid tense debt negotiations with the I.M.F. and European creditors, Greece’s decision holds political and financial-market implications that are hard to predict.

There’s a historical resonance sounding in the brinksmanship going on here.  This isn’t just a matter of debt and punishment.  What’s at stake may extend as far as the post-war and then the post-Cold War idea of Europe.  That would be the one intended to prevent even catastrophically incompetent or indifferent rulers from lurching into any replay of the summer of 1914.

Ludwig_Koch_Die_verbündeten_Monarchen_1915

Here’s Krugthulu, just as worried as I am — and way better informed:**

There’s an odd summer-of-1914 feel to the current state of the Greek crisis. While some of the main players are, rightly, desperate to find a way to head off Grexit and all it entails, others – on the creditor as well as the debtor side — seem not just resigned to collapse but almost as if they’re welcoming the prospect, the way, a century ago, far too many Europeans actually seemed to welcome the end of messy, frustrating diplomacy and the coming of open war.

The most troubling sign to me is the persistence of the disbelief on the part of international elites/opinion shapers that the Greeks might actually bolt from the Euro.  Never mind the risk to  the various institutional ties that are supposed to hold Europe together in a way that bars future conflict, armed and otherwise.  The idea that someone in a dispute might do something you don’t like seems just too difficult to accept on the part of Greece’s negotiating adversaries.

But there is real hardship in Greece right now, and there has been for years.  Political imperatives matter too:  the Greek government is new, left-leaning, and in power because they explicitly promised not to make deals that would satisfy Germany at the expense of the Hellene in the street.  There really is no guarantee — and lots of reasons to believe the reverse — that this one little, broke country will actually do the bidding of its would be financial masters — and yet even the slightest sign that such resistance is real evokes a kind of bemused wonder.

You can see something of the cognitive dissonance even in the brief “breaking” story in the Times linked above:

Although the practice of bundling I.M.F. loan payments into a single sum during a calendar month is allowed under the fund’s rules, the last time that option was taken was by Zambia in the 1970s.

I’m sure there’s a kinder way of reading that sentence, but it hits my ear as “Greece has the right to do this, but they shouldn’t.”  Unwritten rules, old boy.  Unwritten rules.

I’m with Krugman:  whether or not Greece would be better off or not dumping the Euro, Europe and the world gain an enormous amount from financial stability — which would be badly shaken if it looked like Euro-troubles were about to overtake the currency union.  In other words, it looks to me like Europe (even Germany!) needs Greece at this moment at least as much as Athens needs Brussels.

But what do I know:  I once vowed as a blogger not to behave like a pundit, which is to say, to bloviate about stuff I know only superficially and at second hand.  One thing I do know about, though, and have written on, is World War One.  No one’s mobilizing at this moment, and historical analogies are always fraught on so many levels.  But still, the insouciance, the lack of imagination about consequences — that was overwhelming then.  I smell it thickening in the air now.  That’s not good.

*As in, “May you live in interesting times.”

**This was written last Friday, which is to say before this latest news dropped.

Image:  Ludwig Koch, The allied monarchs and their field-marshals in the First World War (Kaiser Wilhelm II of the German Empire with Austria’s Franz Joseph)  c. 1915

Life Without Parole

April 8, 2015

So. Dzokhar Tsarnaev has been convicted on all thirty counts in the Boston Marathon Bombing and (closer still to home), the murder of MIT police officer Sean Collier.

Good.

Now for sentencing, in which the grotesquely termed “Death Qualified Jury”™ will decide between execution and life without parole.

Like an overwhelming majority of my Boston neighbors, I am opposed to the death penalty for Tsarnaev, as I am in all cases.  Three reasons:

1.  Error or malice.  It is hardly news to anyone reading this that police and prosecutors f**k up.  Death at the hands of the state not only renders those errors permanently uncorrectable.  As a citizen in whose name the state kills, I can’t accept that moral burden.

