How USAG destroyed young women

For Maclean’s on January 29, 2018

Beyond inherent ability and genetic advantage, success in high-performance artistic sport—gymnastics, ballet, figure skating—requires militant self-discipline and unwavering dedication to training. All talent begins raw, and each sport has its own developmental program where young athletes hone specific skills and build key areas of strength which underlie the advanced demands of the competitive system. While elite programs differ in terms of sport-specific training strategies, the best and worst systems share a common, underlying component: abuse, either in their zero tolerance for it, or the centrality of it.

My own time as a dancer and gymnast saw the full range of abuses, and escaping one kind of mistreatment only led to being the target of and witness to another. For me, the most destructive was being subjected, starting at the age of 8, to an abusive sort of body-policing where my young physique was relentlessly scrutinized and compared to the bodies of girls who were older—girls whose athletic and physical development were naturally more advanced than my own.

I was told, repeatedly, how horrible my body was, where it looked wrong, how unacceptable it might forever be. I was told I was too fat to have friends; my weight and measurements were strictly monitored and widely broadcast. All talent was rendered insignificant by my apparently horrendous self. I was shamed, belittled and humiliated, over and over, and I developed a severe eating disorder by age 11, relapsing once at 14. The anorexia was ultimately surmountable. The intense self-hate and outright abhorrence of my body, however, was not.

Though my own work ethic and drive to train ultimately earned that lean, muscular body, enviable strength and elite level of fitness as an older athlete, my grim self-assessment was firmly, irrecoverably ingrained—which affects me to this day.

That’s why the excruciating testimony in the sentencing of disgraced sports doctor Larry Nassar resonated so deeply for me, and I suspect for other female athletes who’ve been through the same. In addition to the horrors of Nassar’s serial molestation, the stories of endemic abuse by coaches and staff forced USA Gymnastics (USAG) to acknowledge the truth of its system, and the rot at its core—a rot that too often exists in programs across competitive athletics.

Last week, USAG complied with the U.S. Olympic Committee’s ultimatum for mass resignations from the director’s board, preventing the USOC from decertifying USAG, which would have stripped its status as the sport’s governing body. Regardless of the intentions behind this purge, the lifeblood of USAG’s twin cancers remain.

The first: An ideology where coach deification and institutional worship results in unquestioned, untouchable authority—the ideal conditions for abuse to thrive. When not enduring mistreatment, athletes are forced to be complicit in cruelty toward others. Speaking up will incur further abuse or outright end a career. Less powerful coaches, too, find they can do little more than witness in silence. Either their concerns will be ignored, or they’ll be out of a job. Sometimes, it’s both.

The second: A method of training built on insidious forms of abuse, where harm to the mental and emotional well-being of young female athletes is but collateral damage in the quest for glory, and where the aftermath—eating disorders, depression, anxiety, self-harm, suicide—is shrugged off as somebody else’s problem.

We saw how entrenched this was in the survivor testimony at the Nassar trial. On the sixth day, former U.S. national team member and 2010 floor champion Mattie Larson named two now-retired figures central to the notoriously abusive system that currently exists: Bela and Martha Karolyi, icons in their field, whose Ranch served as the national team’s training centre, hosting camps billed as integral to Olympic glory.

Before defecting to the U.S. in the ‘80s, the Karolyis were the power couple of Romanian gymnastics. At the 1976 Montreal Olympics, their gymnast Nadia Comăneci scored the sport’s first perfect 10 at an Olympic Games. In America, their stars included gymnastic legends Mary Lou Retton and Kim Zmeskal, as well as two members of the 1996 Olympics’ “Magnificent Seven,” Dominique Moceanu and Kerri Strugg. In a glowing 2016 profile in the New York Times, Martha credited her system, and the ranch, as the prime reason that the “United States dominates the world of gymnastics.”

Larson, however, testified the Ranch was little more than a USAG-sanctioned centre for uninterrupted physical, emotional, psychological—and, from Nassar, sexual—abuse.

She told of an “intense and destructive six-year eating disorder” that developed in an effort to be skinny enough for the coaches’ affection and approval; the Karolyis were notorious for imposing a severe caloric restriction on athletes on top of the schedule, which demanded overtraining. During one camp, Larson was told she was fine by the doctor Nassar, despite later revelations that she had dislocated and fractured both ankles. She also recounted a time she intentionally injured herself in a desperate bid to escape the relentless abuse at the Ranch.

