Photo: Kaytee Riek, whose other photos of this recent demo can be found at kayteeriek.com
President Obama is making big mistakes on global AIDS. Click to read South African AIDS activist Zackie Achmat explaining why.
See also:
TakeANumber.org
New York Times
Zackie Achmat in New York, May 13 2010:
Unless Republicans in the Senate manage to somehow find a way to sink the nomination, it looks like Don Berwick will be the new Medicare/Medicaid chief. I think that is actually big news. It suggests that in the next phase of healthcare reform, Obama's emphasis will be quality improvement--and likely, linking payment to quality outcomes.
Medicare has already started moving in that direction. And healthcare reform quietly includes some important tools to help it move farther. But this may suggest that Obama is going all in on changing payment structures.
Why do I say that? Because Berwick is the person who has probably best popularized the quality improvement movement within healthcare. Though he runs an institute and has evidently done a good job of it, he is primarily an evangelist, not an administrator. So you wouldn't choose him for a big job unless you thought the job required evangelism.
Someone called Stupak a "baby killer" on the Senate floor. (But... isn't a baby killer a guy who votes against the Children's Health Insurance Program? I must be confused.)
Campbell, initially suspected as the lawmaker who shouted the phrase, told reporters that he didn't say it and believed that it came from a member sitting a row behind him, where the Texas Republicans usually sit. Campbell said he heard "a Southern accent".
"The people who know won't give it up," Campbell told reporters.
He said the remark was "clear as a bell."
iPhone photo in the lobby of the West Roxbury VA hospital. Maybe it shouldn't, because it's the same hospital and the same patients--with a few more younger guys back from Iraq and Afghanistan than the last time I was here--but the president and retired General Shinseki (now the chief of the VA) make it feel a little different to walk in the door.
For all the fuss about Joe Wilson disrespecting Obama by shouting "You lie!" (to which, it can only be said, he never would have said that to a white president)--
the biggest crime is not disrespecting the president, but that he was doing so in the cause of trying to make sure some Guatemalan girl can't deliver her baby, and some Chinese guy can't get treatment for HIV infection, and some old Mexican lady is going to die for reasons regular medical care could have prevented.
And now, politicians are bending over backwards to say, Joe Wilson is disrespectful, but to his larger point, they only respond, please, fellow Americans, be assured, we won't be taking this love your neighbor thing too far.
I've started a Facebook group:
"I'm a doctor, and the AMA doesn't speak for me"
I hope my colleagues will consider joining.
One of the group members linked to this article:
Abraham Verghese on the AMA
Wikimedia commons photo: Samuel Delany. NASA photo: Charles Bolden in 1992
Yesterday, I was registering the fact that President Obama has appointed Charles Bolden, an African American astronaut, to run NASA. I googled him, thinking about how it's not that incredible anymore to have black people go up in space, and that therefore it doesn't seem incredible that there's a black astronaut in charge of NASA. And then one article, which included various people gushing about Bolden, included a comment from his astronaut buddy Franklin Chang-Diaz, whose daughter is a Massachusetts politician with the same last name.
I don't want to dwell on the point, but "Franklin Chang-Diaz" used to not be an astronaut kind of name, nor a Boston politician name either. In fact, it is hard to know which would have seemed more improbable in 1950, or 1960, or even 1970.
I don't want to be the white guy who looks on in wondrous rapture about little victories of diversity as a way of ignoring inequality and discrimination. So let me pause and register that the world is still what it is; inequality still is the rule, not the exception. At the same time, the world is different than it used to be.
NASA made a decision, when it started the shuttle program, to change what astronauts looked like. Now, many years later, there are a fair number of black astronauts, women astronauts, astronauts from different parts of the world. Some of them are rising through the ranks. There are still plenty of white guy astronauts and white guys slapping each other five in Mission Control--the world hasn't changed so much--but it's different than Apollo.
This got me thinking about science fiction. I've mostly left the genre behind in my own reading over the last few years. My friend S. knows it better and is able to write about it more seriously. Still, from the reading I did in years past, I can say there are a few different versions of the society of space in science fiction. One of those versions comes from an often quietly utopian impulse, which involves more small-bore problems of dealing with difference, or of trying to make a better society, or of living in a different way than we now imagine. It does not describe utopias, but its broad imagination, its sense of possibility, is a form of utopianism. It is a way of saying, anything is possible. This genre uses science fiction as a way of stretching our imaginations about what could be. Some of the practitioners of this kind of science fiction, people like Octavia Butler or Samuel Delany, were African American, and the humans who inhabited their worlds were often of many colors, not to mention genders and sexual orientations. In fact, not at the time, but retrospectively, some people call them pioneers of Afrofuturism.
