Pierre Auguste Cot - The Storm (1880)
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Peeling Away Health Care’s Sticker Shock

In the early 1950s, it was nearly impossible to know the value of an automobile. They had prices, yes, but these would differ radically from dealer to dealer, the customer a pawn in the hands of the seller. This all changed in 1958, when US senator Mike Monroney of Oklahoma shepherded a bill through Congress requiring that official pricing information be glued to the window of every new automobile sold in the US. The “Monroney sticker,” as it came to be known, has been with us ever since. It became an effective means of disclosing the manufacturer’s suggested retail price, or MSRP, and a billboard for other data disclosures to the consumer: the car’s fuel economy, its environmental rating, and so on.

The sticker price was one of the triumphs of consumer-rights legislation and has made buying a car an easier—though never altogether easy—experience. What’s more, window stickers made automobile pricing rational and understandable. A customer who knows the base price going in will expect more value coming out. In economic terms, the sticker turned a failed market flummoxed by information asymmetry into something resembling a functioning, price-driven marketplace.

If there is ever an industry in need of a Senator Monroney today, it is health care, in which 1950s-era thinking still rules the day, and irrational and inexplicable pricing is routine. The health care industry plays a gigantic game of Blind Man’s Bluff, keeping patients in the dark while asking them to make life-and-death decisions. The odds that they will make the best choice are negligible and largely depend on chance. Patients need to have data, including costs and their own medical histories, liberated and made freely available for thorough analysis. What health care needs is a window sticker—a transparent, good-faith effort at making prices clear and setting market forces to work.

How bad is it? Uwe Reinhardt, a leading health care economist, described the pricing of hospital services as “chaos behind a veil of secrecy.” Chaos due to lack of predictability; veil of secrecy because many organizations take a proprietary attitude toward data.

Consider a recent study of the costs of routine appendectomies performed throughout California. Though the procedures were largely identical, the charges varied more than 100-fold—from $1,529 at the cheapest to $182,955 at the most expensive.

What accounted for this bizarre spread? Good question—but efforts to discover the answer turned out to be futile. Although the research highlighted how large the bills for these hospitalizations were, various costs were declared to be trade secrets. The providers (i.e., the hospitals) and insurers involved in the study would not share how much the insurers actually paid for the visits, only what the providers charged. To me, understanding the logic here requires a chain of reasoning that could appear only in Alice in Wonderland. We don’t just need an MSRP sticker—we need a medical Freedom of Information Act!

In business, as time goes on, weak industry participants will try to improve their status, and, of course, incumbents will attempt to protect their positions. Two common ways of imposing or maintaining market power are by forming coalitions or by outright acquisitions, and that’s what has happened in medicine. Consolidation among health care providers has resulted in a number of large organizations becoming even more powerful as they’ve started to use their size and reach. And they’ve wielded this power to keep a lid on some of the information that would make for better health care.

The past several decades have seen major strides in technology of all kinds. Improvements in semiconductors have allowed faster computation and communications, as well as the construction of databases that outdo themselves every year. In many industries, technology development has spurred further improvements in efficiency—a virtuous cycle. In health care, this process is happening at a much slower rate. It has taken decades to complete even relatively simple tasks such as digitizing medical records.

by Andy Grove, Wired |  Read more:

Chenyang Liu
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Randy Dudley Verifying Dissonant Statistics 1981
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The Plot to Destroy America's Beer

Brian Rinfret likes imported beer from Germany. He sometimes buys Spaten. He enjoys an occasional Bitburger. When he was 25 years old, he discovered Beck’s, a pilsner brewed in the city of Bremen in accordance with the Reinheitsgebot, the German Purity Law of 1516. It said so right on the label. After that, Rinfret was hooked.

