Ruth Bader Biden
No matter the obstacles that Donald Trump creates for himself, Joe Biden’s candidacy remains an existentially risky, perhaps disastrous, proposition.
By Mark LeibovichJune 7, 2024
We are a little over one week removed from the verdict—that verdict—and Democrats have what they’ve long been craving: a conviction of Donald Trump, 34 times over. What impact, if any, is it having on this noisy roulette game in which we’re trapped? Let us do the responsible thing and hedge: too soon, too soon. But early polls suggest that a significant plurality of Americans agree with the jury’s decision, and that it could produce at least a small bump in support for President Joe Biden.
The Manhattan verdict has interrupted the flare-up of bad vibes that had afflicted Democrats for weeks. “A pervasive sense of fear has settled in at the highest levels of the Democratic Party,” began one assessment in Politico a few days before Trump’s conviction. This followed a grim set of battleground polls in May from The New York Times and Siena College, and another survey, from The Cook Political Report With Amy Walter, finding that Biden was significantly underperforming Democratic Senate candidates in five of those key states.
But here is a broader thematic reality for the president: Bad vibes have been the persistent feature of his campaign. No matter the obstacles Trump creates for himself, Biden remains a comprehensively weak incumbent, weighed down by the same liabilities that burdened him from the start, beginning with the largest, and completely unfixable, one: At 81, he is much too old to run for president. Durable supermajorities of voters still do not want any part of Biden at this age. His bullheaded insistence on doing something no one has ever done (Ronald Reagan, then the oldest president in American history, was 77 when he retired), along with the unwillingness or inability of Democrats to stop him, remains an existentially risky, potentially disastrous, proposition. The stakes remain appallingly high. If Biden loses in November, that’s all anyone will remember him for.
If Biden manages to win in November, I will apologize happily—ecstatically—for feeding the bad vibes of spring. But it’s not just vibes: It’s the stagnant data behind them, a dynamic that’s been locked in place for months. At best, Biden is still tied in national polls, and he has shown little evidence of reversing his deficits in the most contested states.
Whatever benefit Biden received from the jury in New York, something else will inevitably smack him back in the other direction. The Wall Street Journal ignited one such furor Tuesday night when it published a story that included several accounts of the president showing “signs of slipping” in private meetings. The article was criticized, with some validity, for relying heavily on accounts from obviously partisan sources—Speaker of the House Mike Johnson and his predecessor, Kevin McCarthy. The White House protested, as it always does over matters of Biden’s age and fitness, easily the topic that members of the Biden administration get most touchy about—for good reason.
Meanwhile, last week’s verdict seems to have sparked something akin to activation energy among Republicans. The claim, no matter how dubious, that Democrats have “weaponized” the courts against Trump has clearly galvanized sectors of the right. “Through two primaries and two general elections I have never voted for Trump,” Conn Carroll, the commentary editor for the conservative Washington Examiner, posted on X last week. “I would crawl over broken glass to vote for him now.” Trump’s campaign and the Republican National Committee said that they raised a combined $141 million in May, boosted by a surge in donations in the 24-hour period following the verdict. This nearly doubles what Trump and the RNC raised in April.
At the same time, the various RC Cola candidates—Robert F. Kennedy Jr., Cornel West, Jill Stein—keep landing on swing-state ballots, or getting close to them. (Stein, the Green Party nominee, says she’s nearly there in Pennsylvania.) This could easily prove to be bad news for Biden, as evidenced by an NPR/PBS NewsHour/Marist poll last month that had Biden up two points over Trump in a two-person race, but losing by four when Kennedy, Stein, and West were included.
In its ongoing effort to console nervous Democrats, Bidenworld keeps trotting out its usual barrage of “Don’t worry,” “Voters haven’t really tuned in yet,” and “There’s still plenty of time left.” It is now June. Is this reassurance or wishful thinking? Does Biden’s team have any coherent message about what he hopes to accomplish in a second term, apart from thwarting Trump and staying alive?
A credible case could be made that Biden has done a good job as president, starting with the achievement that has earned him hero-of-democracy status: beating a racist autocrat in 2020. Biden has passed meaningful legislation; managed, to some degree of success (so far, at least), a welter of impossible foreign-policy crises; and generally been a norm-respecting mensch. You could also make a case that he has been a terrible candidate for reelection from the start. His presidential approval numbers would likely be higher had he imposed a four-year limit on himself and actually served as a “bridge” to younger Democratic leaders, as he suggested he would during his 2020 campaign.
It is too late for Democrats to do anything about their predicament now, barring some 11th-hour event that triggers an extremely unlikely swap-out of nominees at the Democratic National Convention. Trump and his party keep pushing further beyond the bounds of what would have been unthinkable even a year ago.
I’ve written variations of this before, most recently in March, following an earlier stink bomb from the Times and Siena. The next day, Biden delivered his high-energy and well-received State of the Union address, which, of course, instantly rendered all concern about his age and fitness inoperative—for a few weeks. Biden’s average approval rating from 538 now sits at 37.6 percent, slightly down from the 38.1 percent he was registering before the State of the Union.
Like many people, I’ve made the unwelcome comparison between Biden and Supreme Court Justice Ruth Bader Ginsburg, the late liberal icon whose legacy was stained by her unwillingness to retire while Barack Obama was still president. Ginsburg’s death, at 87, occurred in the final months of the Trump administration, which allowed him to appoint her successor (Amy Coney Barrett). The Real Time host Bill Maher dubbed the octogenarian president “Ruth Bader Biden” on his HBO program last September. Biden, Maher said, was “the person who doesn’t know when to quit and so does great damage to their party and their country.”
Biden’s conduct is far worse than Ginsburg’s, in fact, given the awesome power of the presidency and the havoc Trump could unleash with it this time.
I don’t keep bringing this up because I enjoy having jittery Democrats who secretly agree with this assessment tell me to shut up, that my doomsaying is “not helpful.” They reiterate that Trump would be tragically worse for the country than even an 86-year-old Biden in the White House. That’s essentially been Biden’s message for the past five years: “Don’t compare me to the Almighty. Compare me to the alternative.” He continues to submit that the main rationale for his presidency is as a high-stakes game of keep-away. There’s no question he’s better than the alternative, but that doesn’t mean it’s enough.
Monday, June 10, 2024
Monday, January 29, 2024
Brooks, Placebo Article
Harness the Power of Suggestion for Your Happiness
The placebo effect can’t cure disease, but it really can work for you.
By Arthur C. Brooks
December 7, 2023
I remember once, at summer camp in the 1970s, 3,000 miles from home, I came down with a nasty case of strep throat. Before I could call my parents or go to the nurse, the coolest kid in camp took me aside. “You know it’s all in your head, right?” he said. “Just decide you don’t have a sore throat, and you won’t.” He was very cool, so it made sense to my early-adolescent brain to take his medical advice. Two days of extreme willpower later, I had a fever of 103 and couldn’t swallow.
“The problem is that you are mentally weak,” Cool Kid explained. Defeated, I went to the nurse, who took me to the doctor, who gave me penicillin, which relieved my symptoms within 24 hours. Cool Kid was undaunted. “That stuff is just a placebo,” he told me, referring to a phenomenon in which the mere mental suggestion derived from taking a drug that is actually inert has a therapeutic result. “You cured yourself.”
Cool Kid’s medical advice, flawed as it was, nevertheless took inspiration from the popular belief that “biology is psychology,” and that we can harness the placebo effect to get better. This belief has not stood up well in recent years; where physical maladies are concerned, evidence has emerged that the placebo effect is as fake as the fake drug itself. [NOTE: this is a link to the study: https://www.nejm.org/doi/full/10.1056/nejm200105243442106 ]
Even so, although placebos can’t kill bacteria, they can change your attitude toward your problems. And that means they deserve serious consideration in your pursuit of happiness. In fact, properly understood, the strategic use of placebos might be an indispensable tool in your well-being kit.
