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Tales From City of Hope #5: My Stem Cells Have Come Home to Papa

| Thu Apr. 23, 2015 1:28 PM EDT

It is 9:49 am PDT on April 23, and my stem cell transfusion is complete. It took less than 20 minutes. Now the stem cells just have to graft and start multiplying, each of them eventually maturing into some kind of blood product (red blood cell, white blood cell, platelet, etc.). This will take about a month, but I'm not home free even then. It turns out that these will initially be "baby" cells, and it takes them about a year to fully learn how to do their jobs. Who knew that itty bitty cells had to attend cell training school?

The entire remainder of my visit at City of Hope is just waiting for my immune system to recover and to keep an eye out for severe side effects in case they happen. In a few days I'll be losing my appetite, but apparently this is because I'll be losing my sense of taste. In the past, I've lost my appetite due to IV painkillers in the hospital or extreme fatigue at home. In both cases food tasted normal, but I just couldn't stand the thought of eating anything.

So will this be better or worse? Presumably, food will be tasteless but not repulsive. That strikes me as no fun, but actually more tolerable than being actively repulsed by food. We'll see.

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Who's Tired Of Politics?

| Thu Apr. 23, 2015 12:21 PM EDT

Yesterday lifelong political junkie George Packer reluctantly confessed something: "It might not be wise for a sometime political journalist to admit this, but the 2016 campaign doesn’t seem like fun to me."

Ed Kilgore and Dylan Byers both took issue with this. In a nutshell, Kilgore thinks 2016 will be a fairly consequential election and the horse race will be fairly unpredictable, while Byers thinks the horse race will have as many twists and turns as usual. Lots of fun for everyone!

I'm a bit of an odd duck on this subject: a daily blogger and political junkie who has only a slight interest in the campaigns themselves. I have some interest, and I usually end up writing plenty of campaign posts, but it mostly seems like uninteresting kabuki to me. Candidates are so thoroughly media trained these days that you mostly know what they're going to say before they open their mouths. "Gaffes" are seldom more than slightly ambiguous extemporaneous constructions that the media plays along with either out of boredom or a desire to seem like they're not playing favorites. All the marketing minutiae of ad buys and demos and GOTV innovations is interesting in an academic sense, but it hardly seems to matter much in the face of overwhelming evidence that a few basic fundamentals decide the race months before Election Day. And the tired and almost childish obsession of the press corps with dumb adherence to narratives and personalities is enough to make any serious reader scream.

But these aren't really Packer's main beefs with presidential campaigns. This is:

The reason is the stuckness of American politics. Especially in the years after 2008, the worst tendencies of American politics only hardened, while remaining in the same place. Beneath the surface froth and churn, we are paralyzed. You can sense it as soon as you step out of the train at Union Station in Washington, the instant you click on a Politico article about a candidates’ forum in Iowa: miasma settles over your central nervous system and you start to go numb. What has happened is that the same things keep happening. The tidal wave of money keeps happening, the trivialization of coverage keeps happening, the extremism of the Republican Party keeps happening (Ted Cruz: abolish the I.R.S.; Rand Paul: the Common Core is “un-American”). The issues remain huge and urgent: inequality, global warming, immigration, poorly educated children, American decline, radical Islamism. But the language of politics stays the same, and it is a dead language. The notion that answers will come from Washington or the campaign trail is beyond far-fetched.

This is it, and it's a common complaint. Both parties are stuck in the same sound bites; neither is willing to seriously compromise; and given the structure of the US government it's vanishingly unlikely that either party can get much of anything done. Tax policy can be changed via reconciliation, and Barack Obama had a short window where he got some things done via a huge Democratic majority in the Senate. Neither party is likely to replicate that in the near future. Likewise, for all the sound and fury, the differences between mainstream Democratic and Republican foreign policy have become pretty narrow since George Bush's Iraq debacle.

As Packer says, American politics is stuck. It's paralyzed. Exhibit 1: We've just witnessed a historically unprecedented delay in confirming an Attorney General that everyone agrees is eminently qualified. Why? Because of a bit of clever Republican gameplaying over an abortion clause that was fundamentally trivial but great red meat for the base. When the Democratic base finally cottoned on to the game, they went predictably ballistic and everything stalled. It was all just dumb kabuki: gameplaying from Republicans, predictable outrage from Democrats, and all over a long accepted principle that bans federal funding of abortion. Two months of gridlock over trivial symbolism. And why not? Everyone knows there was nothing important that had any chance of getting done anyway.