CaravaggioSalomeLondon

That some cases, like Tsarnaev’s, are open and shut doesn’t alter the moral and practical force of the argument above, I think. The moment you introduce discretion into death penalty jurisprudence, you re-open the opportunity for error or malice to kick in..  If the standard is overwhelming obviousness, then who decides; who processes the evidence in support of that definition, and so on.  The only way to be certain you’re not killing innocents is not to kill anyone under the cover of state-imposed penalties.

If that makes me soft, so be it.

2.  Soft or not, I’m vengeful, too.   To my mind, LWOP is a fate worse than death.  Because I do not believe in an afterlife, the only punishments that matter, like the only rewards, are those we receive in this life.  Fifty years in a maximum or super-max prison is, to me, a much more thorough and exemplary penalty than oblivion.

3.  I’m practical.  See reason one.  Cops and government lawyers f**k up.  We kill their errors and the urgency of addressing particular patterns of incompetence, indifference, and outright viciousness diminishes.  Patterns of bad behavior and unjust outcomes become much harder to discern.  Any hope, slim as it may be, of creating a better, more justice-driven law-enforcement system, evaporates when the living reasons to address current injustices disappear.  If we want to make things better, we need not to kill the people whom the system failed.  Simple as that.

One more thing:  I’m not non-violent.  But I’m anti-violence.  The fact that we (in theory) surrender to the state a monopoly on violence means that we need to hedge that power around with a mighty wall.  Not killing those in our power, even the most evil, is part of that wall.  Whether the more pragmatic arguments above carry greater weight some days than others, at bottom there is a moral imperative that I can’t find a way to avoid:  when we, or I, don’t need to kill, choosing to do so anyway is wrong.

Me being me, I could go on, but that there’s the gist.

What do y’all think?

Image:  Caravaggio, Salome with the head of John the Baptist, before 1610.

Brrrraaaaaiiiiiiinnnnssss…

February 6, 2015

Or rather…

MMMMMorrrrrronnnnns:

The reanimated corpse of Dr. Jonas Salk, the medical researcher who developed the first polio vaccine, rose from the grave Friday morning on what authorities believe is a mission to hunt down idiots.

Wiertz_burial

The usual suspects beware.

Another drive-by post, but go read the whole of Andy Borowitz’s update to his eponymous report.*  It’ll help your mood.

You’re welcome.

*Yes.  I did put this post up solely for the purpose of getting to type “eponymous.” It’s the little pleasures…

Image:  Antoine Wiertz, The Premature Burial, 1854.

Offense, Speech, Redress

January 7, 2015

In the thread below yesterday’s post on the shootings in Paris in its Balloon Juice version, a … lively … discussion broke out around various forms of the question of provocation.  No one, I think, suggested that the murders were anything but grotesque, an expression of evil.  But several people noted that they weren’t surprised that the atrocity occurred, given the known impact of the sort of satire in which Charlie Hebdu traded.

That evoked discussion — and sharp disagreement — about the duty of respect, especially to minority views or senses of identity.  (I’m paraphrasing and drastically shrinking the discussion here.  Feel free to correct, demur, dismiss in the comments.)

My view is pretty simple.  The price to pay for living in an open society is suffering the existence and the independence of those who drive you crazy.  Sort of like being the parent of a teenager.

But I digress.

Bluntly:  the appropriate response to speech that pisses you off is speech.  Nothing else.  I am a cultural relativist in my daily work. (What is a historian, even or especially a popular historian like myself, but someone who tries to grasp that foreign country, the past, in its own terms as well as in our own time’s?)

But that relativism has limits.  It commands empathy, sympathy, the effort to understand; it does not require, or even permit any veto on thought or behavior based on the cultural demands of one group over another.

That’s why anti-abortion groups become terrorists when they shoot clinic workers.  That’s why those who provide public accommodations — bakers, for example — no more get to choose to deny a gay couple a wedding cake than they would an African American one.  And so on.