The modern use of the word placebo originates from a mistake made by the fourth-century Catholic saint Eusebius Sophronius Hieronymus, better known as Jerome, an early translator of the Bible into Latin. In the ninth line of Psalm 116, Jerome erroneously translated the Hebrew for “I will walk before the Lord” as “I will please the Lord in the land of the living”—in Latin, Placebo Domino in regione vivorum.Subsequently, hired professional mourners at funerals chanted that line and became known as “placebos.”
The placebo as a concept in medicine appeared in the 18th century, most famously in the case of the German physician Franz Anton Mesmer, who introduced the technique that took his name of mesmerizing patients, by means of gestures and special instruments, to relieve them of various physical ailments. His explanation for how this—what he called “animal magnetism”—worked was debunked by a commission including none other than Benjamin Franklin, who helped demonstrate that a substantial benefit of the technique relied simply on the patient’s imagination.
Although animal magnetism was not real, the power of suggestion could be. The physician Benjamin Rush, another signer of the Declaration of Independence, was a pragmatist who decided that if there was an effect, he didn’t really care where it came from: “Let us avail ourselves of the handle which these powers of the mind present to us.”
By the early 20th century, the therapeutic effects of suggestion on physical disease were widely believed to be genuine, and even the medical journal The Lancet reported on some apparent evidence of the phenomenon. Skeptics never quit the cause, however, and today, the placebo-doubters appear to have won out: A 2001 comprehensive analysis of well-designed studies showed that placebos of all types (whether drug tablets or supposedly therapeutic conversations) might affect our feelings of health, but they did not have a significant physical effect on diseases. [this is a link to the same 2001 study Brooks referenced above: https://www.nejm.org/doi/full/10.1056/nejm200105243442106 ]
In other words, I wasn’t mentally weak for failing to cure my own strep, and the penicillin was not a placebo. (If the now-50-something Cool Kid is reading this, he will be feeling a little chastened, and less cool.)
Before we dismiss placebos entirely as a legitimate form of treatment, however, we should note that no one claims they can’t have a psychological effect on people. As a result, they may still be beneficial when a malady is primarily psychological in nature.
The same applies to happiness, for which placebos can work wonders. For example, researchers in 2005 showed their study participants a series of disagreeable photos. The participants were given an anti-anxiety medication, which muted activity in parts of the brain—the rostral anterior cingulate cortex and the lateral orbitofrontal cortex, to be exact—that govern perceptions of unpleasantness. The next day, the subjects were told they were getting the same medication when they viewed more photos but were given saline solution instead. The placebo affected the overlapping areas of the brain and lowered perceived unpleasantness.
When it comes to well-being, placebos may work even when they are “open-label”—in other words, when people know they’re not a real medicine. In one 2022 experiment, participants were told they were getting either a placebo (in the form of a nasal spray) or no treatment at all. After they were asked to make self-deprecating statements (such as “I do not want to be the way I am”) and listen to melancholy music, the nasal-sprayers experienced less sadness.
The most likely mechanism of a placebo’s action on happiness and unhappiness is that your expectation can stimulate unconscious behavioral conditioning, which leads to the release of neurotransmitters and neurohormones that change how you feel. So, say you have your “happiness nasal spray,” which you know is a placebo, but when you use it, it reminds you to smile, and think about people you love and the parts of your life for which you’re grateful. This effect might temporarily lower your production of cortisol and other stress hormones, giving you a sense of calm and peace.
Nothing suggests that you can will away strep or treat it with a fake pill. You can get a lot happier using suggestion and placebo, however. Here are three practical ideas.
1. Invent your own unhappiness remedy.
You can create an open-label placebo for yourself when you need relief from negative emotion or want a boost in joy and gratitude. Break a negative cycle of thought and feeling by walking a familiar circuit (for example, around the block). Write down a prayer or poem that you like to recite, to remind yourself that your life is a blessing and you will not be controlled by destructive emotions.
You might even want to create a happiness medicine—your very own placebo pill. For a few years, I used menthol cough drops for this purpose, which I would pop into my mouth as part of my behavioral conditioning. I stopped that only when I took a job running a nonprofit, which was so stressful that I was eating 50 of them a day; I smelled like a chemical plant, which wasn’t great for fundraising, so I switched to sugarless gum.
2. Avoid human “nocebos.”
If a placebo can have positive mental outcomes, then a “nocebo”—telling people that an intervention has unpleasant side effects, which increases the likelihood of experiencing the effects—tends to create negative mental results. Some evidence suggests that medical patients can do better in treatment with encouraging doctors, and worse with discouraging ones. Although no research to date has experimented on the unhappiness effects of discouraging words, we hardly need it to know that relentless negativity from others makes it hard for us to feel happy. Sometimes you need to hear the truth, but you don’t need more exposure to critics than necessary.
While you’re at it, think about the places where you’re most likely to encounter these discouraging people who are all too ready to dispense their negative feedback, such as social media or cable television. If you notice that certain channels make you feel worse about yourself and the world, cut out those nocebos.
3. Dispense the placebo to others.
The placebo effect of happiness works on others, not just you. Start prescribing them freely: Give others encouragement; take others on your happiness stroll; share your candy. You will quickly find that prescribing a positivity placebo to others is a secret to getting happier yourself. It also means developing the best identity and reputation you can have. Above all, strive never to be someone else’s nocebo.
Cool Kid didn’t know science, and Saint Jerome’s Hebrew may have been a mess. But we can still benefit from placebos, perhaps not to alter our physical circumstances but to change our attitude toward them. And therein lies one of the great insights to living a better life. Adverse events are inevitable for everyone, and negative emotions are an appropriate response. We evolved this way to help us recognize and avoid adversity when we can. But a surplus of negativity in response to hard times can easily make things worse. Managing our own emotions can allow us to bear and accept life’s inescapable trials, and even learn from them. A homespun placebo now and again can help.
Thursday, January 4, 2024
Ozempic Can’t Fix What Our Culture Has Broken
Tressie McMillan Cottom
Oct. 9, 2023
We have become fluent in the new language of pharmacology, diabetes, and weight loss. Ozempic, Wegovy and Mounjaro are part of our public lexicon. Glucagon-like peptide-1 (GLP-1) receptor agonists are lifesaving drugs, created to help the hundreds of millions of people with Type 2 diabetes and clinical obesity. They promise to rid the United States of obesity, if our country can figure out how to make the pricey fix affordable.
But these wonder drugs are also a shorthand for our coded language of shame, stigma, status and bias around fatness. Untangling those two functions is a social problem that one miracle drug cannot fix.
It is hard to recall the last time a drug so excited the general public. Fen-phen in the 1990s, maybe? Viagra or Botox in the 2000s? Each had amazing hype cycles but none as explosive as Ozempic. Market watchers have flagged Novo Nordisk, the Danish pharmaceutical giant that makes Ozempic and Wegovy, as a contender for most valuable company in Europe. With better drugs still in various stages of development, the anti-obesity gold rush has just begun.
If GLP-1 drugs only treated diabetes and did not promote weight loss, they would still be medically groundbreaking. But Ozempic, Wegovy and Mounjaro probably would not have social media hashtags. These drugs are blockbusters because they promise to solve a medical problem that is also a cultural problem — how to cure the moral crisis of fat bodies that refuse to get and stay thin.
That many people don’t even question that eliminating fat people is an objectively good idea is why it is such a powerful idea. Thinness is a way to perform moral discipline, even if one pursues it through morally ambiguous means. Subconsciously, consciously, politically, economically and culturally, obesity signals moral laxity.