One Friday night in January, Rinfret, who is now 52, stopped on the way home from work at his local liquor store in Monroe, N.J., and purchased a 12-pack of Beck’s. When he got home, he opened a bottle. “I was like, what the hell?” he recalls. “It tasted light. It tasted weak. Just, you know, night and day. Bubbly, real fizzy. To me, it wasn’t German beer. It tasted like a Budweiser with flavoring.”

He examined the label. It said the beer was no longer brewed in Bremen. He looked more closely at the fine print: “Product of the USA.” This was profoundly unsettling for a guy who had been a Beck’s drinker for more than half his life. He was also miffed to have paid the full import price for the 12-pack.

Rinfret left a telephone message with AB InBev, the owner of Beck’s and many other beers, including Budweiser. Nobody got back to him. He had better luck with e-mail. An AB InBev employee informed him that Beck’s was now being brewed in St. Louis along with Budweiser. But never fear, the rep told Rinfret: AB InBev was using the same recipe as always.

He wasn’t satisfied. In March, he posted a plea on Beck’s official Facebook page: “Beck’s made in the U.S. not worth drinking. Bring back German Beck’s. Please.” He had plenty of company. “This is a travesty,” a fellow disgruntled Beck’s drinker raged. “I’m pretty bummed,” wrote another. “I’ve been drinking this beer religiously for over 20 years.” Rinfret kept trashing Beck’s on Facebook. Until, he says, AB InBev unfriended him in May. “They banned me from their site. I can’t post anything on there any longer.”

Rinfret was only temporarily silenced. He now complains on a Facebook page called Import Beck’s from Germany. AB InBev may be paying a price for disappointing Beck’s loyalists like him. According to Bump Williams, a beer industry consultant in Stratford, Conn., sales of Beck’s at U.S. food stores were down 14 percent in the four weeks ending Sept. 9 compared with the same period last year. “They are getting their proverbial asses kicked,” Williams says. “Too many customers were turned off when the switch was made.” Sales of Budweiser in the U.S. have fallen recently, too. And yet AB InBev is extraordinarily profitable.

There has never been a beer company like AB InBev. It was created in 2008 when InBev, the Leuven (Belgium)-based owner of Beck’s and Stella Artois, swallowed Anheuser-Busch, the maker of Budweiser, in a $52 billion hostile takeover. Today, AB InBev is the dominant beer company in the U.S., with 48 percent of the market. It controls 69 percent in Brazil; it’s the second-largest brewer in Russia and the third-largest in China. The company owns more than 200 different beers around the world. It would like to buy more.

The man in charge of AB InBev is 52-year-old Carlos Brito. The Brazilian-born chief executive is a millionaire many times over. He speaks English fluently and dresses like the manager of a local hardware store. At the Manhattan headquarters, he wears jeans to work and tucks in his shirts. He keeps his company identification badge clipped to his waist where everybody can see it, even though everyone knows who he is. To the rest of the world, he keeps a low profile. He does not, for example, accept interview requests from Bloomberg Businessweek. That might be his character, and it might be calculated. The Busch family is a legendary American dynasty. Many people in the U.S. aren’t thrilled that a foreign company now owns Budweiser, America’s beer.

by Devin Leonard, Bloomberg Businessweek |  Read more:

Image via: Wikipedia

Picasso
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Your Brain on Pseudoscience

An intellectual pestilence is upon us. Shop shelves groan with books purporting to explain, through snazzy brain-imaging studies, not only how thoughts and emotions function, but how politics and religion work, and what the correct answers are to age-old philosophical controversies. The dazzling real achievements of brain research are routinely pressed into service for questions they were never designed to answer. This is the plague of neuroscientism – aka neurobabble, neurobollocks, or neurotrash – and it’s everywhere.

In my book-strewn lodgings, one literally trips over volumes promising that “the deepest mysteries of what makes us who we are are gradually being unravelled” by neuroscience and cognitive psychology. (Even practising scientists sometimes make such grandiose claims for a general audience, perhaps urged on by their editors: that quotation is from the psychologist Elaine Fox’s interesting book on “the new science of optimism”, Rainy Brain, Sunny Brain, published this summer.) In general, the “neural” explanation has become a gold standard of non-fiction exegesis, adding its own brand of computer-assisted lab-coat bling to a whole new industry of intellectual quackery that affects to elucidate even complex sociocultural phenomena. (...)