“While [Nassar] is a mentally deranged pedophile, he is not the head of the monster,” wrote Valorie Kondos-Field—head coach of the six-time champion UCLA women’s gymnastics team—in a post published days before Larson’s testimony. That, she said, was the cult of Karolyi: “Martha, and before her Bela, and before him Don Peters, who has been banned from coaching for his own sexual abuse allegations. For decades they established a culture of abuse that was widely accepted and mimicked by other club coaches because ‘we won medals.’ ”

This draconian method of “creating champions” is what allowed Nassar to prey with maximum reward, especially at the Ranch. He befriended the athletes, offered an empathetic, kind respite from the ongoing viciousness, and masterfully groomed each young gymnast for use to satisfy his own depraved sexual pleasure. While Nassar has been made to face consequences, and despite USAG’s vow to implement policies to better protect athletes from sexual misconduct, there has been no commitment to end the methodical mistreatment which remains.

Having coached 46 former U.S. national team members through their NCAA gymnastic careers, Kondos-Field witnessed the fallout of the system where “verbal, emotional, and physical abuse were simply the way of life.” She identified Larson as the most “egregious case” she’d seen of a young woman so thoroughly destroyed by the elite stream.

Following three weeks of living as a persona non grata after being blamed for America’s failure to secure team gold at the 2010 World Championships, Larson called Kondos-Field to say she was quitting elite to come to UCLA. When Kondos-Field asked why she’d do that so close to the Olympics, Larson replied: “Because I’ve become invisible. I actually pinch myself at times to make sure I am still alive and not a ghost.”

“I never felt so small and disposable in my life,” Larson said of that experience in her courtroom testimony. And in naming another notable figure, she exposed how inescapable the abuse remains even without the Karolyis at the helm. “It truly bothers me that one of the adults who treated me this way…is the new national team coordinator, Valeri Liukin. I hope for the sake of the current and future national team members he has changed.”

Liukin is gymnastics royalty—a top-tier figure, a two-time Olympic champion, and “one of the most highly regarded coaches in all of gymnastics,” boasts the USAG. Liukin is also the father of beloved American gymnast Nastia, whose awards include the coveted all-around Olympic title from the 2008 Beijing Games.

This wan’t the first time Liukin has been cited as abusive—two-time All-American and Junior National champion Katelyn Ohashi has spoken of aggressive body shaming and weight policing despite her being 70 pounds at the time, leading to bulimia—but it was certainly the most public, and thus inescapable, accusation. And when he replaced Martha as national team coordinator in September — four days after the Indianapolis Star first published Rachael Denhollander’s allegations against Nassar, and one month after its initial bombshell investigation into the systemic cover-up of sex abuse in the sport — the proud and firm believer in the Karolyi method planned for business as usual.

“There is no point in changing something that isn’t broken,” he said at the time.  “… We’re winning a lot of medals, and that’s what we hope to continue to do.”

That system—in which Liukin has been involved since 1999, employing methods he endorses and outcomes he’s entirely pleased with—was the one with shattering repercussions heard in that Michigan courtroom. Nassar, too, was part of that system. And Liukin saw no reason for concern. None.

When USAG recently, belatedly, agreed to close the Karolyi Ranch, Liukin offered his own facility as an interim training centre. Though the athletes would be spared of having to train in the place they were abused by Nassar, they would continue to endure every other abuse of the program.

If USAG is sincerely dedicated to a complete overhaul—if the intention is to truly establish a zero-tolerance attitude regarding the mistreatment of athletes—they will move to replace Liukin with someone outside the Karolyi circle. They will work to find an esteemed coach who isn’t known for targeting athletes in a terribly personal, cruel manner.

USAG has the power to deliver the final blow to the Karolyis’ destructive legacy. Liukin’s future role within the organization will be telling of how much power the old guard maintains in the future, and will send a message to other sports authorities about the need for total reform in their own ranks. After all, as Larson concluded in her testimony: “There is another way, a healthy and supportive way, to make champions.” For gymnastics to have a future, the USAG must believe that a demanding, disciplined program which expects excellence does not need to be abusive. It needs Larson to be right. The good news is that she is.