Any decent cleric will tell you that there is no price too high for salvation, so an entire class of people — the roughly three in four adult Americans who are overweight — is a target for profit-seeking. Medical weight loss interventions have, over the years, led to heart damage, strokes, nerve damage, psychosis and death. But under this moral code, it’s the social policies that promote, subsidize and profit from obesity that are cleansed of their extractive sins. It’s as if fat bodies, by housing slovenly people, do not deserve the protections of good regulations and healthy communities.
There’s something seductive about a weekly shot that fixes the body while skipping right past the messiness of improving the way people have to live. Both diabetes and obesity are conditions that are as much about social policy as they are about what people eat. Studies show that the crops the U.S. government subsidizes are linked to the high-sugar, high-calorie diets that put Americans at risk for abdominal fat, weight gain and high cholesterol. Sprawling communities, car-centered lives and desk jobs make it hard for many Americans to move as much as medical guidance thinks that we should. Under these conditions, telling people to change their lifestyle to lose weight or prevent diabetes is cruel.
It should be no surprise that near-guaranteed weight loss — big, rapid weight loss in many cases — drives millions of people to take the drugs off label, creating consumer demand like the gold nugget that lured miners out West.
The cultural conversation around Ozempic is as obsessed with celebrities as the celebrities are obsessed with themselves. Rumors of which A-list star was on Ozempic peaked with the pejorative “Ozempic face,” a sign that someone was taking a shortcut right to skinny’s spoils. Social media users became adept at finding clues that a celebrity cheated, purchasing obesity absolution through pharma indulgence.
At the top of the status hierarchy, the rich, famous and near famous were getting skinnier. But in the same span of years Ozempic took hold of those buzzy sets, I began noticing that regular people like my friends were being reclassified as insulin-sensitive, insulin-resistant, and the utterly terrifying “prediabetic.”
Most of them are highly educated, self-made successes, with no family wealth or other cultural endowments. They handle their health with the same ferocity they brought to college admissions and career planning. One friend began blowing into a device that told her if she had reached a “fasting” state; another was prescribed metformin, a diabetes medication. So many of them seemed to be on a crash course with a medical liminal state that associated them with diabetes even though none of them were diabetic.
Although it was unknown to me at the time, my friends were swimming with a public health tide that would mark them for medicalization, even though nothing about their physiology, behavior or medical profile had changed. They may have needed drugs, they may not have, but “prediabetes” is not a precise enough predictor of whether anyone will become diabetic to warrant the fear the term provokes.
The American Diabetes Association developed the term “prediabetes” to bring attention to slightly elevated blood sugar levels in some Americans in 2001. Over the next two decades, the organization expanded the definition of the condition, so that by 2019, as Charles Piller reported for Science magazine, 84 million Americans had prediabetes, “the most common chronic disease after obesity.”
There were no drugs specifically designed for prediabetes, so doctors often relied on off-label treatments, a common medical practice. But because off-label drug interventions coincided with the wholesale expanded classification of millions of people with a novel condition, a new market boomed.
This shift broadened the consumer language for medicalizing weight loss as a preventive strategy to treat not only diabetes, but also supposed — though not always proven — diabetes risk. It armed a wellness machine with the medical terminology of “insulin resistance” and “insulin sensitivity,” without the medical expertise to screen for diabetes risk indicators. People could soon buy an astonishing array of apps and devices to self-diagnose insulin efficiency. Enter Ozempic and Wegovy, perfectly designed for our highly developed consumer palates.
Given all these changes, I wondered what Dr. Richard Kahn, the former chief scientific and medical officer at the American Diabetes Association, who helped establish “prediabetes” as a term, now thought about the phenomenon.
When we talked, Dr. Kahn told me that he regretted his role in developing “prediabetes” and its associated grift, but his giddiness about GLP-1 drugs was palpable. He said that encouraging weight loss through lifestyle changes was an “abject failure.” Now, Ozempic offers patients light and hope.
The problem with these drugs, he said, “is that they cost an enormous amount of money.”
Ozempic and all similar formulations are administered by injection, via a pen that lasts about 30 days and costs from about $900 to $1,300. A year of pens can run from $10,000 to $16,000; the median household income in the United States is around $75,000. How in the world can regular people afford it?
It’s easy to assume that the non-wealthy use health insurance to pay for these drugs. And yes, if they’re using Ozempic for diabetes, the health insurance claim is straightforward. But for weight loss, getting health insurance to pay for Wegovy (or even Ozempic) can be more difficult. As Dr. Kahn says, “The vast majority of insurance companies refuse to pay for it no matter what the degree of obesity is.”
Dr. Kahn grasps the big picture of health economics and the insurance cliff we’re standing on. But in the doctor’s office, the cliff is more of a canyon. In 2021, I went to a fancy doctor for my annual checkup. I justify the steep subscription fee for my concierge medical care because I have moderate medical anxiety from years of being talked down to, ignored, dismissed, and victimized by medical malpractice. I consider the concierge fee a convenience tax to be treated like a person.
After two hours of getting to know my new OB-GYN, bloodletting, and internal spelunking, we sat down to talk about my lifestyle and health goals. As an overweight person with high verbal acuity, I was sure to describe my Peloton practice as well as my plan to eat more plants for ethical reasons. The doctor’s face lit up when I finally intimated an interest in, shall we say, size modification.
Glancing at my blood test results she began describing her professional interest in “metabolic medicine.” What followed was a 20-minute presentation on the advancements in weight loss drugs. Ozempic was the star, but there were other drugs, many of them prescribed off label. The seizure medication might curb snacking. Another might slow digestion if it did not ruin your kidneys. And then, of course, there were the “injectables,” the “gold standard” of weight loss medical interventions.
The only problem was that I was not diabetic.
I was not even medically prediabetic.
The doctor said this with great regret.
My A1C, the measurement of average blood sugar levels over the past months, was within the normal range. It was, in fact, bordering on low.
“But these tests malfunction. We can test it again,” she said hopefully.
My doctor was hoping for a higher A1C because it would classify me as prediabetic and would increase the odds of getting health insurance to pay for the off-label use of the pricey drugs she recommended to me that day.
I vacillated between wanting to show my doctor that I could afford to pay for Ozempic out of pocket, not even wanting Ozempic and wanting to prove to her that my A1C was no fluke. I took the A1C test again a week later. It was still low. She was still dismayed.
I switched doctors when I realized one of us was rooting for me to be sicker so I could afford to be skinnier. In her defense, that is exactly the equation that GLP-1 drugs present to the millions of Americans who need health insurance to afford them.
Of course, that says nothing of the 27 million Americans who do not have health insurance at all. People without insurance are typically low-income and are overexposed to the social policies that produced the obesity crisis. For them, the best-in-class drugs may as well not exist.
But, just for the sake of argument, if obesity is a public health crisis and it can be solved with one imperfect injectable, it should be possible to make it so that everyone can afford the solution.
But so far we have done the opposite. To prescribe millions of Americans Ozempic at its current price would stress the health care system to its breaking point. Dr. Kahn did some rough math when we spoke. “If 80 percent of the people with obesity would start to take this drug,” he argued, “it would bankrupt the health care system.” He bases that on the Centers for Disease Control and Prevention’s finding that more than 40 percent of Americans are obese. “We’re hurtling quite rapidly to this game of chicken,” Dr. Kahn said, “where you have the manufacturers saying they’re not going to reduce the price. And you have the insurance companies saying it’s too much to pay.”