Happily, a new branch of the neuroscienceexplains everything genre may be created at any time by the simple expedient of adding the prefix “neuro” to whatever you are talking about. Thus, “neuroeconomics” is the latest in a long line of rhetorical attempts to sell the dismal science as a hard one; “molecular gastronomy” has now been trumped in the scientised gluttony stakes by “neurogastronomy”; students of Republican and Democratic brains are doing “neuropolitics”; literature academics practise “neurocriticism”. There is “neurotheology”, “neuromagic” (according to Sleights of Mind, an amusing book about how conjurors exploit perceptual bias) and even “neuromarketing”. Hoping it’s not too late to jump on the bandwagon, I have decided to announce that I, too, am skilled in the newly minted fields of neuroprocrastination and neuroflâneurship.

Illumination is promised on a personal as well as a political level by the junk enlightenment of the popular brain industry. How can I become more creative? How can I make better decisions? How can I be happier? Or thinner? Never fear: brain research has the answers. It is self-help armoured in hard science. Life advice is the hook for nearly all such books. (...)

The idea that a neurological explanation could exhaust the meaning of experience was already being mocked as “medical materialism” by the psychologist William James a century ago. And today’s ubiquitous rhetorical confidence about how the brain works papers over a still-enormous scientific uncertainty. Paul Fletcher, professor of health neuroscience at the University of Cambridge, says that he gets “exasperated” by much popular coverage of neuroimaging research, which assumes that “activity in a brain region is the answer to some profound question about psychological processes. This is very hard to justify given how little we currently know about what different regions of the brain actually do.” Too often, he tells me in an email correspondence, a popular writer will “opt for some sort of neuro-flapdoodle in which a highly simplistic and questionable point is accompanied by a suitably grand-sounding neural term and thus acquires a weightiness that it really doesn’t deserve. In my view, this is no different to some mountebank selling quacksalve by talking about the physics of water molecules’ memories, or a beautician talking about action liposomes.”

by Steven Poole, The New Statesman |  Read more:

Photo: Getty Images

Lewis Lapham’s Antidote to the Age of BuzzFeed

The counter­revolution has its embattled forward outpost on a genteel New York street called Irving Place, home to Lapham’s Quarterly. The street is named after Washington Irving, the 19th-century American author best known for creating the Headless Horseman in his short story “The Legend of Sleepy Hollow.” The cavalry charge that Lewis Lapham is now leading could be said to be one against headlessness—against the historically illiterate, heedless hordesmen of the digital revolution ignorant of our intellectual heritage; against the “Internet intellectuals” and hucksters of the purportedly utopian digital future who are decapitating our culture, trading in the ideas of some 3,000 years of civilization for...BuzzFeed.

Lapham, the legendary former editor of Harper’s, who, beginning in the 1970s, helped change the face of American nonfiction, has a new mission: taking on the Great Paradox of the digital age. Suddenly thanks to Google Books, JSTOR and the like, all the great thinkers of all the civilizations past and present are one or two clicks away. The great library of Alexandria, nexus of all the learning of the ancient world that burned to the ground, has risen from the ashes online. And yet—here is the paradox—the wisdom of the ages is in some ways more distant and difficult to find than ever, buried like lost treasure beneath a fathomless ocean of online ignorance and trivia that makes what is worthy and timeless more inaccessible than ever. There has been no great librarian of Alexandria, no accessible finder’s guide, until Lapham created his quarterly five years ago with the quixotic mission of serving as a highly selective search engine for the wisdom of the past.