So yeah: unless you're a horse race junkie by nature, it's pretty hard to get excited by the horse race when it has almost no chance of changing things except on the margins. This will change eventually, but probably no time soon.

The American Teen Whose Death-by-Drone Obama Won't Explain

| Thu Apr. 23, 2015 11:15 AM EDT

On Thursday, President Barack Obama appeared in the White House press room to reveal that a US strike in January on an Al Qaeda compound had killed two hostages held by the terrorist group, Giovanni Lo Porto, an Italian, and Warren Weinstein, an American. He offered his condolences to their families for the mistake that led to their deaths.

It's remarkable that Obama spoke of this at all. The US targeted killing program is shrouded in secrecy, and the president had never before issued a statement like this about people accidentally killed by US drone strikes. (He did not use the word "drone.") One such death that stands out is that of Abdulrahman al-Awlaki, a 16-year-old American citizen who was killed in a US drone strike.

Abdulrahman was the son of Anwar al-Awlaki, the radical cleric turned Al Qaeda propagandist. The father was killed in a drone strike that targeted him in Yemen in September 2011. The son was killed weeks later in a separate strike in Yemen. According to his family, the attack was on a restaurant. Attorney General Eric Holder later said that this strike did not "specifically" target the young man.

The US government has never said that Abdulrahman was involved in terrorist activities. In 2012, I asked Obama during a Reddit AMA what he thought about the teen's death, and the question received hundreds of votes from Redditors, meaning the president and/or his social-media team almost certainly noticed it. Yet Obama didn't respond.

Now that he's established the precedent of explaining the killings of US citizens in targeted strikes, Obama and the administration might see fit to say what happened in the case of Abdulrahman. Was his death accidental or is there evidence he was involved with terrorists?

For more on Abdulrahman al-Awlaki, read Tom Junod's 2012 piece on his killing.

It's Not the 1 Percent Controlling Politics. It's the 0.01 Percent.

| Thu Apr. 23, 2015 6:15 AM EDT

Even before presidential candidates started lining up billionaires to kick-start their campaigns, it was clear that the 2016 election could be the biggest big-money election yet. This chart from the political data shop Crowdpac illustrates where we may be headed: Between 1980 and 2012, the share of federal campaign contributions coming from the very, very biggest political spenders—the top 0.01 percent of donors—nearly tripled:

In other words, a small handful of Americans* control more than 40 percent of election contributions. Notably, between 2010 and 2012, the total share of giving by these donors jumped more than 10 percentage points. That shift is likely the direct result of the Supreme Court's 2010 Citizens United ruling, which struck down decades of fundraising limits and kicked off the super-PAC era. And this data only includes publicly disclosed donations, not dark money, which almost certainly means that the megadonors' actual share of total political spending is even higher.

It's pretty fair to assume that most of these top donors are also sitting at the top of the income pyramid. Out of curiosity, I compared the share of campaign cash given by elite donors alongside the increasing share of income controlled by the people who make up the top 0.01 percent—the 1 percent of the 1 percent. The trend lines aren't an exact match, but they're close enough to show how top donors' political clout has increased along with top earners' growing slice of the national income. Again, note the bump around 2010 and 2011, when the Citizens United era opened just as the superwealthy were starting to recover from the recession—a rebound that has left out most Americans.

 

Correction: An earlier version of this article incorrectly stated that a few hundred people control 40 percent of election contributions, based on my own calculations. According to Crowdpac, the number is around 25,000.

This Is Why You Crave Sugar When You're Stressed Out

| Thu Apr. 23, 2015 6:00 AM EDT

Here's something that won't come as a surprise to anyone who has ever devoured a pint of Rocky Road after a miserable day at work: Researchers at the University of California-Davis recently found that 80 percent of people report eating more sweets when they are stressed. Their new study, published in the the Journal of Clinical Endocrinology & Metabolism, offers a possible explanation.