So, no.  I don’t have a lot of sympathy for the contextualization of the murder of foul mouthed, blasphemous satirists as an extreme (and — everyone agreed on this — utterly unacceptable) extension of genuine grievances.  Even if it is true that France treats its former-colonial Muslim population culpably wretchedly.  Speech is speech.  Murder is murder.  The former never ameliorates, much less excuses guilt for the latter.  It doesn’t, really, even make it comprehensible.  Those who kill over cartoons (or use a cartoon as a pretext for a killing for other ends) are neither sembables or frères

That thought is what, earlier today, led me back to one of the monuments of 2oth century American jurisprudence.  It’s only surprising that the William Rehnquist wrote the opinion in Hustler Magazine v. Falwell in light of the current debasement of the Supreme Court.  I can actually remember when the party identification of the appointing President was not a wholly reliable guide to where opinions would land.

The issue in dispute in Hustler v. Falwell was whether or not the egregious preacher was entitled to damages for emotional suffering imposed by Hustler’s publication of a mock advertisement that showed a drunken Falwell having sex with his mother in an outhouse.

As Rehnquist wrote,

There is no doubt that the caricature of respondent and his mother published in Hustler is at best a distant cousin of the political cartoons described above [works by Thomas Nast and others], and a rather poor relation at that.

Boss_Tweed,_Nast

Nonetheless, crappy, nasty, or downright mean political speech is still vital, Rehnquist and a unanimous Supreme Court (Fat Tony included!) agreed, to the point that the no-doubt sincerely pissed off Falwell had to suck it up:

If it were possible by laying down a principled standard to separate the one from the other, public discourse would probably suffer little or no harm. But we doubt that there is any such standard, and we are quite sure that the pejorative description “outrageous” does not supply one. “Outrageousness” in the area of political and social discourse has an inherent subjectiveness about it which would allow a jury to impose liability on the basis of the jurors’ tastes or views, or perhaps on the basis of their dislike of a particular expression. An “outrageousness” standard thus runs afoul of our longstanding refusal to allow damages to be awarded because the speech in question may have an adverse emotional impact on the audience.

Rehnquist was hardly my beau-ideal of a jurist.  But he was always strong on the first amendment.  And in this  opinion, he nailed the essence of what freedom of speech means and requires from a society that values and trusts itself:

France isn’t the US.  I can imagine a different view of what might constitute shouting “Fire!” in a crowded theater if one were in Lebanon, say, rather than the Bronx — or the Marais.  But the underlying theme in the Hustler v. Falwell opinion talllies with the way I believe free societies would choose to live.

It remains vital to have enough sympathy to be able to recognize genuine pain evoked carelessly or deliberately by speech.  It’s an important part of living well to model the best definition I’ve heard for what it means to be a gentleman:  someone who never insults another person unintentionally.

But granting the reality of grievance in the face of either deliberate or ignorant disdain, still Rehnquist had it right:

 

“[T]he fact that society may find speech offensive is not a sufficient reason for suppressing it. Indeed, if it is the speaker’s opinion that gives offense, that consequence is a reason for according it constitutional protection.

Amen and amen.

The full text of the opinion follows below the jump.

Image:  Thomas Nast, Boss Tweed, before 1871.

(more…)

Nous Sommes Tous Charlie

January 7, 2015

By now I’m assuming everyone’s heard about the dreadful attack on the offices of the French satirical newspaper Charlie Hebo:

Masked gunmen burst into the Paris offices of a French satirical newspaper on Wednesday and killed 12 people, including top journalists and two police officers, before fleeing in a car. The gunmen were still at large at dusk, as an extensive police dragnet spread across a traumatized city.

Among the dead were four prominent cartoonists who have repeatedly lampooned Islamic terrorists and the Prophet Muhammad, leading to speculation that the attack on the newspaper, Charlie Hebdo, was the work of Islamic militants acting alone or in concert with extremist groups.

The gunmen — reports suggest there were three — are still at large, and, according to Times coverage, it remains unknown what group, if any, organized the attack.