Which is why the spartan quarters of the Quarterly remind me of the role rare and scattered monasteries of the Dark Ages played when, as the plague raged and the scarce manuscripts of classical literature were being burned, dedicated monks made it their sacred mission to preserve, copy, illuminate manuscripts that otherwise might have been lost forever.

In the back room of the Quarterly, Lapham still looks like the striking patrician beau ideal, slender and silvery at 77 in his expensive-looking suit. A sleek black silk scarf gives him the look of a still-potent mafia don (Don Quixote?) whose beautiful manners belie a stiletto-like gaze at contemporary culture. One can sense, reading Lapham’s Quarterly, that its vast array of erudition is designed to be a weapon—one would like to say a weapon of mass instruction. Though its 25,000 circulation doesn’t allow that scale of metaphor yet, it still has a vibrant web presence and it has the backing of a wide range of erudite eminences.

When I asked Lapham about the intent of his project, he replied with a line from Goethe, one of the great little-read writers he seeks to reintroduce to the conversation: “Goethe said that he who cannot draw on 3,000 years [of learning] is living hand to mouth.” Lapham’s solution to this under-nourishment: Give ’em a feast.

Each issue is a feast, so well curated—around 100 excerpts and many small squibs in issues devoted to such relevant subjects as money, war, the family and the future—that reading it is like choosing among bonbons for the brain. It’s a kind of hip-hop mash-up of human wisdom. Half the fun is figuring out the rationale of the order the Laphamites have given to the excerpts, which jump back and forth between millennia and genres: From Euripides, there’s Medea’s climactic heart-rending lament for her children in the “Family” issue. Isaac Bashevis Singer on magic in ’70s New York City. Juvenal’s filthy satire on adulterers in the “Eros” issue. In the new “Politics” issue we go from Solon in ancient Athens to the heroic murdered dissident journalist Anna Politkovskaya in 21st-century Moscow. The issue on money ranges from Karl Marx back to Aristophanes, forward to Lord Byron and Vladimir Nabokov, back to Hammurabi in 1780 B.C.

Lapham’s deeper agenda is to inject the wisdom of the ages into the roiling controversies of the day through small doses that are irresistible reading. In “Politics,” for example, I found a sound bite from Persia in 522 B.C., courtesy of Herodotus, which introduced me to a fellow named Otanes who made what may be the earliest and most eloquent case for democracy against oligarchy. And Ralph Ellison on the victims of racism and oligarchy in the 1930s.

That’s really the way to read the issues of the Quarterly. Not to try reading the latest one straight through, but order a few back issues from its website, Laphamsquarterly.org, and put them on your bedside table. Each page is an illumination of the consciousness, the culture that created you, and that is waiting to recreate you.

by Ron Rosenbaum, The Smithsonian |  Read more:

Photo: Lapham's Quarterly

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A Taste of the Divine

We have taken our places. This evening’s performance, sold out months in advance, is about to begin. The programme, handwritten in a traditional script on a rolled parchment, tied with string, tells us to expect a prologue, two chapters and an epilogue, without interval. I’m nervous with anticipation but I’m somewhat embarrassed to admit that it’s not because I am waiting for the curtain to rise on a Wagner opera or a Shakespeare play. I’m actually waiting for my dinner.

This is no ordinary meal, however. It’s the 19-course tasting menu at one of the world’s best restaurants, Frantzén/Lindeberg in Stockholm. Ranked number 20 in Restaurant magazine’s influential annual survey, it earned two Michelin stars in its first two years and is almost certain to get a third. Food doesn’t get much, if any, better than this. (...)

When you’re having a tasting menu, it’s a lot about the rhythm, and the speed you’re serving things,’ says Frantzén. So the frozen lemon verbena, for instance, is one of the simplest dishes on the menu, but it’s in exactly the right place at the right time.

A meal like this is not just about delicious food. Frantzén says it sounds pretentious, but ‘it’s like going to the theatre … more than just what’s on the plate, it’s a lot of other things: storytelling, ingredients, where they’re coming from, how you present it, the look and feel of the restaurant’.