Making GLP-1 drugs accessible for Type 2 diabetes and weight loss at a cost that regular Americans could afford would be an achievement for our health care system. The Biden administration is rolling out its Medicare Drug Price Negotiation program. For now, none of these drugs are included. The Treat and Reduce Obesity Act would expand Medicare coverage for obesity. These are the kind of policy approaches that could be a game changer for obesity management and diabetes care while this country continues to work on the bigger problem: our poverty of imagination for the ethical care of all bodies.
For now, cash-strapped American consumers are left to contend with a society in which the price of being fat is so high that there will always be a rational reason to pay an exorbitant amount to be thin.
There is weight loss for health. There is also weight loss for status and avoiding stigma. While both men and women experience greater discrimination if they are fat, women suffer more for failing to be thin enough. Study after study shows that overweight women are more likely to be unemployed than their thinner counterparts. When they are employed, larger women earn less, with smaller penalties for Black and Hispanic women, who already earn less, on average. Overweight white and Asian women experience the labor market discrimination that Black and Hispanic women already do.
Outside of the workplace, the trend of educational and economic elites marrying, befriending and socializing with one another — assortative matching and mating — is also a marked characteristic of our time. Elite homogeneity has a look, and the look is thin. So when women say that it is better to be sick and thin than healthy and fat, they are perfectly rational.
Kate Manne, a philosopher, says that the fear of being fat — fatphobia — is structural and intersectional. In her forthcoming book, “Unshrinking,” she questions whether solving obesity is something that can truly be done by eradicating fat people. Ozempic mania is not just a perfect example of how self-defeating our health economics are in this country, as Dr. Kahn points out. It is also an example of how the American penchant for solving structural issues by fixing individual bodies is excellent at creating demand without solving social problems.
I was overweight before I entered the concierge medical office. But being overweight was incongruent with a person who could afford concierge medicine. My doctor assumed I would want to be thin. In many ways, she was providing exactly the service I didn’t realize I was paying for — acculturating me to the expectations of the right body for my station. Minimizing weight stigma was a health service, even if my health indicators did not require intervention.
The mere existence of Ozempic and the like encourages millions of people to self-diagnose in a way that stigmatizes. If they walk into doctors’ offices begging to be classified as medically vulnerable, it’s not for some provision from the state like housing or food. They want a drug that can help them manage an environment that works against their aspirations. That is a condemnation of our culture.
Ozempic’s implicit promise is that it can fix what our culture has broken. There aren’t breathless profiles of a pharmaceutical drug because it will help a diabetic manage her blood glucose level. They exist because it promises to democratize access to the holy grail of embodied privilege, that sexy sexism of “nothing tastes as good as skinny feels.”
Whether fatness is a problem for the millions of people whom these drugs are poised to leave behind depends on perspective. It’s perfectly normal to live a happy, full life in a body that is above the medically recommended healthy size. Plenty of people do it and have done it. But being overweight becomes a social problem when it’s a population level statistic with a status hierarchy attached.
When supply chain disruptions made it harder for diabetic patients to get Ozempic last year, wealthy people bought the drug at a premium for weight loss while people who needed it struggled to fill their prescriptions. Then, the grim picture of inequality was clear.
But as the supply rebounds, the inequality may get harder to see. That would be unfortunate.
Inequality of access to Ozempic and Wegovy is not between the deserving sick and undeserving obese. The inequality is in attaching any moral clause to why people use the drugs in the first place. As long as most Americans cannot afford the drug that democratizes weight, the stigma of obesity is still controlled by those who can afford to be thin. GLP-1 drugs — or any miracle drug that cures obesity on label or off — works only if people who need the drug can afford it.
But solving for obesity will require more than drugs. It will require solving for a culture that makes being fat a woman’s burden, a means test for dignity, work, social status, and moral citizenry.
Until we end that stigma, we can create drugs that help people lose weight, but the conditions for making some people undesirable — at a cost — will still be lurking in the shadows.
Tressie McMillan Cottom (@tressiemcphd) became a New York Times Opinion columnist in 2022. She is an associate professor at the University of North Carolina at Chapel Hill School of Information and Library Science, the author of “Thick: And Other Essays” and a 2020 MacArthur fellow.
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A version of this article appears in print on Oct. 15, 2023, Section SR, Page 10 of the New York edition with the headline: Ozempic Can’t Fix What Our Culture Has Broken. Order Reprints | Today’s Paper | Subscribe Culture, economic sociology, inequality and digital life.
Tressie McMillan Cottom
Oct. 9, 2023
We have become fluent in the new language of pharmacology, diabetes, and weight loss. Ozempic, Wegovy and Mounjaro are part of our public lexicon. Glucagon-like peptide-1 (GLP-1) receptor agonists are lifesaving drugs, created to help the hundreds of millions of people with Type 2 diabetes and clinical obesity. They promise to rid the United States of obesity, if our country can figure out how to make the pricey fix affordable.
But these wonder drugs are also a shorthand for our coded language of shame, stigma, status and bias around fatness. Untangling those two functions is a social problem that one miracle drug cannot fix.
It is hard to recall the last time a drug so excited the general public. Fen-phen in the 1990s, maybe? Viagra or Botox in the 2000s? Each had amazing hype cycles but none as explosive as Ozempic. Market watchers have flagged Novo Nordisk, the Danish pharmaceutical giant that makes Ozempic and Wegovy, as a contender for most valuable company in Europe. With better drugs still in various stages of development, the anti-obesity gold rush has just begun.
If GLP-1 drugs only treated diabetes and did not promote weight loss, they would still be medically groundbreaking. But Ozempic, Wegovy and Mounjaro probably would not have social media hashtags. These drugs are blockbusters because they promise to solve a medical problem that is also a cultural problem — how to cure the moral crisis of fat bodies that refuse to get and stay thin.
That many people don’t even question that eliminating fat people is an objectively good idea is why it is such a powerful idea. Thinness is a way to perform moral discipline, even if one pursues it through morally ambiguous means. Subconsciously, consciously, politically, economically and culturally, obesity signals moral laxity.
Any decent cleric will tell you that there is no price too high for salvation, so an entire class of people — the roughly three in four adult Americans who are overweight — is a target for profit-seeking. Medical weight loss interventions have, over the years, led to heart damage, strokes, nerve damage, psychosis and death. But under this moral code, it’s the social policies that promote, subsidize and profit from obesity that are cleansed of their extractive sins. It’s as if fat bodies, by housing slovenly people, do not deserve the protections of good regulations and healthy communities.
There’s something seductive about a weekly shot that fixes the body while skipping right past the messiness of improving the way people have to live. Both diabetes and obesity are conditions that are as much about social policy as they are about what people eat. Studies show that the crops the U.S. government subsidizes are linked to the high-sugar, high-calorie diets that put Americans at risk for abdominal fat, weight gain and high cholesterol. Sprawling communities, car-centered lives and desk jobs make it hard for many Americans to move as much as medical guidance thinks that we should. Under these conditions, telling people to change their lifestyle to lose weight or prevent diabetes is cruel.
It should be no surprise that near-guaranteed weight loss — big, rapid weight loss in many cases — drives millions of people to take the drugs off label, creating consumer demand like the gold nugget that lured miners out West.
The cultural conversation around Ozempic is as obsessed with celebrities as the celebrities are obsessed with themselves. Rumors of which A-list star was on Ozempic peaked with the pejorative “Ozempic face,” a sign that someone was taking a shortcut right to skinny’s spoils. Social media users became adept at finding clues that a celebrity cheated, purchasing obesity absolution through pharma indulgence.
At the top of the status hierarchy, the rich, famous and near famous were getting skinnier. But in the same span of years Ozempic took hold of those buzzy sets, I began noticing that regular people like my friends were being reclassified as insulin-sensitive, insulin-resistant, and the utterly terrifying “prediabetic.”