 

Advertisements

On loneliness​ and the winter low

For Maclean’s on December 24, 2017

“Lonely people have a natural affinity for the internet,” wrote the late film critic Roger Ebert in a 2010 entry on his online journal. “It’s always there waiting, patient, flexible, suitable for every mood. But there are times when the net reminds me of the definition of a bore by Meyer the hairy economist, best friend of Travis McGee: ‘You know what a bore is, Travis. Someone who deprives you of solitude without providing you with companionship.’

“What do lonely people desire? Companionship. Love. Recognition. Entertainment. Camaraderie. Distraction. Encouragement. Change. Feedback … what all lonely people share is a desire not to be—or at least not to feel—alone.”

Embedded in the post was a poignant cartoon of a simple figure, looking downward with a pink heart on its chest, showered by an unforgiving rain from a cloud hovering above. Beside this image, there were these words: “Sometimes I take a carton of eggs out of the fridge and look at it and think that maybe one day I’ll crack an egg and a little baby chicken will fall out, and I’ll wash him off and raise him indoors and then… then I’ll have a friend.”

For many, the winter brings an increasing darkness beyond the shortened daylight—a shadow which stubbornly hovers like the cloud haunting the figure in the cartoon—a cycle best captured by an Icelandic term: “Skammdegisskuggar.” The meaning, as noted by author Robert Macfarlane, is “literally, ‘shadows of the short days’; metaphorically, the darkness that can be cast into both land and spirit by deep winter.”

Winter depression, and the loneliness it invites, can make the year’s final months seem, at times, unbearable. The holidays can prove to be a particular challenge, as the reluctance on one end to reach out for support, combined with uncertainty on the other of when and how to extend a hand amid overwhelming cheer, intensifies the aching sort of isolation, which then begets further loneliness.

Why, with all the campaigns dedicated to understanding mental illness and promoting emotional well-being, does there remain a reluctance to seek support for social isolation? Loneliness hasn’t been granted the same sort of legitimacy as, say, depression. It’s largely subjective, deeply personal, and remains so stigmatized, people are deeply reluctant to discuss—or even admit to—this honest emotion. There’s a profound vulnerability in doing so, as if loneliness itself indicates or reveals some fundamental failing or flaw of character.

Some won’t acknowledge their own lingering sadness because they imagine loneliness only affects those who are, quite literally, all alone. But the fact is, you can be married, have children, enjoy a stable, successful career, be surrounded by like-minded colleagues, and still, at the end of the day, feel lonely. You can still lie awake with an emptiness, yearning for some specific, meaningful connection to something or someone that would satisfy some persistent void.

“Human connection lies at the heart of human well-being,” wrote Dr. Dhruv Khullar in his December 2016 column in the New York Times outlining the “dire physical, mental and emotional consequences” of social isolation. Though we’re more connected online than ever, those ties are increasingly superficial. Not only have deep, meaningful bonds become scarce for many, modern demands of life and work have made it more difficult to maintain and nurture—or at least, far too easy to neglect—those important few that are still held.

Whether you’re married, single, an extrovert or generally shy, close, meaningful friendships matter. It’s not the number of connections or the proximity, but the quality of them.

Despite the evolutionary role of interdependence for well-being and survival, rugged individualism is too often romanticized. As recent research on the medical, as opposed to the psychological, fallout of loneliness has shown, the biological and physiological consequences of the prolonged stress from loneliness can be, quite literally, lethal.

According to Khullar, “analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 per cent higher risk of dying in the next seven years, and that this effect was largest in middle age. Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions.”

What’s more, the fallout begins early. “Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors.”

“It’s up to all of us,” concludes Khullar, “to maintain bonds where they’re fading, and create ones where they haven’t existed.”

If you find yourself, to use Ebert’s words, among “the lonely people” as the year draws to a close, it’s important to understand that, no matter the reason, you’re not alone in that feeling. If you reach out to someone—whether a close friend or a mere acquaintance; a family member or a crisis line—you’ll be met with far more empathy and understanding than you might expect, because everyone, at some point, to some extent, has been there too.

Rekindle ties with those you value and with whom you may have fallen out of touch. Write a letter or an email, or give them a call. Do something tangible, even if it feels forced at first, to begin to reconnect and rebuild the relationships which remain, in some way, important to you.

If you’re someone who will be surrounded by family and friends over the holidays, consider taking a moment, or finding meaningful time, for a person you suspect might not be as fortunate. It could be an elderly neighbour who lives alone, or perhaps a colleague you’ve noticed withdraw in recent months. You never know when the simple act of checking in—sending a simple text or e-mail, calling to chat, leaving a message, or dropping by—will change, or even save, a life.