Our evening was full of theatre. As soon as we took our seats we saw a glass-topped wooden box on our table containing a small baguette-shaped piece of dough, proving. It was then taken away and baked over an open fire and brought back with some buttermilk, churned in front of us. At one point the maître d’ Jon Lacotte brought a piece of raw veal to our table and blow-torched it through a piece of coal. It was then taken away to return later as a ‘tartare’, with tallow from an 11-year-old milk cow, smoked eel and black roe.

This is not the cheap theatricality of banging plates or a flamboyant chef tossing pasta. Like a good play, you see only the action that is relevant to the plot, and that moves it forward to a satisfying resolution. So the freshest, most delicious bread and butter I’ve ever eaten, the very definition of simplicity, takes its rightful place alongside the most elaborate creations, because behind both is an incredible amount of care and effort to get it exactly right.

Still, there is the nagging question of cost. How could anyone possibly justify the bill? There is at least a financial logic to it. Ingredients such as the top-grade oyster, which came with frozen rhubarb, cream and juniper, cost a fortune. Frantzén’s business partner, the pastry chef Daniel Lindeberg, told me that 40 per cent of the bill is the cost of the ingredients alone. The rest is time. One dish we were served was whole turbot, which was baked for four hours at 55°C (130°F), with white asparagus baked for three hours with pine, lemongrass and mint. It takes longer to prepare a single ingredient of a single dish than it does for us to eat the whole meal. And it takes eight people in the kitchen, and about the same again outside it, to serve a total of 25 guests for dinner. Since I visited, that proportion has been ratcheted up again, with more kitchen space and less eating room: 11 chefs to 16 guests. Like an opera that requires an orchestra, a chorus and the world’s best solo voices, it’s this expensive because it costs this much to produce.

by Julian Baggini, Aeon |  Read more:

Two Girls 1905 (by Blue Ruin1)
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by ben///giles on Flickr.
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Why Hackathons Suck (and don’t have to)

Techies love hackathons. What could be better than getting together for an evening, or a weekend, with food, friends, maybe a beer, and using one’s magic powers to create a piece of technology that saves the world?

I exaggerate. Most people don’t think they’ll save the world in a weekend, but sometimes they act as if they believe they can.

As software professionals, when was the last time we went to our bosses and said “No problem. I’ll build that brand new production system for you in 8-16hrs”? Probably never.

Certainly not as often as we’ve freaked-out when the boss came to us with some impossible deadline. “You can’t expect me to build something effective, reliable, great in N-months!” we scream. “Be reasonable!”

So why do we sell the myth of the 2-day app to non-profits and other mission driven organizations?

Maybe we like the buzz of seeing ourselves as heroes able to jump tall-buildings with our nerd super-powers.

Or maybe we just like the pizza.

Either way, there are several problems with the way a typical hackathon model that make it almost impossible for them to succeed. I list some specifics below, but first I can sum up the core issue:

Hackathons just aren’t serious. They are in no way up to the challenge of delivering effective, useful, impactful technology.

A little more detail:

by jwishnie, ThoughtWorks |  Read more:

Photo: Ashely Ellis

Geoengineering: Testing the Waters

In 2010, the chairman of the House Committee on Science and Technology recommended more research into geoengineering; the British government has begun to spend public money in the field.

Bill Gates has funneled millions of dollars into geoengineering research. And he has invested in a company, Intellectual Ventures, that is developing at least two geoengineering tools: the “StratoShield,” a 19-mile-long hose suspended by helium balloons that would spew sun-blocking sulfur dioxide particles into the sky and a tool that can supposedly blunt the force of hurricanes.

The appeal is easy to understand. Geoengineering offers the tantalizing promise of a climate change fix that would allow us to continue our resource-exhausting way of life, indefinitely. And then there is the fear. Every week seems to bring more terrifying climate news, from reports of ice sheets melting ahead of schedule to oceans acidifying far faster than expected. At the same time, climate change has fallen so far off the political agenda that it wasn’t mentioned once during any of the three debates between the presidential candidates. Is it any wonder that many are pinning their hopes on a break-the-glass-in-case-of-emergency option that scientists have been cooking up in their labs?