Most of them are highly educated, self-made successes, with no family wealth or other cultural endowments. They handle their health with the same ferocity they brought to college admissions and career planning. One friend began blowing into a device that told her if she had reached a “fasting” state; another was prescribed metformin, a diabetes medication. So many of them seemed to be on a crash course with a medical liminal state that associated them with diabetes even though none of them were diabetic.
Although it was unknown to me at the time, my friends were swimming with a public health tide that would mark them for medicalization, even though nothing about their physiology, behavior or medical profile had changed. They may have needed drugs, they may not have, but “prediabetes” is not a precise enough predictor of whether anyone will become diabetic to warrant the fear the term provokes.
The American Diabetes Association developed the term “prediabetes” to bring attention to slightly elevated blood sugar levels in some Americans in 2001. Over the next two decades, the organization expanded the definition of the condition, so that by 2019, as Charles Piller reported for Science magazine, 84 million Americans had prediabetes, “the most common chronic disease after obesity.”
There were no drugs specifically designed for prediabetes, so doctors often relied on off-label treatments, a common medical practice. But because off-label drug interventions coincided with the wholesale expanded classification of millions of people with a novel condition, a new market boomed.
This shift broadened the consumer language for medicalizing weight loss as a preventive strategy to treat not only diabetes, but also supposed — though not always proven — diabetes risk. It armed a wellness machine with the medical terminology of “insulin resistance” and “insulin sensitivity,” without the medical expertise to screen for diabetes risk indicators. People could soon buy an astonishing array of apps and devices to self-diagnose insulin efficiency. Enter Ozempic and Wegovy, perfectly designed for our highly developed consumer palates.
Given all these changes, I wondered what Dr. Richard Kahn, the former chief scientific and medical officer at the American Diabetes Association, who helped establish “prediabetes” as a term, now thought about the phenomenon.
When we talked, Dr. Kahn told me that he regretted his role in developing “prediabetes” and its associated grift, but his giddiness about GLP-1 drugs was palpable. He said that encouraging weight loss through lifestyle changes was an “abject failure.” Now, Ozempic offers patients light and hope.
The problem with these drugs, he said, “is that they cost an enormous amount of money.”
Ozempic and all similar formulations are administered by injection, via a pen that lasts about 30 days and costs from about $900 to $1,300. A year of pens can run from $10,000 to $16,000; the median household income in the United States is around $75,000. How in the world can regular people afford it?
It’s easy to assume that the non-wealthy use health insurance to pay for these drugs. And yes, if they’re using Ozempic for diabetes, the health insurance claim is straightforward. But for weight loss, getting health insurance to pay for Wegovy (or even Ozempic) can be more difficult. As Dr. Kahn says, “The vast majority of insurance companies refuse to pay for it no matter what the degree of obesity is.”
Dr. Kahn grasps the big picture of health economics and the insurance cliff we’re standing on. But in the doctor’s office, the cliff is more of a canyon. In 2021, I went to a fancy doctor for my annual checkup. I justify the steep subscription fee for my concierge medical care because I have moderate medical anxiety from years of being talked down to, ignored, dismissed, and victimized by medical malpractice. I consider the concierge fee a convenience tax to be treated like a person.
After two hours of getting to know my new OB-GYN, bloodletting, and internal spelunking, we sat down to talk about my lifestyle and health goals. As an overweight person with high verbal acuity, I was sure to describe my Peloton practice as well as my plan to eat more plants for ethical reasons. The doctor’s face lit up when I finally intimated an interest in, shall we say, size modification.
Glancing at my blood test results she began describing her professional interest in “metabolic medicine.” What followed was a 20-minute presentation on the advancements in weight loss drugs. Ozempic was the star, but there were other drugs, many of them prescribed off label. The seizure medication might curb snacking. Another might slow digestion if it did not ruin your kidneys. And then, of course, there were the “injectables,” the “gold standard” of weight loss medical interventions.
The only problem was that I was not diabetic.
I was not even medically prediabetic.
The doctor said this with great regret.
My A1C, the measurement of average blood sugar levels over the past months, was within the normal range. It was, in fact, bordering on low.
“But these tests malfunction. We can test it again,” she said hopefully.
My doctor was hoping for a higher A1C because it would classify me as prediabetic and would increase the odds of getting health insurance to pay for the off-label use of the pricey drugs she recommended to me that day.
I vacillated between wanting to show my doctor that I could afford to pay for Ozempic out of pocket, not even wanting Ozempic and wanting to prove to her that my A1C was no fluke. I took the A1C test again a week later. It was still low. She was still dismayed.
I switched doctors when I realized one of us was rooting for me to be sicker so I could afford to be skinnier. In her defense, that is exactly the equation that GLP-1 drugs present to the millions of Americans who need health insurance to afford them.
Of course, that says nothing of the 27 million Americans who do not have health insurance at all. People without insurance are typically low-income and are overexposed to the social policies that produced the obesity crisis. For them, the best-in-class drugs may as well not exist.
But, just for the sake of argument, if obesity is a public health crisis and it can be solved with one imperfect injectable, it should be possible to make it so that everyone can afford the solution.
But so far we have done the opposite. To prescribe millions of Americans Ozempic at its current price would stress the health care system to its breaking point. Dr. Kahn did some rough math when we spoke. “If 80 percent of the people with obesity would start to take this drug,” he argued, “it would bankrupt the health care system.” He bases that on the Centers for Disease Control and Prevention’s finding that more than 40 percent of Americans are obese. “We’re hurtling quite rapidly to this game of chicken,” Dr. Kahn said, “where you have the manufacturers saying they’re not going to reduce the price. And you have the insurance companies saying it’s too much to pay.”
Making GLP-1 drugs accessible for Type 2 diabetes and weight loss at a cost that regular Americans could afford would be an achievement for our health care system. The Biden administration is rolling out its Medicare Drug Price Negotiation program. For now, none of these drugs are included. The Treat and Reduce Obesity Act would expand Medicare coverage for obesity. These are the kind of policy approaches that could be a game changer for obesity management and diabetes care while this country continues to work on the bigger problem: our poverty of imagination for the ethical care of all bodies.
For now, cash-strapped American consumers are left to contend with a society in which the price of being fat is so high that there will always be a rational reason to pay an exorbitant amount to be thin.
There is weight loss for health. There is also weight loss for status and avoiding stigma. While both men and women experience greater discrimination if they are fat, women suffer more for failing to be thin enough. Study after study shows that overweight women are more likely to be unemployed than their thinner counterparts. When they are employed, larger women earn less, with smaller penalties for Black and Hispanic women, who already earn less, on average. Overweight white and Asian women experience the labor market discrimination that Black and Hispanic women already do.
Outside of the workplace, the trend of educational and economic elites marrying, befriending and socializing with one another — assortative matching and mating — is also a marked characteristic of our time. Elite homogeneity has a look, and the look is thin. So when women say that it is better to be sick and thin than healthy and fat, they are perfectly rational.
Kate Manne, a philosopher, says that the fear of being fat — fatphobia — is structural and intersectional. In her forthcoming book, “Unshrinking,” she questions whether solving obesity is something that can truly be done by eradicating fat people. Ozempic mania is not just a perfect example of how self-defeating our health economics are in this country, as Dr. Kahn points out. It is also an example of how the American penchant for solving structural issues by fixing individual bodies is excellent at creating demand without solving social problems.
I was overweight before I entered the concierge medical office. But being overweight was incongruent with a person who could afford concierge medicine. My doctor assumed I would want to be thin. In many ways, she was providing exactly the service I didn’t realize I was paying for — acculturating me to the expectations of the right body for my station. Minimizing weight stigma was a health service, even if my health indicators did not require intervention.