Helping others through a difficult stretch doesn’t require special training or knowledge, just a moment of patience and an empathetic ear.

Never underestimate the value of time. Whether seeking it from another, or offering some of your own, it can prove to be the most cherished gift exchanged through the holidays. These connections have a way of growing into deep, lasting friendships—the kind that are the ultimate antidote to loneliness, even after the winter low has lifted.

 

Of flawed men and dangerous​ ones

For the CBC on November 30, 2017

In early November, Breaking Bad star Bryan Cranston weighed in on the stunning allegations of sexual misconduct levelled against Hollywood icon Kevin Spacey — one of the early casualties of the so-called Weinstein effect — in an interview with BBC Newsbeat.

Cranston suggested Spacey was “a phenomenal actor, but not a very good person,” describing Spacey’s alleged predatory behaviour as “beyond disgusting. It’s almost animalistic … his career now I think is over.”

Cranston’s response was, at the time, a minor entry on the list of celebrity reactions. It was a chat with BBC’s Will Gompertz, just days later, which drew considerable attention — and outrage.

Finding a way back

Cranston was asked if he thought there was a way back for some of the “Weinsteins and Spaceys of the world.” (To be clear, the full conversation was far more substantive than subsequent clickbait-y headlines would suggest.) In response, Cranston spoke of the wider societal problem of sexual harassment and specifically called for male introspection. Then he went on:

“It would take time,” he said. “It would take a society to forgive them, and tremendous contrition on their part … a knowingness that they have a deeply rooted psychological and emotional problem [that] takes years to mend. If they were to show they put the work in and are truly sorry and making amends, not defending their actions but asking for forgiveness, then maybe down the road there is room for that, maybe so.”

It was an admirably honest, thoughtful response to an uncomfortable question of how to deal with perpetrators of sexual harassment and abuse.

Must every offender become a pariah, or is there room for rehabilitation — possibly even forgiveness — depending on the severity of the crime, sincerity of remorse, input from the victims and totality of circumstances?

As Ruth Marcus, deputy editorial page editor for The Washington Post, argued: “The notion of the cleansing purge has its satisfactions.” There’s a tendency, however, to “overcorrect for past sins. If society once ignored sexual harassment — and we certainly did — one risk…is overcompensating for earlier apathy.”

Marcus has a point. That’s not to suggest men like Harvey Weinstein, who embody a particularly heinous sort of sexual predator — those who not only victimize prey, but implicate all those around by terrorizing them into silence — deserve any shot at redemption. Nor do men who prey on children.

But this overdue reckoning with inappropriate conduct will include transgressions that are arguably minor, and not so straightforward; behaviour more ambiguous — boorish and repulsive, perhaps, but not habitual or necessarily criminal, if still wrong. I suspect most — if not all — men have behaved in some regrettable manner at a given time. But it’s a mistake to assume a man’s worst days accurately reflect his character or potential to reform.

Case in point: Senator Al Franken.

Earlier this month, Los Angeles radio personality Leeann Tweeden alleged that the comedian-turned-senator forcibly kissed her while rehearsing a comedy bit back in 2006 on a USO tour. The same tour produced the now-infamous photo of Franken mugging for a camera while reaching for Tweeden’s breasts as she slept.

After the allegations were made public, Franken conceded that he “let a lot of people down,” but said he is determined to make amends: to prove himself a better man and still-worthy senator.

“This is not going to happen quickly,” Franken said. “I have to earn this over time and that’s what I plan to do.”

Long a sincere and fierce advocate for women, Franken recognizes the unique betrayal many women feel and the additional challenge of repairing that bond. “I know I’m not going to regain their trust immediately. There’s no magic words I can say here to make that happen.”

Compare with Weinstein who immediately sought victimhood, claiming his sexual crimes — which were so obviously premeditated choices — were the result of “sex addiction.” The diagnosis has become a handy tool, of late, to absolve sexual predators of responsibility.

After a single week of “intensive therapy” at a luxury Arizona rehab/resort — a choice “treatment” destination for Spacey, too — Weinstein checked himself out. Far from seeking to earn a second chance, Weinstein, who considers himself “the good guy,” apparently feels entitled to one.

Franken, meanwhile, has welcomed a Senate ethics investigation, vowing to fully co-operate and take responsibility.