But with rogue geoengineers on the loose, it is a good time to pause and ask, collectively, whether we want to go down the geoengineering road. Because the truth is that geoengineering is itself a rogue proposition. By definition, technologies that tamper with ocean and atmospheric chemistry affect everyone. Yet it is impossible to get anything like unanimous consent for these interventions. Nor could any such consent possibly be informed since we don’t — and can’t — know the full risks involved until these planet-altering technologies are actually deployed.

While the United Nations’ climate negotiations proceed from the premise that countries must agree to a joint response to an inherently communal problem, geoengineering raises a very different prospect. For well under a billion dollars, a “coalition of the willing,” a single country or even a wealthy individual could decide to take the climate into its own hands. Jim Thomas of the ETC Group, an environmental watchdog group, puts the problem like this: “Geoengineering says, ‘we’ll just do it, and you’ll live with the effects.’ ”

The scariest thing about this proposition is that models suggest that many of the people who could well be most harmed by these technologies are already disproportionately vulnerable to the impacts of climate change. Imagine this: North America decides to send sulfur into the stratosphere to reduce the intensity of the sun, in the hopes of saving its corn crops — despite the real possibility of triggering droughts in Asia and Africa. In short, geoengineering would give us (or some of us) the power to exile huge swaths of humanity to sacrifice zones with a virtual flip of the switch.

by Naomi Klein, NY Times |  Read more:

Illustration: Jacob Escobedo

The New Pot Barons: Businessmen Bank on Marijuana

Full dark in downtown Denver, and inside one of the twinkling high-rises that make the skyline, drug dealers are putting money into envelopes. They’re trying to be discreet. No one signed the security logbook in the lobby. All assume the room could be bugged. But if your image of the drug trade involves armed gangs or young men in parked cars, these dealers offer a surreal counterpoint. There’s a finance veteran, two children of the Ivy League, multiple lawyers, and the son of a police chief. At their side is a Pulitzer Prize–winning communications consultant, two state lobbyists, and a nationally known political operative. And the guest of honor: a state senator who likes the look of those envelopes being stuffed.

“What’s the maximum contribution?” one of the dealers asks. “Do you take cash?” wonders another. A third man breaks into a smile. “You better,” he says, eyebrows dancing, “because the banks don’t like doing business with us.” Laughter fills the room as the envelopes are passed forward and slipped into a briefcase. “Huge thank you, everyone,” the politician says, guiding the conversation back to the next legislative session and the kinds of legal changes this group would like to see. Here again, it’s not what you’d expect: there’s talk of a youth drug-abuse-prevention program and a bill to define “drugged” driving. When the politician finally rises to leave, after more than an hour, the dealers, in their pressed shirts and suit jackets, clap heartily. The average participant looks to be about 35, white and male, and on good terms with a barber. “Thank you,” the politician says, bowing slightly. “Thank you for what you do.”

What they do is sell marijuana. And not on street corners. Colorado is the developed world’s only regulated for-profit cannabis market, and sales—to the 100,000 residents who have a thumbs up from their M.D.s—are closing in on $200 million this year, a sum that generates tens of millions of dollars in local, state, and federal taxes. (Yes, the IRS taxes marijuana operations, even as the Justice Department attempts to shut them down.) Colorado is not the world’s only experiment in free-market pot, but it’s the most sophisticated, pushing beyond the Netherlands’ confusing ban on wholesale and California’s hazy nonprofit status. Denver’s former city attorney has called it California “on steroids.”