The mere existence of Ozempic and the like encourages millions of people to self-diagnose in a way that stigmatizes. If they walk into doctors’ offices begging to be classified as medically vulnerable, it’s not for some provision from the state like housing or food. They want a drug that can help them manage an environment that works against their aspirations. That is a condemnation of our culture.
Ozempic’s implicit promise is that it can fix what our culture has broken. There aren’t breathless profiles of a pharmaceutical drug because it will help a diabetic manage her blood glucose level. They exist because it promises to democratize access to the holy grail of embodied privilege, that sexy sexism of “nothing tastes as good as skinny feels.”
Whether fatness is a problem for the millions of people whom these drugs are poised to leave behind depends on perspective. It’s perfectly normal to live a happy, full life in a body that is above the medically recommended healthy size. Plenty of people do it and have done it. But being overweight becomes a social problem when it’s a population level statistic with a status hierarchy attached.
When supply chain disruptions made it harder for diabetic patients to get Ozempic last year, wealthy people bought the drug at a premium for weight loss while people who needed it struggled to fill their prescriptions. Then, the grim picture of inequality was clear.
But as the supply rebounds, the inequality may get harder to see. That would be unfortunate.
Inequality of access to Ozempic and Wegovy is not between the deserving sick and undeserving obese. The inequality is in attaching any moral clause to why people use the drugs in the first place. As long as most Americans cannot afford the drug that democratizes weight, the stigma of obesity is still controlled by those who can afford to be thin. GLP-1 drugs — or any miracle drug that cures obesity on label or off — works only if people who need the drug can afford it.
But solving for obesity will require more than drugs. It will require solving for a culture that makes being fat a woman’s burden, a means test for dignity, work, social status, and moral citizenry.
Until we end that stigma, we can create drugs that help people lose weight, but the conditions for making some people undesirable — at a cost — will still be lurking in the shadows.
Tressie McMillan Cottom (@tressiemcphd) became a New York Times Opinion columnist in 2022. She is an associate professor at the University of North Carolina at Chapel Hill School of Information and Library Science, the author of “Thick: And Other Essays” and a 2020 MacArthur fellow.
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A version of this article appears in print on Oct. 15, 2023, Section SR, Page 10 of the New York edition with the headline: Ozempic Can’t Fix What Our Culture Has Broken. Order Reprints | Today’s Paper | Subscribe Culture, economic sociology, inequality and digital life.
Monday, January 1, 2024
https://www.nytimes.com/2023/12/31/nyregion/yusef-salaam-central-park-five-city-council.html
He Was One of the Central Park Five. Now He’s Councilman Yusef Salaam.
Mr. Salaam will take office 34 years after a wrongful prosecution for rape led to his spending nearly seven years in prison.
Dec. 31, 2023
Yusef Salaam stood at the front of the City Council Chamber in Lower Manhattan with his right hand raised and his left hand on the Quran held by his wife. It was the one that his mother gave him when he was 15 years old and standing trial for a crime he did not commit. Its pages, filled with notes and bookmarks, were kept intact by a cloth cover that Mr. Salaam made during nearly seven years in prison.
Surrounded by relatives including his mother, sister and some of his children, Mr. Salaam was asked by Michael McSweeney, the city clerk, to repeat an oath.
With each passage that Mr. McSweeney recited and Mr. Salaam repeated, their voices took on volume and urgency: “I will support the Constitution of the United States and the Constitution of the State of New York,” Mr. Salaam said. “I will faithfully discharge the duties of the office of council member of the ninth district, in the borough and county of New York, in the City of New York, according to the best of my ability.”
“Council Member Salaam,” Mr. McSweeney said, “Congratulations.”
Mr. Salaam’s family broke into cheers. He placed his hand over his heart.
Yusef Salaam was sworn in on the Quran he had with him during his trial and in prison.Katherine Rosman/The New York Times
It was one day and 21 years after his exoneration from a first-degree rape conviction in a case so brutal that it had stunned a crime-weary city and aligned New York’s political, law enforcement and media establishment squarely against him and his co-defendants.
In 1990, Mr. Salaam was sent to prison as one of the “Central Park Five.” This summer, he beat two incumbent State Assembly members in a Democratic primary and officially won the Council seat in an uncontested election in November. He will take office on New Year’s Day.
Mr. Salaam is a political neophyte whose skill as an operator within the byzantine universe of the city’s municipal government is completely untested. “I’m not a part of that world,” he acknowledged. “It takes time.”
His value to his constituents in Harlem is not measured, at least not yet, by a talent for weighing policy matters or solving neighborhood problems.
He brings to his community the power and the symbolism of his own life story. “Everything — every single thing — that I experienced has prepared me for this,” Mr. Salaam said before being sworn in on Dec. 20. “I needed to be in the belly of the beast, because now I can see that those who are closest to the pain need to have a seat at the table.”
Those who have followed the story closely, watching Mr. Salaam’s rise from a powerless member of the Central Park Five to an elected official in the very city that wronged him so terribly, appreciate the astonishing arc of his life.
“This is what justice looks like,” said Ken Burns, one of the directors of the 2012 “Central Park Five” documentary that told the hard-to-stomach story of the arrest, conviction and exoneration, weaving together interviews with the five men and details about the conduct of the police and the press.
“It is a testament to the resilience of the man who is about to take this position, and I think we can only just stand in awe,” Mr. Burns said.
For the other men who made up the Central Park Five — “my brothers,” as Mr. Salaam refers to Kevin Richardson, Raymond Santana, Korey Wise and Antron McCray — it is “a full-circle moment,” said Mr. Santana.
“There is a lot of emotion in knowing that we are all these years later still trying to make a difference, still trying to give back,” he said.
Does New York deserve the effort?
“Not at all,” Mr. Santana said. Then he added, “But the people do.”
When Mr. Salaam, now 49, walks the streets of Harlem, even on a blustery cold day when few are outdoors, he is recognized. “I’ve really been a public citizen since I’ve been 15,” he said.
One day in December, he left the campaign office on West 135th Street and headed east. He shook his head at a man on a bicycle who whizzed by on the walkway. “I really want to get these bikes and scooters off the sidewalk,” he said. “I want there to be quality of life in Harlem.”
Darryl T. Downing, a marketing consultant, stopped to say hello. “Let me shake your hand,” Mr. Downing said. He had met Mr. Salaam during the campaign and thought his experience would benefit Harlem. “He knows about renaissance,” Mr. Downing said. “He knows about rebirth.”
Mr. Salaam ambled on, chatting easily with other constituents as he strode the neighborhood that has defined the most important events in his life.
In April 1989, along with other Black and Latino teenagers, he was accused of the rape and assault of a white woman who had gone for a nighttime jog in Central Park. Mr. Salaam had been near the park with a friend and happened upon a larger group of teenagers whom the police and the press later accused of “wilding” — a term which, from that moment, entered the lexicon of New York, creating a fear that large groups of young men of color were suddenly marauding through the city.
New York in the 1980s was already on edge because of crime and violence, and the report of “wilding” and a rape in Central Park amplified the panic. Mayor Edward I. Koch called the teenagers “monsters.” A Daily News front page headline said, “Wolf Pack’s Prey: Female jogger near death after savage attack by roving gang.” Donald Trump, then a prominent developer, took out full-page advertisements in newspapers including The New York Times about the case. “Bring Back the Death Penalty,” the headline said.
In two trials, juries convicted the five teenagers based on false confessions, inconclusive physical evidence and no eyewitness testimony. (Mr. Salaam never signed a confession, nor was he videotaped providing one.)
The five unsuccessfully appealed their convictions and maintained their innocence.