“I’m going to be held accountable, and I’m going to try to be productive in the way I speak about this,” he said. In addition to his personal, unequivocal apology to Tweeden, which she graciously accepted without hesitation, Franken’s introspection has been laudable. For instance, though he maintains a different recollection of the USO rehearsal, he understands Tweeden’s interpretation differs from what he believes was his intent, and he accepts that some violation happened on account of his actions.

Learning from mistakes

What adds weight to Franken’s words are his actions: he hasn’t just said the right things, he has already taken steps to atone for his sins and learn from his offending conduct. Short of his resignation, what more should we reasonably ask?

Tempting as it is to “burn it all down” amid the torrent of allegations of sexual impropriety — an inclination which gains appeal with each, seemingly daily bombshell (see: Matt Lauer) — tangible progress and lasting change happen incrementally.

Allowing imperfect men to be part of the solution, even if they were, at some point, in some way, part of the problem, can make for a powerful allied force for good. The passion and dedication that those reformed often bring to a cause shouldn’t be overlooked or underestimated.

It’s important we listen to the stories of those who have been targeted and victimized by powerful, horrible men. But careful weighing of the appropriate, proportional response toward all accused will help ensure irredeemable offenders — and their network of enablers — are fully exposed and held to account. Misdirected anger is wasted energy and, ultimately, a distraction from the larger, most crucial end.

 

Confronting prejudice and changing minds

For Maclean’s on August 31, 2017

One year ago on C-SPAN, Heather McGhee—an African-American woman and the president of Demos, an equality-focused public policy organization—was the featured guest of a call-in program in Washington. Half an hour into the broadcast, a caller introduced himself as Garry from North Carolina, and made a remarkable request: “I was hoping that your guest could help me change my mind about some things,” he began. “I am a white male, and I am prejudiced.”

Garry said his views were rooted in fear—among other things, the fear of black crime and “young black males” needing to turn to crime “to get money for drugs”—and he didn’t want to think or feel that way. But he didn’t know how else to feel.

McGhee, recognizing that Garry had for some reason found a friend in her, took a deep breath and thanked him for being honest, and for opening up a conversation that, too often, isn’t had. “Asking the question you asked, ‘how do I get over my fears and my prejudices,’ is the question that all of us … people of all races and ethnicities and backgrounds hold onto these prejudices … your ability to just say ‘this is what I have, I have these fears and prejudices and I want to get over them,’ is one of the most powerful things that we can do at this moment in our history.”

McGhee recognized Garry’s aversive racism—“I don’t want my fears to come true, so I try to avoid… and I come off as prejudiced”—and gently and non-judgementally addressed the racist assumptions Garry listed before offering concrete suggestions of how he could work to counter and confront those fears, like visiting a multi-ethnic church, getting to know non-white community members, fostering conversations about these fears with family, and learning more about African-Americans in the country.

The compassion offered by McGhee not only allowed for a truly constructive bit of discourse, it provided a direct refutation to Garry’s belief that blacks were inherently angry, aggressive, and dangerous. Had McGhee mocked or chided Garry for his beliefs, or responded in the way that’s become far too common across social media—vindictiveness or dismissal—Garry’s fears would seem justified, and that small window for change would be forever sealed.

When it comes to racial prejudice and intolerance, there are far more Garrys than there are David Dukes or Richard Spencers—a sentiment that, in today’s charged climate, can feel false. On its own, that August weekend in Charlottesville where toxic male aggression, combined with seething racial tensions and overt white supremacist ideology, inevitably ended in violence, would seem to prove otherwise. But while this degree of far-right extremism and neo-fascism needs to be explicitly called out and unequivocally denounced, it would be a mistake to assume that racist, bigoted, or discriminatory beliefs are wholly indicative of the individuals who harbour them.

However morally satisfying, viewing racism through a Manichean lens—where people are either evil or good, “racist” or “not racist”—misunderstands the complexities which drive the formation of irrational beliefs and misguided assumptions of someone else. It assumes—wrongly—that all people who hold racist views explicitly choose to hold them. Quiet, implicit biases, for instance, are often come by honestly. And while no one is free of them—within every race and ethnicity you’ll find varying degrees of prejudice toward specific others, as it’s part of an evolutionary in/out group tendency—there are differing degrees of awareness to individuals’ own soft bigotries.