There is no immediate relationship between Samuel Delany, a gay man with a big unruly beard who now teaches creative writing at Temple, and Charles Bolden, a former Marine and astronaut, who will now run NASA. They are both black men who are interested in outer space, but then, so was Sun Ra. I can't really imagine Borden and Delany at the same event. And though there must be someone who knows them both, I don't think they travel in overlapping circles. They have outer space in common, sort of (though Samuel Delany does not even depend on that trope). But one of them is interested in imagining different planets as metaphors for different ways of living. The other is interested in specific real different planets as places we might drive a space ship to. Delany is wildly progressive; Bolden is not, at all.
When NASA chose its astronaut corps for the shuttle program, it did so for political reasons that were very much of the here and now. NASA understood then and understands now that its work can either seem like an inspiration, a bold project of building human capacity, a project on behalf of nothing smaller than humanity itself; or, alternatively, a wasteful boondoggle and gadget racket that has nothing to do with anyone's concrete problems. Choosing a diverse astronaut corps helped keep NASA looking like it was staying on the right side of that line. That has nothing to do with anything as edgy or visionary as Samuel Delany. Yet, if you would have written a science fiction story, in 1969, that imagined a black president and NASA chief, you would have placed yourself firmly in the left wing of the genre.
There are all sorts of possibilities come true lately, which I've been noticing simultaneously. Less lofty but maybe more spectacular: in my pocket, my iPhone seems more spectacular than a lot of gadgets I read about in science fiction books when I was a kid, exactly because it is an everyday device. Without any mythic resonance, an improbable-seeming thing I carry in my pocket, the iPhone is not a super phaser or a scanning diagnostic tool that instantly does my medical work for me. It's just a phone, a newspaper, a street map of the developed world, a global positioning device (the very existence of which is improbable, much less that it is in my pocket), a massive encyclopedia written by a global collective, a camera, some video games, a music player, a way to write people brief letters or read letters from others, and other things as well. And I put it in my pocket and carry it around! Every so often, we do make note of how incredible this seems. Perhaps I'm just getting older, and remember more and more time, more and more of my own history, that took place before we could take such things for granted.
Whether for the head of NASA, or my iPhone, the future is harder to accurately imagine than it first seems, and not just because you thought the phone/clock/navigational device would be a Dick Tracy-style watch and not some pocket version of the monoliths from 2001: A Space Odyssey. Once the future arrives it seems ordinary. To imagine the future puts a wondrous glow on it.
The future is not simply a time like other times; it is a time when anything is possible and therefore it is a time made up of a larger-than-appropriate proportion of our hopes and fears. When we find ourselves in the time that used to be the future, there is no such resonance. Some things are newly possible, others not possible anymore, and we simply find ourselves in a new set of circumstances. We fear and hope for new things. AT&T sends a bill for the iPhone minutes. The future is no longer the future.
But there is something about this year, and I know I'm not the only person to feel this way, that feels a bit more like science fiction than most years. The dull apocalyptic dread of the American economic empire in collapse; a black president with a Muslim name; iPhones in our pockets; gay marriage through all of New England but not in California or New York; a black astronaut in charge of NASA. Some Puerto Rican lady gets appointed to the Supreme Court and it is the exact person that the press has been predicting all along, which makes her appointment seem like an almost unadventurous boring political move by our president, who--we're almost used to it now--is a black man named Barack Obama. (Afrofuturism, indeed.) We take the internet for granted but we're still figuring out how to use it; we're also now used to things like dance music made entirely by computer programming; and we forget how extraordinary it is that in so many ways, from dumb television to crucial navigation, we depend on satellites orbiting the earth.
It's not future shock I feel; just a sense that the present is improbable, and thus, that the future must be even more so, for better, for worse, or, simply, for different. Really different. All possibilities remain possible. We are in a time that feels like the future even as it arrives. This year, more than most years, I find myself in the future, still catching up.
Pop music reflects social change and also rides it like a surfer on a wave, not in it, only on top of it, reflecting its contours, but using the wave for its own purposes.
The summer, with Barack Obama locking up the nomination, was full of hope and excitement. And two songs were on the charts that are worth looking back at now. They're going to define this last year in a funny kind of way, even though they're dumb songs--maybe because they're dumb songs.
1.
Katy Perry will perform at the Grammy Awards this weekend, performing her song "I Kissed A Girl", which is simultaneously:
* one of the stupidest songs I've ever heard;
* one of the catchiest pop songs of last year, with a great guitar hook along with a great synthesizer bass throb underneath it;
* and, in its totally stupid way, maybe some small part of the decades-long process of queer liberation, in a "gateway drug" kind of way. For better or for worse there are cheerleaders in Texas singing along to this song, and you can make what you will of that.