Better Not Bitter
Mr. Salaam celebrates at his primary watch party at Harlem Tavern in June. He beat two veteran New York politicians in the primary and then won his Council seat in an uncontested general election. Jeenah Moon for The New York Times
In 1997, Mr. Salaam was released from prison. He moved back into the Schomburg Plaza housing development in Harlem with his mother but, as a felon and registered sex offender, struggled to find work. He was ill-equipped at 23 to pick up the life he left at 15. “Coming home was the most exciting time of my life, but it was also the most challenging,” he said. “You don’t know how to live.”
He found relief in books and motivational speakers. He tried to internalize Nelson Mandela’s words, “Resentment is like drinking poison and then hoping it will kill your enemies.”
In early 2002, after four of the Central Park Five had finished serving their prison terms, a man named Matias Reyes, a murderer and serial rapist who was already in prison, confessed to the rape, providing a DNA match to evidence found at the scene. By year’s end, a judge voided the convictions of the five men.
In 2007, Mr. Salaam met and then married his wife, Sanovia Salaam, becoming a father to her three children, in addition to the three daughters from his first marriage. (Together they also have four children, ages 7 to 15). He began to work with the Innocence Project, a criminal justice reform group that seeks to overturn wrongful convictions, and is now a member of the board.
But he said he and the others still lived under the shadow of the crime.
That began to change in 2011, when the book “The Central Park Five” by Sarah Burns led to a documentary of the same name, directed by Ms. Burns, her husband, David McMahon, and her father, Ken Burns.
Mr. Burns, Mr. Salaam said, “gave us our voices back.”
The film helped Mr. Salaam build a career as a motivational speaker. The release of the Ava DuVernay Netflix series “When They See Us” and his own memoir, “Better, Not Bitter” heightened his renown.
A few years after the documentary aired, bringing widespread attention to the injustices suffered by the young men, the city agreed to a settlement, paying each about $1 million for each year they served in prison.
“The compensation is a Band-Aid,” Mr. Salaam said. “It’s not complete justice, but it gives you the opportunity to finally take a break from the rigors of what life had become for us.”
Mr. Salaam and his wife decided to raise their family in Stockbridge, Ga., near Atlanta. They lived in a nice house, surrounded by deer, rabbits and humming birds. But it was almost too peaceful. When he looked up at the sky, it reminded him of “The Simpsons.”
“It felt like I retired,” he said.
Mr. Salaam had been traveling the country and speaking to audiences about racial justice, and he began to think about running for public office.
“You could go into politics anywhere,” he said a cousin told him, “but anywhere other than New York is Off Broadway.”
The timing was good. In 2022, Keith Wright, the New York County Democratic leader, flew to Atlanta to ask Mr. Salaam to consider running for City Council. The meeting confirmed his perception of Mr. Salaam as a figure of intellectual heft and righteousness, he said.
“Yusef is Harlem’s version of Nelson Mandela,” he said.
Much of the political establishment, including Mayor Eric Adams, supported Mr. Salaam’s more seasoned primary opponents. And while some in Harlem privately say they are reserving judgment, others say his inexperience is not a concern — and may perhaps provide a breath of fresh air. “Harlem suffers from a tenacious grip that the old guard retains on positions of power,” said Shawn Hill, a founder of the Greater Harlem Coalition, a group of community-based organizations working for systemic justice.
Now that he has won, Mr. Salaam knows there will be a learning curve at City Hall — and that he will have to manage his constituents’ expectations.
He found a four-day orientation session illuminating. A portion of one day was spent learning how a road gets fixed, to show the complications of municipal government.
“The process isn’t like, ‘Oh, I want a road built, let me block the street for a second with no permits and just have my friends help and, oh, shucks, how am I going to get a cement truck?’” he said. “It’s a whole process, and it might not happen tomorrow. It might not even happen during the entire time of your elective office.”
Mr. Salaam shared with voters his vision for a “new Harlem renaissance” and said he hopes to focus on the quality of public schools, availability of affordable housing and keeping young people engaged in their community.
He said his background leads many to miscast him as a far-left progressive. “People think I am ‘Defund the Police’ and ‘Abolish Prisons,’ but we need prisons for real criminals,” he said.
“I mean, if we abolished prisons, where would Donald Trump go,” he said, allowing himself the quickest smile. Mr. Trump declined to comment.
A ‘Script Writer Could Not Make This Up’
Mr. Salaam speaks to supporters at a fund-raising event at Melba’s Restaurant this month. Many people mentioned Donald J. Trump.
Many people at a fund-raising celebration held at Melba’sRestaurant in Harlem after Mr. Salaam’s swearing-in mentioned Mr. Trump — mostly to note Mr. Salaam’s transcendence amid Mr. Trump’s legal woes.
“A movie script writer could not make this up,” said Hisham Tawfiq, who grew up in the neighborhood. He recalled the way that the police seized on the term “wilding” amid the Central Park Five case. “You all going wilding?” he said a police officer once asked him, pointing a gun at him and a group of friends on the subway just after Mr. Salaam’s arrest in 1989.
“Imagine how many brothers and sisters were harassed like that because of that incident,” he said.
Mr. Salaam’s supporters talked local politics, as waiters passed trays of macaroni-and-cheese bites and fried chicken and waffles. For many, it was also a night of personal reflection.
“It’s incredible that our last name is now a part of a legacy,” said one of his daughters, Poetry Salaam, 20.
Kevin Richardson came from New Jersey to toast Mr. Salaam.
Mr. Salaam (center), along with Raymond Santana and Kevin Richardson, mark the unveiling of the Gate of the Exonerated, named in their honor, along a Central Park perimeter wall in 2022.Ted Shaffrey/Associated Press
During their incarceration, the two men were for a time housed in the same prison. When they saw each other at meals, they would link eyes, lift a milk carton and call out, “To the good life.”
Mr. Richardson remembered it as an act of hope. “We had to change the dynamic,” even for a moment, he said.
Now, he said, “I’m a girl-dad.” He took a look around the room. “Life is good.”
Soon Mr. Salaam addressed the crowd. “You all stood by me, you all stood with me, you carried me up,” he said.
As he campaigned through the district, “You all were telling me that I was what you had hoped for,” Mr. Salaam said.
He added, “What people see in me, I see in you.”
Katie Rosman is a reporter for the Metro desk, contributing narratives and profiles about people, events and dynamics in New York City and its outer reaches.
Thursday, October 12, 2023
Saturday, October 7, 2023
FOUNDATIONAL PRACTICES IN THE INTEGRAL YOGA OF SRI AUROBINDO AND MIRRA ALFASSA
PART 1: INTIMATIONS OF OUR ESSENTIAL NATURE
(NOTE – This is part of a series I’m writing on “Integral Yoga in Everyday Language.” While this is somewhat more complex than the previous essays, the practice, “Space of Awareness,” is easily accessible even to those with no prior familiarity with yogic philosophy or practice. Please read it very slowly, with long pauses between sentences – and allow the experience to which it is pointing to unfold slowly, easefully and with much quiet, peace and deep stillness)
THE VIEW FROM INFINITY
Intimations of Infinity
While India – the home of yogic psychology – has always placed great value on intellectual understanding, the yogic tradition takes direct spiritual experience to be the foundation for any valid intellectual view. the spiritual experience at the core of the Indian tradition has been described as the experience of an infinite Consciousness, an infinite Being in whom the entire universe has its existence.i But it is important to remember that the description of the vision is not itself a “view from infinity” – that is, the direct “knowing” of that Reality. It is meant only to be a pointer to an experience or way of knowing which cannot be captured in words.