Sugar, the researchers found, can diminish physiological responses normally produced in the brain and body during stressful situations. With stress levels on the rise, this could explain why more people are reaching for sweets.

The three-phase study involved 19 women, ages 18 to 40, who spent three days on a low-sugar diet at the research facility. Saliva samples and MRIs were taken and stress was induced through timed math tests. After being discharged, over the course of 12 days, the women consumed sweetened drinks three times a day. Half had beverages sweetened with the artificial sweetener aspartame, while the rest had drinks sweetened with real sucrose. This phase was followed by an additional three-day stint at the facility during which MRIs and saliva samples were taken again.

After the 12-day period, the group that had sucrose-sweetened beverages showed higher activity in the left hippocampus (an area of the brain responsible for learning and memory that is sensitive to chronic stress) and significantly reduced levels of cortisol (the hormone released in response to stress) compared to those who had artificially sweetened beverages.

While this study was one of the first to show that sugar can reduce stress responses in humans, it followed up on previous studies that found similar conclusions in animal subjects. The researchers noted the need for future research—especially on whether long-term sugar consumption has the same effect.

"The concern is psychological or emotional stress could trigger the habitual overconsumption of sugar," lead author Kevin D. Laugero told Science Daily. Not exactly great news for those of us who enjoy eating our feelings.

Tales From City of Hope #4: The Smell of Victory in the Morning

| Wed Apr. 22, 2015 10:45 PM EDT

Chemotherapy is over and tomorrow is Tag Null: that is, Day Zero, when they pump my own frozen stem cells back into me. The entire process takes about 20 minutes, but I'll be in the hospital practically the entire day getting liters and liters of IV fluids. This is partly to keep me hydrated and partly just because they want to keep me under observation for a while.

But here's the interesting thing. The stem cells are kept in a preservative solution to keep them fresh, and apparently this will give me a strong body odor of some kind. But what? One nurse said I would smell like bad garlic for a day. That sounds bad. But a different nurse said I would smell like creamed corn. That seems more tolerable. Yet a third suggested it differed by nationality, and a white boy like me might smell like iodine.

But which is it? To me, of course, I will smell fresh as a new-plucked daisy. It's only other people who have to put up with my olfactory weirdness. In any case, I plan to ask everyone who comes into my room what I smell like. Spoiled tuna? A lovely cheese casserole? Bacon and eggs? Who knows?

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Obama Just Called Out Florida's Climate Deniers in Their Own Backyard

| Wed Apr. 22, 2015 4:05 PM EDT
Obama speaking this afternoon at Everglades National Park

President Barack Obama just marked Earth Day with a speech on climate change, given from a podium in Florida's Everglades National Park. The choice of venue was appropriate from an environmental perspective—the Everglades is already acutely feeling the impacts of sea level rise—but it was also telling from a political standpoint. Although our swampiest national park has a long history of bipartisan support, it's located in a state that has recently produced some of the most absurdist climate denial in recent memory—and Obama didn't forget to mention it.

Florida is home not just to Sen. Marco Rubio, a GOP presidential contender who maintains that humans can't affect the climate, but also to Gov. Rick Scott, who landed in headlines last month after apparently barring state employees from talking about climate change.

"Climate change can no longer be denied," Obama said today. "It can't be edited out. It can't be omitted from the conversation…Simply refusing to say the words 'climate change' doesn't mean climate change isn't happening."

Obama also took a jab at Sen. James Inhofe (R-Okla.) for bringing a snowball onto the Senate floor. "If you have a coming storm, you don't stick your head in the sand," he said. "You prepare for the storm."

You can watch the full speech below (starts at 48:00):

By Immense Coincidence, GOP Benghazi Probe Scheduled to Finish Up During Height of 2016 Hillary Campaign

| Wed Apr. 22, 2015 3:16 PM EDT

From Bloomberg News:

The findings of a Republican-led committee investigating Hillary Clinton’s response to the deadly 2012 attack in Benghazi, Libya, likely will not be released until next year, just months before the 2016 presidential election.

I am shocked, shocked to hear this news.