The sentiment of the song--a straight girl tries on kissing girls because, hey, it's kinda cute and cool and why not?--was sort of dumb even fifteen years ago. Or, more precisely, in 1995, it was Jill Sobule's song "I Kissed a Girl". That song was folkier, a little more alterna, with smarter and more emotionally honest lyrics (the protagonist just had a marriage proposal from a guy and doesn't want to say yes, then goes and makes out with a friend of hers) and a pretty catchy melody of its own.
Still, it was a small little song in its lyrical ambitions and its musical sound. And ultimately, it was just as dumb as Katy Perry's song in its relationship to what it means to be a lesbian or an enduringly bisexual woman, someone who has to actually live queer instead of flirting with it.
More importantly, it had nowhere near as much pure pop power as 2008's "I Kissed a Girl". Sobule's variation on the theme was an alternative radio novelty song for coffeehouses and college girls; Katy Perry sings for all of America, though perhaps first and foremost for strippers. And presumably, for the coffeehouse college girls who work as strippers.
But the song is definitely for all of America's pop music fans; from the moment the first guitar attacks of the chorus start up (at 33 seconds into it, in true pop music factory production-line formula style), you know it's a big pop hit. It's perfectly designed. The lyrics could have been about a Toyota Corolla and that beat still would have rocked some dance floors.
The only reason I think this is oddly subversive--as opposed to just being a #1 hit song destined to be played in strip clubs for the next twenty years--is that CBS has now sponsored a contest for ordinary people to record their videos, you're supposed to vote on them, and the winner gets to perform with Katy Perry.
In other words, this song is about same-sex kissing and it is officially totally banal.
Here's the kind of contender you'd expect:
And then you realize, it's inevitable that this song would need to be lip-synched by a gay man.
(If you want this guy to be rocking with Katy Perry in her Grammy performance, as I do, vote here)
Just to give Jill Sobule her due, here she is with her song:
2.
Speaking of pop culture, after the big Obama love-in, and a bit of an Obama let-down as his health policy point man turns out to be (surprise!) a huge ho, I'm trying to reclaim the Obama love by going through iTunes and looking at all the songs that reference this new moment.
This summer, somehow I wasn't listening to pop radio enough. Because I missed June 08's "My President", in which Young Jeezy, bless his soul, gets excited about the coming of a black president, with the following lyrics:
"My president is black
My Lambo's blue
I'll be god-damned if my rims ain't too"
The video involves Young Jeezy and some of his associates dancing around Mr. Jeezy's blue Lamborghini (which--god damn!--has blue rims) along with swelling inspirational movie-soundtrack strings and pictures of people marching, mobilizing, bringing a new day in politics. Also--hells yeah!--a blue Lamborghini with blue rims. And, John Lewis! Jumping up in the air! (As one music website puts it, "If all that's okay with John Lewis, it's okay with us.")
I think this song will turn out to be one of the smartest songs about the Obama age.
will.i.am is rocking it with "It's a New Day" in which he namechecks Harriet Tubman along with Lincoln, Kennedy and King: "The dreams that I've been dreaming have finally come true," he sings. (I hope the New York Times refers to him as Mr. am; I know I will, from now on). This is a very sincere song, and the sort of thing you can sing at the inauguration, which Mr. am did.
But Young Jeezy kind of had it nailed. The song is a combination of sentiments: I'm really excited about this amazing thing happening, and also, I'm the same knucklehead I always was, and really, what I've managed to accomplish is get a bunch of thugs to love me and give me enough money to buy myself a Lamborghini; but then, on the other hand, all things considered, it's a pretty great car.
Of course, hip-hop makes things bigger, blows up the parody until it's not even parody any more, and you're not sure when it's a joke and when it's just stupid. At the end of the song, Young Jeezy makes clear he knows it's a joke, kind of, when he starts listing black heroes, then tries to go back and give himself a role in black history, for being the first guy to drive a Lamborghini through his neighborhood. He's laughing and delivering the lines in a way that makes it clear he understands the comparatively smaller scale of this accomplishment, even though he himself is pretty proud of it.
In a remix, Jay-Z added on some more pointed lyrics, while also just adding in some comments about the color of his Porsche.
But though having a more direct political element changes the song, maybe Young Jeezy's June '08 song anticipates a more core American impulse that will doubtlessly persist. All the nobility of hope and change and a young black president inspires us. And at the same time, most of us are all just trying to live our own stupid lives, with our own self-centered goals, hoping the president manages to get the economy back to the point where we can start imagining not just getting by, but living large. In a hybrid, maybe, but--if he is truly a great president--it'll be a fast shiny blue turbo hybrid with 22-inch blue rims.
Here's Jay-Z and Young Jeezy at an inaugural party. On January 19th, the enthusiasm was sweeping over Young Jeezy, and he wasn't joking anymore--just really really psyched.