While the cannabis market remains illegal under federal law, attitudes are changing quickly, and it’s that fact that the Colorado growers are banking on. The number of regular pot users is up by 3 million in the past five years, and the rate of high-school experimentation is at a 30-year high. When a kid first lights up at about age 16, it’s usually not with a cigarette. Twelve states now treat a personal stash like a minor traffic offense, 17 allow medical marijuana, and this Election Day, if current polls hold, voters in Washington State and Colorado will vote to legalize marijuana—not for medical purposes but, as Rolling Stone recently enthused, “for getting-high purposes.”

That would close out a 40-year fight launched by boomers and carried through by a big tent of talented reformers, growing bigger all the time. “Weed is the new gay,” says Ted Trimpa, a Democratic strategist who helped engineer Colorado’s flip from red state to blue. He’s now focused on marijuana reform. But what I saw in Colorado was something altogether new: self-described “social entrepreneurs,” the Sergey Brins and Mark Zuckerbergs of the Green Rush. They could have done almost anything with their lives—“my brother is a physician” is the kind of thing one hears from them—but they chose to enter the pot business because they see it as a boom market, miracle cure, and social movement decades in the making and suddenly, thrillingly, near.

“This is our Facebook,” says one of my hosts, Norton Arbelaez, the owner of two dispensaries and a commercial grow. “This is the same kind of environment, the same kind of setting, and the same kind of people.” He was a founding member of the Medical Marijuana Industry Group (MMIG), a powerful young lobby that’s buried the age of drum-circle activism and instead strives to partner with law enforcement and politicians. It was their board meeting in the high-rise downtown, a weekly gathering two blocks from the Capitol dome. And it is their goal to dress legal pot in a style as conservative as their own.

by Tony Dokoupil, Newsweek |  Read more:

Photo: Andrew Hetherington

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State of the Species

The problem with environmentalists, Lynn Margulis used to say, is that they think conservation has something to do with biological reality. A researcher who specialized in cells and microorganisms, Margulis was one of the most important biologists in the last half century—she literally helped to reorder the tree of life, convincing her colleagues that it did not consist of two kingdoms (plants and animals), but five or even six (plants, animals, fungi, protists, and two types of bacteria).

Until Margulis’s death last year, she lived in my town, and I would bump into her on the street from time to time. She knew I was interested in ecology, and she liked to needle me. Hey, Charles, she would call out, are you still all worked up about protecting endangered species?

Margulis was no apologist for unthinking destruction. Still, she couldn’t help regarding conservationists’ preoccupation with the fate of birds, mammals, and plants as evidence of their ignorance about the greatest source of evolutionary creativity: the microworld of bacteria, fungi, and protists. More than 90 percent of the living matter on earth consists of microorganisms and viruses, she liked to point out. Heck, the number of bacterial cells in our body is ten times more than the number of human cells!

Bacteria and protists can do things undreamed of by clumsy mammals like us: form giant supercolonies, reproduce either asexually or by swapping genes with others, routinely incorporate DNA from entirely unrelated species, merge into symbiotic beings—the list is as endless as it is amazing. Microorganisms have changed the face of the earth, crumbling stone and even giving rise to the oxygen we breathe. Compared to this power and diversity, Margulis liked to tell me, pandas and polar bears were biological epiphenomena—interesting and fun, perhaps, but not actually significant.

Does that apply to human beings, too? I once asked her, feeling like someone whining to Copernicus about why he couldn’t move the earth a little closer to the center of the universe. Aren’t we specialat all?

This was just chitchat on the street, so I didn’t write anything down. But as I recall it, she answered that Homo sapiens actually might be interesting—for a mammal, anyway. For one thing, she said, we’re unusually successful.

Seeing my face brighten, she added: Of course, the fate of every successful species is to wipe itself out.

by Charles C. Mann, Orion |  Read more:

Photo: Miniature Worlds Digitally Assembled from Hundreds of Photographs by Catherine Nelson | Colossal

Fade to Light

Dementia is a problem around which the curtains are often gently drawn, so when I first met Lowell and Julie, over a year ago, I explained that I wanted to get a peek at what they were “struggling with.”