Salman Rushdie knows something about words and art and the threat of deadly violence aimed at suppressing it.  He’s one of many who have responded to the attack.  The statement was apparently up at PEN’s site, but that’s down now, and (via a Neil Gaiman tweet) I found it at the Wall St. Journal.  Here it is:

“Religion, a mediaeval form of unreason, when combined with modern weaponry becomes a real threat to our freedoms. This religious totalitarianism has caused a deadly mutation in the heart of Islam and we see the tragic consequences in Paris today. I stand with Charlie Hebdo, as we all must, to defend the art of satire, which has always been a force for liberty and against tyranny, dishonesty and stupidity. ‘Respect for religion’ has become a code phrase meaning ‘fear of religion.’ Religions, like all other ideas, deserve criticism, satire, and, yes, our fearless disrespect.”  –Salman Rushdie

Bad times, sad times.  My thoughts and deepest sympathy to all the families and friends of the murdered.

Inequality Kills. Policy Drives Inequality. Elections Matter

March 16, 2014

Annie Lowrey in The New York Times today:

Fairfax is a place of the haves, and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County up to $107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.

One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq.

There have long been stark economic differences between Fairfax County and McDowell. But as their fortunes have diverged even further over the past generation, their life expectancies have diverged, too. In McDowell, women’s life expectancy has actually fallen by two years since 1985; it grew five years in Fairfax. [Links in the original]

Albrecht_Dürer_013

Lowrey is careful to note that the causal connection between poverty and longevity (or its absence) is hard to establish, and the data are both incomplete and fraught with co- and confounding factors.  But such caution does not in the end distract her from the basic point of her reporting:

It is hard to prove causality with the available information. County-level data is the most detailed available, but it is not perfect. People move, and that is a confounding factor. McDowell’s population has dropped by more than half since the late 1970s, whereas Fairfax’s has roughly doubled. Perhaps more educated and healthier people have been relocating from places like McDowell to places like Fairfax. In that case, life expectancy would not have changed; how Americans arrange themselves geographically would have.

“These things are not nearly as clear as they seem, or as clear as epidemiologists seem to think,” said Angus Deaton, an economist at Princeton.

Further, there is nothing to suggest that, for a given individual, getting a raise in pay or moving between counties would mean outliving her peers.

“The statistical term is the ecological fallacy,” Mr. Kindig said. “We can’t apply aggregate data to an individual, and that’s underappreciated when you’re looking at these numbers.” But, “having said that, I still think that the averages and the variation across counties tells us a lot,” he added. “We don’t want to let the perfect be the enemy of the good here.”

Despite the statistical murk, many epidemiologists, economists and other researchers say that rising income inequality may be playing into the rising disparity in health and longevity. “We can’t say that there is no effect, just because we don’t have clear methods to test the effect,” said Hui Zheng, a sociologist at Ohio State University…

Mr. Zheng has also posited that inequality, by socially disenfranchising certain groups and making them distrustful of public systems, may have a long-range effect on health.

To some extent, the broad expansion of health insurance to low-income communities, as called for under Obamacare, may help to mitigate this stark divide, experts say. And it is encouraging that both Republicans and Democrats have recently elevated the issues of poverty, economic mobility and inequality, But the contrast between McDowell and Fairfax shows just how deeply entrenched these trends are, with consequences reaching all the way from people’s pocketbooks to their graves.

I’ll mostly pass over Lowrey’s seeming willingness to take as hopeful recent Republican rhetoric on poverty absent any policy proposals that would do anything about it, whilst continuing to propose, inter alia, the destruction of Obamacare, the one program she cites as having the potential to help.  This kind of both-sides-ism seems to be an ineradicable MSM pathology.

What matters much more is the basic point to draw from the evidence within Lowrey’s piece:  poverty kills — or perhaps better, wealth saves. Increases in inequality correlate with an increasing gap between rich and poor on the most basic of measures, how long we all get to enjoy the pursuits of life, liberty and happiness.  Policies that drive such inequality, or do nothing to mitigate, are implicated in those lost years, in deaths before time.  Those policies are the current program of the Republican Party.

Literally:  Vote like your live depends on it.

Image: Albrecht Dürer, The Death of Crescentia Pirckheimer, 1504.