I don't want to forget the sincerity of this moment. And I don't want to shortchange the sincerity of the Texas cheerleader who's dancing around her room singing along with that Katy Perry song, thinking something different about what it means to kiss a girl than her predecessors might have. Like all of the best pop songs, these two songs are both dumb songs, but also get their momentum from reflecting a new moment, a new way of thinking, a new time in which these songs are allowed to exist as dumb songs, climbing the pop charts.
Hey! We've got a black president! I can kiss who I want to! It's a new day!
Pop music's insidious but undeniable power comes from being banal, stupid and meaningless, while at the same time, meaningful and sincere and in some way perceptive about who we are when we are young. Even if social change brings black presidents and queer love, those new elements are just the picture frame for more stable and eternal elements of American pop culture, dominating the pop charts since at least the middle of the last century. In this case, those elements are:
1. awesome cars; and
2. hot girls, as in:
being one
making out with one
or--
genius! great bass line! love the guitar hook! sexy video!
--both.
photo: from wikimedia commons, Barack Obama hearing from Ohio voter Marian Edwards about health insurance
At a small social gathering recently, a policy wonk doctor and I chatted about what the Obama era might bring to healthcare.
"I think he's going to try to do something quickly", the policy wonk said. "The difference between 1992 and now is that big business then was opposed to government involvement just on principle. But now they want it off their table. They can't keep bearing the cost of the whole system. They're ready."
I think the goal should not be a single-payer system. It should be a system that could eventually become a single-payer system in which the government runs an opt-in portion that gradually more and more people opt in to as business ditches health benefits. This is akin to building a hybrid car with the capacity, once a better battery is available on the market, to become a plug-in hybrid with a much greater share of electric power.
Gen X, for all of its pretensions, was the most conservative of generations for a long time. People my age are a lousy-ass voting bloc, plus our generational size is tiny. But my sister's generation--you know, the kids today, the Generation Y, the twenty-somethings of the moment--they're a different breed. And I'm hoping that through the power of inspirational slow jams, they will change the world.
(Also, for the hyperattentive, how awesome are Tyra and Landry from Friday Night Lights that they are both in this video?)
How does Barack Obama do all that traveling instead of just hanging at home with Michelle?
That's the question I have tonight.
Not coincidentally, I am in Cape Cod and Ms. Dr. Hemodynamics is not.
[Note: click on the graphs to get a full view including more-or-less readable data labels].
Here's a shout out to the graphic designers at the New York Times, who often produce great pieces of informational design, and who illustrated this op-ed about the black vote and the white vote in the Democratic primary. (I hope one of the data labels is in error: it cites the end of the graph as April 2, when the graph would really only be truly relevant if the end was May 2.) The article and the graphic make an important point: while the media has been fussing about whether Obama can win over white working-class men (many of whom will not vote for Clinton in the general election either), fewer observers of this political spectacle have been paying attention to the black votes that Clinton has been more or less deliberately throwing away and probably permanently losing.
The NYT article and graph are about a very specific question.
Contrast this to the more general and more common political discussion of whether a candidate is viewed favorably or unfavorably overall. Here's my quickly Excel-graphed illustration of Obama's approval ratings from November until now.
This graph uses overall national "approval" polling data from Rasmussen (the raw data are here) to show Barack Obama's approval ratings over time. The graph shows that the primary season has probably not had that much impact on how the overall electorate views Obama: mainly, people's views have on average become more certain (more "very" and less "somewhat"), but have not changed whether they like or dislike Obama.
The biggest shift came in late February where his "favorable" ratings got as high as 56% and his "unfavorable" ratings as low as 42%. In other words, the monumental flux of this campaign has been about 8% of voters who moved the center line between "kinda like" and "kinda don't like" back and forth.
My graph shows the effects of the political circus, the "who's up/who's down" tallies of cable news--and reveals a much more stable and enduring divide among voters, the one that persists election after election and actually does transcend personality. The smaller fluxes in "favorability" of any given candidate may or may not be important overall.
The NYT graph shows something more important: the actual effects of Hillary Clinton's behavior on a specific part of her base, and what could be one effect of her tactics if she were to win the primary. There is a significant inference here--the assumption that favorability ratings drive turnout. Maybe, maybe not. It may be that black voters would dislike her but vote for her anyway, which would probably be a rational choice. And there are a lot of things left unexamined in this graphic: it compares one group's view of one candidate with another group's view of another rather than comparing both groups' views of both candidates, which would likely be a more nuanced and less dramatic picture. Nonetheless, this single comparison and the clear presentation of the difference is much more interesting and reveals more significant shifts than where her favorability/unfavorability ratings have been going overall. (Not much changed.)
Sometimes smaller questions yield bigger answers.
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