Obama Has a Plan to Expand Medicaid in Red States—by Weakening It

| Wed Apr. 22, 2015 3:10 PM EDT

One of the Affordable Care Act's major provisions sought to expand the number of people covered by Medicaid by allowing people earning up to 138 percent of the poverty line to enroll.

But in many parts of the country, it hasn't worked out that way. Individual states are largely responsible for running Medicaid, and despite the act's generous terms—the federal government promised to initially cover 100 percent of the cost, then 90 percent after 2016—only 29 states have taken the deal. Of the holdouts, most are conservative states with Republican governors where Obama is unpopular.

Some red states have been coming around, lured by of the enormous infusion of federal funds they'll receive by expanding Medicaid. And without participating, states soon stand to lose billions in other payments designed to compensate hospitals for care for the uninsured. (Florida could lose more than $2 billion on account of leaving 800,000 residents uninsured who could otherwise be covered under Medicaid.)

Despite that carrot and stick, Republican-controlled states have demanded additional concessions from the Obama administration before taking part in the expansion—and in many cases, as a new paper from the National Health Law Program suggests, the administration has agreed to changes that undermine its own goal of expanding coverage.

These changes have made some states' Medicaid programs more, well, Republican—not to mention punitive. Take Arkansas, which in 2013 was allowed to use its Medicaid funds to let poor residents buy private insurance on the state health exchange—policies that may not have the same protections or coverage as traditional Medicaid. Iowa and New Hampshire have followed suit. According to the NHLP, these initial waivers emboldened states to seek even greater concessions. An example is Indiana, where, in exchange for agreeing to expand Medicaid, officials not only won the right to charge poor people premiums and co-payments, but also to lock people out of the program for at least six months if they fail to pay those premiums.

The administration has granted such waivers through its authority to authorize so-called demonstration projects to encourage policy innovation in the states. But NHLP contends that waivers like Indiana's violate the law, which "requires demonstrations to actually demonstrate something." As NHLP points out, reams of research have long showed that such premiums dramatically reduce health coverage for low-income people. After the Obama administration granted Indiana's request, Arkansas went back to ask for permission to charge premiums, too. And it prevailed.

And yet some states still want more. Florida, for instance, is considering a bill that would use billions of dollars of Medicaid money to provide vouchers to poor people to buy private insurance. But anyone getting a voucher would have to pay mandatory premiums, and also either have a job or be in school. Childless adults need not apply. (The administration hasn't signed off on this one—yet.)

NHLP suggests that the Obama administration is undercutting its very strong bargaining position by allowing states to dismantle Medicaid through waivers, at the expense of the very poor and sick. Its white paper notes that Medicaid's history proves even the most ardent opponents of government health care eventually come around: In 1965, when the program was first created, only 26 states joined in. Five years later, though, almost all had.

Scott Walker Celebrates Earth Day by Proposing To Fire 57 Environmental Agency Employees

Wed Apr. 22, 2015 1:48 PM EDT

Happy Earth Day! Today is a day we can all band together and share our love for this beautiful planet—or at least drown our sorrows about climate change with nerdy themed cocktails. Later today, President Barack Obama will mark the occasion with a climate-focused speech in the Florida Everglades. Wisconsin Gov. Scott Walker, a frontrunner for the GOP presidential nomination, had a different idea: Fire a big chunk of the state's environmental staff.

From the Milwaukee Journal-Sentinel:

Fifty-seven employees of the state Department of Natural Resources began receiving formal notices this week that they might face layoff as part of Gov. Scott Walker's budget for the next two fiscal years…

The DNR's scientific staff conducts research on matters ranging from estimating the size of the state's deer herd to to studying the effects of aquatic invasive species. Work is paid for with state and federal funds…

All told, Walker's budget would cut 66 positions from the DNR. Of this, more than 25% would come from the science group. Cosh said a smaller number of employees received notices than the 66 positions in the budget because some positions targeted for cuts are vacant.

It's no secret that a signature tactic in Walker's controversial environmental record has been to degrade the DNR, which in addition to carrying out research is tasked with regulating the state's mining industries. Still, the timing of this particular announcement is striking. I guess no one marked Earth Day on Walker's calendar.

Neither Walker's office nor DNR immediately returned requests for comment.

As consolation for this depressing news, here's is a webcam of pandas at the San Diego Zoo.