Yup. Holder Goes There. (About Damn Time Too)

February 11, 2014

Here’s Eric Holder on the systematic elimination of political rights from millions of Americans:

“It is unwise, it is unjust, and it is not in keeping with our democratic values.” [Via TPM]

Vincent_Willem_van_Gogh_037

And just who might be disproportionately represented among those barred from giving their consent to their governing?

African-Americans represent more than a third of the estimated 5.8 million people who are prohibited from voting, according to the Sentencing Project, a research group that favors more liberal sentencing policies. And in Florida, Kentucky, and Virginia, more than one in five African-Americans has lost the right to vote. [link in the original]

And the last question in this mockery of a catechism, what lies behind the desperate push to of keep ex-cons from resuming full participation in our polity? The question answers itself:

Studies show that felons who have been denied the right to vote are far more likely to vote for Democrats than Republicans. In 2002, scholars at the University of Minnesota and Northwestern University concluded that the 2000 presidential election “would almost certainly have been reversed” had felons been allowed to vote. [link in the original]

In Florida, the state that tipped that election, 10 percent of the population is ineligible to vote because of the ban on felons at the polls, Mr. Holder said.

Denying those who’ve completed the sentences the law requires for their acts the right to vote is nothing new.  It’s just the latest in a guerrilla campaign running more than a century now, one aimed at reversing the results of the shooting war that only nominally ended in 1865.  Bad enough that African Americans could no longer be bought and sold, but heaven forfend that they actually exercise the essential rights of any citizen.  Or, as Holder put it in terms suited to the meanest understanding:

“Although well over a century has passed since post-Reconstruction states used these measures to strip African-Americans of their most fundamental rights, the impact of felony disenfranchisement on modern communities of color remains both disproportionate and unacceptable” he said….

The sad truth is that Holder and the Department of Justice can’t do much here.  States retain the right to set election law, and, as the Times noted,

The question of how people vote is contentious, particularly since the Supreme Court struck down part of the Voting Rights Act last year. That decision allowed states to pass voting laws that would otherwise have needed federal approval.

But still, good on him for getting this out there, and in the terms he used.  Racism isn’t a residue of times gone by, eroding with each passing year.  It’s not a state of mind, something that is or isn’t in someone’s heart.  It inheres in the actual decisions made, consequences sought and embraced, that result in harm done to specific individuals and groups.  It lies at the heart of the choices being made right now, overwhelming by one political party, the GOP, as it attempts to return to the pinnacle of power.

Holder’s making that clear in surprisingly  (to me) uncompromising language.  Good.  This is how both Overton Windows and, over waaaaay too much time, actual policy shifts.

Image: Vincent van Gogh, Prisoners Exercising, 1890. (Yeah. I’ve used this one before. You gotta problem with that?)

Worst People In The World

December 13, 2013

For the life of me, I can’t see why we shouldn’t invoke the UN convention on genocide against Big Tobacco:

Tobacco companies are pushing back against a worldwide rise in antismoking laws, using a little-noticed legal strategy to delay or block regulation. The industry is warning countries that their tobacco laws violate an expanding web of trade and investment treaties, raising the prospect of costly, prolonged legal battles, health advocates and officials said.

Alarmed about rising smoking rates among young women, Namibia, in southern Africa, passed a tobacco control law in 2010 but quickly found itself bombarded with stern warnings from the tobacco industry that the new statute violated the country’s obligations under trade treaties.

“We have bundles and bundles of letters from them,” said Namibia’s health minister, Dr. Richard Kamwi.

Three years later, the government, fearful of a punishingly expensive legal battle, has yet to carry out a single major provision of the law, like limiting advertising or placing large health warnings on cigarette packaging.

I’m a little emotional on this issue, as my mother died ten days before my scheduled wedding day, murdered by RJ Reynolds.

But at least when Mom started smoking in the late 1930s/early 1940s, the explicit tobacco-cancer connection was still obscure, with the first case-control studies clearly linking cigarettes to cancer emerging in 1948 (per Siddhartha Mukherjee’s first rate The Emperor of all Maladies.  See especially the chapter titled “The Emperor’s Nylon Stockings”).  Her death may reasonably be considered involuntary manslaughter.