This experience – perhaps more correctly referred to as a recognition – provides a means of a radical transformation in our own body and mind, and potentially, a transformation in the very root of how we understand the universe. Having “attained” this recognition, we can learn to bring attention to the various workings of the Infinite Being throughout the universe, and to provide intimations of Its Presence here and now, in our every thought, feeling and sensation, every rock, plant and animal in our environment, and each person we encounter. The various streams of the yoga tradition are one in their agreement that the ordinary human mind is not capable of perceiving the Infinite. However, yogis of all traditions have always made use of words to evoke something beyond the mind, to open a window onto the richness, beauty and vastness of that Reality which is the very substance of all we experience.
While the Indian spiritual tradition has perhaps been the one to speak most openly of the all- pervasive, all-embracing nature of the Infinite Divine Being, all spiritual teachigns have – at least at their mystic core – pointers to this experience.
In the New Testament, St. Paul describes God at that “in whom we live and move and have our being.”ii In the Koran, Allah is referred to as being closer to us than life itself, closer than “the jugular vein.” In the Hebrew Bible, God, speaking to Moses, gives His name as “I Am That I Am.”iii Native American and other indigenous peoples recognize Spirit to be present and active throughout the universe.
Jewish scholar Abraham Heschel describes a state of mind that can make the experience of this greater Reality more accessible. He suggests cultivating an attitude of awe which is “itself an act of insight into a meaning greater than ourselves... [enabling] us to perceive in the world intimations of the Divine... to sense the ultimate in the common and the simple; to feel in the rush of the passing the stillness of the eternal.”iv
But how can we cultivate an attitude of awe? For some, a “thinning of the veil” which opens us to the sense of awe can occur in communion with the power and beauty of nature: listening to the gentle, unearthly silence of a large metropolis blanketed in snow... watching the play of light dancing on the wind-swept surface of Lake Geneva... walking down Fifth Avenue in the hush of twilight, lost in thought, suddenly catching sight of the deep orange sunlight setting fire to skyscraper windows. The awesome quality of these experiences tends, to some extent, to calm the disjointed play of our ordinary thought, bringing about an openness and tranquility that allows for something deeper to emerge from within.
Literature, painting, dance, theatre, cinema, and religious ritual have all, since prehistoric times, been at heart, a means of softening the boundaries of our ordinary awareness, thus helping us to experience something that transcends our limited selves. In the solemn intonation of a priest’s chanting of a sacred text, our hearts softened, our minds stilled, we feel a mysterious Presence spreading throughout the cathedral... we are transported with Sri Aurobindo’s Savitri, as she voyages “through worlds of splendor and of calm”v ... in a darkened theater, we face death with Sir Thomas More, at peace in the noble equanimity of a high ideal.
The various practices of the yoga tradition are designed to make it possible for us to enter into this deeper experience at will, without need for external triggers. Ultimately these practices can help to dissolve the filmy screen altogether so that the “stillness of the eternal,” the soft and luminous presence of the Infinite is always and everywhere present in our experience. All yogic practice calls upon us to shift our attention – to step back from the familiar round of thoughts, feelings and sensations that tend to absorb us, and to gently redirect our attention inward. We invite you to join us in doing just that.
Shifting Attention: The Space of Awareness
Bring your attention to the sensations of your body. Let your eyes remain open, taking in the words of the text with a gentle, non-grasping awareness. Move your attention to different parts of the body, noticing the different sensations that arise...
As you attend to various sensations, notice that there is no clear boundary in your awareness between the sensations that make up the body and the space around the body...
As you release the sense of a clear boundary, begin to notice the larger space in which these sensations move...
Allow the sense of this larger space to continue to expand until you lose the sense of it having a beginning or ending, just open space...
As your sense of this space expands, see if you can notice a quality of stillness and calm associated with the unchanging nature of the space, the feeling of simply being which remains unchanged while the sensations continue to move and change in various ways...
Notice any sounds which are occurring, notice that they all occur within this larger space... notice whether near or far, the sounds all exist within the same open space ...
Notice images arising in the mind... these too are moving and changing in various ways, all within this larger space ...
Thoughts arise in space, move through it, dissolve back into it, the space remains, unchanged by whatever moves through it...
Feelings come and go – whether feelings of happiness, sadness, anger, joy, liking or disliking – constantly changing, leaving the space untouched, unchanged...
Staying aware of sensations, images, thoughts and feelings arising and passing away, notice the tendency of the mind to hold on to them, to harden them into solid objects... Releasing this tendency, see if you can become aware of a sense of ease and calm that may emerge as the sense of spaciousness expands... As the feeling of wide open space continues to expand, a feeling of quiet joy may enter into awareness...
Notice how everything moves, changes constantly within this space – sensations, thoughts, feelings – all patterns of moving energy, contained within the space, but not disturbing it...
The Field and the Knower of the Field
Within various spiritual traditions, there are many words to describe these two aspects of experience – the changing, shifting field of sensations, thoughts and images, and the still space of Consciousness in which they exist. The sacred yogic text, The Bhagavad Gita (literally “The Song of God”) refers to these, respectively, as the “Field” and “Knower of the Field.”vi
The Knower (or “Conscious-Being”) refers to that Infinite Being which holds the entire universe within Its Awareness. It is also That which, at this very moment, is seeing through our eyes, but which – in the words of the Kena Upanishad – “our eyes cannot see... which hears through our ears, but our ears cannot hear.”vii It is seeing and hearing equally through all eyes and ears – those of an ant as well as those of a cat or human being. It remains aware whether we are awake or asleep. We can get a sense of it by looking for that in us which is unchanging from infancy through all the changes of life, that core feeling of “I am” in the depths of our psyches.
This Infinite Conscious-Being is frequently referred to as “God,” but that word has so many images and associations attached to it, it rarely serves as a portal to experience. Describing the advantage of a simple word like “Being,” Ekhart Tolle writes:
The word ‘Being’ explains nothing, but nor does ‘God’. Being, however, has the advantage that it is an open concept. It does not reduce the infinite invisible to a finite
entity. It is impossible to form a mental image of it. Nobody can claim exclusive possession of Being. It is your very essence, and it is immediately accessible to you as the feeling of your own presence, the realization “I am” that is prior to “I am this” or “I am that.” So it is only a small step from the word “Being” to the experience of Being.viii
The Field (or “Conscious-Energy”) includes all that we sense – sights, sounds, physical sensations, tastes and smells; all that we feel – pleasure and pain, liking and disliking, anger, joy, love, sadness; and all that we think – our beliefs, memories, plans, worries, ideas, and the images passing through our minds; everything that exists within space and time. All are forms of Conscious-Energy, movements of Conscious-Energy arising out of the Being of the Knower – over billions of years of evolution, throughout our lifetimes, and in this moment and every moment of experience.
All that exists is the interaction of the Knower and the Field. Every atom, every tree, bird, rock and mountain range are movements of Conscious-Energy within the Consciousness of the Being at the center of all things. But these two – the Knower and the Field, Conscious-Being and Conscious-Energy – are not actually two. They are inseparable aspects of one unbroken Infinite Reality – one aspect being the still, changeless, witnessing Consciousness, the other an ever-moving, ever-changing Consciousness – outside of which nothing exists.
i Regarding postmodernists’ concerns about “totalizing” systems: the “view from infinity” is neither a system nor a view.
ii Acts 17:26-28.
iii Exodus, 3:14
iv Heschel, A., God in Search of Man.
v Sri Aurobindo, Savitri, Book I, Canto II, Verse 37.
vi The Bhagavad Gita, Chapter 13, Verse 2. For translation, see Sri Aurobindo, Essays on the Gita.
vii Kena Upanishad, Part I, Verses 6 and 7.
viii Tolle, E., The Power of Now, p. 14.
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