“Living with,” Julie corrected me. “Some days it’s a struggle, other days not.”

That hopeful pragmatism squares nicely with the Alzheimer Society of Canada’s philosophy. In fact, early on in Lowell’s illness, Julie was asked to apply for the organization’s vacant CEO role, but she decided it would be “too much Alzheimer’s.” Increasingly, we will all feel the deluge. The prevalence in Canada of all forms of dementia—Alzheimer’s is the most common, accounting for nearly two-thirds of all cases—is projected to double from half a million this year to 1.1 million by 2038. Meanwhile, Alzheimer’s has rocketed up the list of diseases we fear most; according to recent polls, it is second only to cancer, and it sits first for those fifty-five and up.

Although Lowell is twelve years older than the oldest baby boomer (and seventeen years older than Julie), he knows he personifies the coming wave. A critical difference is that while many people with moderate, or middle-stage, Alzheimer’s have anosognosia, or impaired insight, Lowell remains alert to his plight. Still, he had trouble understanding my designs—Were we going to write a letter together? To whom?—and Julie had to warm him to the idea of being profiled. On one of my initial visits, Lowell, with a twinkle in his eye, seemed to be rehearsing first lines for a full-blown biography: “Lowell Jenkins grew up in Faucett, Missouri. His childhood was not all blue skies… Lowell Jenkins is a natural-born helper… Lowell Jenkins woke up one night and couldn’t figure out where he was…”

In the summer of 2007, Julie and Lowell moved to another condo in the same building. Not only was the new unit a disorienting mirror image of the old, with the kitchen and bedrooms to the left rather than the right, but a full renovation was under way. Carpets were torn up, the kitchen cupboards had been knocked out, and wires hung down. Lowell sat up in bed and surveyed the rubble: “Where am I? What have we done? ”

Around the same time, he was showing uncharacteristic agitation while riding the subway, and when they started planning a trip to Russia he became strangely reticent, though he had visited there many times before on cross-cultural exchanges tied to his teaching. Julie knows now that she rationalized the more subtle changes. “Things happen as you get older,” she said. “You do get older.” But Lowell’s disquiet about the new condo was of a different scale. Such was her struggle to pacify him that in the days following they booked the appropriate tests. “He asked before we knew,” Julie said: “‘Do you think I have it?’ ”

They will knock on our doors,” Dr. Serge Gauthier says about the baby boomers. “All of them, I’m sure.” He is director of the Alzheimer’s Disease Research Unit at the McGill Centre for Studies in Aging, in Verdun, Quebec. The question, he says, is what to tell the individual keen to know his or her risk: “Does everyone who is forgetful need a PET scan? No—but who does? ”

Age is the risk factor that encompasses the other big ones: family history and genetics, gender (twice as many women as men get Alzheimer’s), cardiovascular disease, and diabetes. Evidence is gathering to support what ought to be an intuitive leap between brain health and heart health. Alzheimer’s can cause cerebral bleeding and vice versa, and aerobic activity three times a week has been shown to slow the rate of shrinkage in the hippocampus.

“If you’re preventive about heart attacks in your fifties and strokes in your sixties, you may reduce the risk of dementia in your seventies,” Gauthier says. “That’s a lot of bang for your buck.”

Further motivation is that there is no magic bullet in the offing; not a single new Alzheimer’s drug has been approved in the past nine years. Dr. Judes Poirier, the centre’s former director, says if anything positive has come from the “miserable failure” of recent drug trials, it is the new attention being paid to the idea of “simply and humbly” keeping dementia at bay. Delaying onset by two years would drop the rate of incidence by 33 percent within a generation, and a delay of five years would cut it in half. “If we delay it by ten years, something else will kill you,” Poirier says. “This is the beauty of Alzheimer’s.”

by Dave Cameron, The Walrus |  Read more:

Image: Amy Friend

The Civil Wars

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