Now, though, there is no way to work for a tobacco company and not know that what you do is sell poison, and that the ultimate effect of your product, used as is intended, is slaughter.

2_Andrea_di_Bartolo._Massacre_of_the_Innocents_1380s._Walters_Museum_of_Art.

Most people, I’d like to think, would take a long look in the mirror and decide that there are other ways to spend our three score and ten than making a living off the wholly preventable suffering and death of uncounted others.

But clearly those working for Big Tobacco somehow missed that day in school when the class talked about the golden rule — not to mention  just about any version of the minimum expectations for human moral behavior.  Which is why first world tobacco titans  now seek to compel cash-strapped nation-states to accept the sale of death as just another bit of misery those with power can enforce on those with less.*

Let me be clear:  the law may say otherwise, but forcing tobacco on countries trying to restrict its use seems to me to be murder, pure and simple.

Sure, the victims are unknown, and their deaths in many cases decades in the future.  But the link between cigarettes and fatal disease is clear.  The motive for the companies’ actions are clear.  The gain in exchange for decisions that will inevitably result in many, many deaths is right out there in dollars and cents.  One may argue the formal distinctions between degrees, or between murder and manslaughter, but for me, deaths that the killer has reason to expect will happen as a consequence of his or her own actions count as the worst of crimes.

Regulation is needed.  So are tumbrels.

*Props, btw, to Michael Bloomberg, who the NYT reports paid for Uruguay’s defense in a suit  brought by Phillip Morris at a point where the country would have had to drop its tobacco law for lack of funds to defend it.  But hoping that right-minded billionaires will answer the call is no substitute for policy, and no remedy for the utter moral depravity on display in this story.

Image: Andrea di Bartolo, Massacre of the Innocents,  1380s

Your Daily Apocalypse, Outsourced Antibiotic Edition

November 21, 2013

Go read this piece by Maryn McKenna — who is, in my never humble opinion, one of the handful of very best reporters on matters of infectious disease, global health, and really scary stuff.

I was born in 1958, fifteen years into the era of clinically-available antibiotics.  I was my mother’s third child.  Had we shifted that timeline back a few years, that would have meant that there would have been a measure of luck in mom simply making it to and not through her third lying in.  As Maryn writes, before antiobiotics, five out of 1,000 births ended with the death of the mother.  No worries by the time I popped my head out into the maternity floor at Alta Bates.

But this a must read not because of any remembrance of the pre-antibiotic era, but because Maryn plausibly analyzes a post-antibiotic future.

Plaguet03

Here’s a sample:

Doctors routinely perform procedures that carry an extraordinary infection risk unless antibiotics are used. Chief among them: any treatment that requires the construction of portals into the bloodstream and gives bacteria a direct route to the heart or brain. That rules out intensive-care medicine, with its ventilators, catheters, and ports—but also something as prosaic as kidney dialysis, which mechanically filters the blood.

Next to go: surgery, especially on sites that harbor large populations of bacteria such as the intestines and the urinary tract. Those bacteria are benign in their regular homes in the body, but introduce them into the blood, as surgery can, and infections are practically guaranteed. And then implantable devices, because bacteria can form sticky films of infection on the devices’ surfaces that can be broken down only by antibiotics

Dr. Donald Fry, a member of the American College of Surgeons who finished medical school in 1972, says: “In my professional life, it has been breathtaking to watch what can be done with synthetic prosthetic materials: joints, vessels, heart valves. But in these operations, infection is a catastrophe.” British health economists with similar concerns recently calculated the costs of antibiotic resistance. To examine how it would affect surgery, they picked hip replacements, a common procedure in once-athletic Baby Boomers. They estimated that without antibiotics, one out of every six recipients of new hip joints would die.

As Maryn reports, the problem is tangled and complex — but there are clear actions that could be taken and aren’t, most obviously ending the reckless use of antibiotics in agriculture, which consumes something like 80% of the total produced.  But don’t waste time here: go read the whole thing. Get scared; get mad; call your congressfolk.

Image: Josse Lieferinxe, St. Sebastian prays for plague victims, 1497-99.