Knowing this makes it easier to accept that good people—including those you may know and love—can hold deplorable views without being fundamentally deplorable human beings, and in getting beyond the desire to write off those who maintain such views as entirely irredeemable, you can actively work toward challenging—and changing—their flawed mindset.

While some eagerly embrace intolerance, many are reluctant to acknowledge—or may be entirely blind to—their own prejudices, because those quietly acquired beliefs are so far out of line to their consciously held morals. As Ta-Nehisi Coates observed in 2013, “we believe racism to be the property of the uniquely villainous and morally deformed, the ideology of trolls, gorgons, and orcs. We believe this even when we are being racist.”

 It’s easier to cling to the “white hood” theory of racism—the notion that hateful people like Duke are the epitome of the problem—than to confront our own subtle, insidious views about a given other. This makes harmful beliefs pertaining to race and matters of social justice so notoriously resistant to change. While there’s no single foolproof approach to changing misguided ideas, what’s been proven the least effective and most counterproductive effort is the shaming method.

“When people have their self-worth validated in some way, they tend to be more receptive to information that challenges their beliefs,” said Peter Ditto, a psychology professor at UC Irvine—that is, treating the person as worthy of debate, no matter how unworthy you’ve deemed their opinion, creates opportunity for constructive dialogue. Because mood factors into how receptive we are to new information or different ideas, direct antagonism—whether through point-scoring, name-calling, or the use of epithets (which includes the allegation of being “racist”)—immediately puts the other on the defensive, which not only kills any chance for discussion, but instinctively drives a doubling-down on the problematic beliefs.

Further, by separating the person from their views, thus removing any sense of moral failure or shame on their part, you can more effectively, even directly, challenge the faulty beliefs without attacking at a personal level. In acknowledging someone’s identity outside of a particular view, you provide assurance that while you may find their point of view detestable, you don’t hold them personally so. When people respect your approach and feel they’ve been fairly heard—that care has been taken to consider a point of view they may hold passionately—they are increasingly likely to consider your counter-argument.

Once you’ve started some dialogue, asking the other to expand on their specific idea—giving them full opportunity to explain, in detail, precisely why they hold that opinion—will open them to the limits of their own understanding. It’s easy to hold some gut-level belief, but given how those often arrive without conscious effort, asking for in-depth reasoning will expose the absence of it, and without any effort on your part. Even if the person’s mind isn’t changed, the introduction of doubt to one’s certainty can help begin the education process. And if you can’t offer a thorough response yourself, to help fill the information gap the other has revealed, then chances are your own knowledge of the matter isn’t as complete as you believe it is. This presents an opportunity for you to broaden your own understanding and deepen your knowledge, which will then strengthen your argument down the road.

In The Knowledge Illusion: Why We Never Think Alone, co-authors Steven Sloman and Philip Fernbach explore the limits of knowledge, and the precise role that groups play. The way we rely on the expertise of others to make personal sense of the world is what sets the stage for over-confidence in what we think we know. Leaning on others’ knowledge without a full understanding, over time, creates the illusion that we ourselves possess the expertise. 

“This is how a community of knowledge can become dangerous,” they observe. “As a rule, strong feelings about (fraught political) issues do not emerge from deep understanding.” Exploring the complexities of an issue and patiently working through the details offers the best chance to “shatter the illusion of explanatory depth and change people’s attitudes.”

Another promising approach deals with the precise framing of debate. By appealing to the moral concerns of the person whose beliefs you’re challenging, you can work toward finding common ground. “There’s this tricky difference between moral difference and the absence of morality,” notes Matt Feinberg who, along with Robb Willer, studies effective persuasion across ideological lines.

Jonathan Haidt studies the psychological foundations of morality, and his book The Righteous Mind: Why Good People are Divided by Politics and Religion introduced the Moral Foundations Theory, positing that liberals and conservatives are uniquely motivated by five distinct moral dichotomies that frame their thinking. Liberals, for instance, place greater importance on matters of care/harm and fairness/cheating, while conservatives value the concepts of loyalty/betrayal and authority/subversion. These competing values, in part, fuel the Black Lives Matter vs. Blue Lives Matter fight.

Take, for instance, the case of Jeronimo Yanez, an officer with Minnesota’s St. Anthony Police Department, who was acquitted in June on all charges of criminal wrongdoing in the shooting death of Philando Castile, a black man who he’d pulled over on account of a broken tail light. Castile was, by all accounts, the sort of man conservatives routinely suggest are absent in black communities—his record was clean, he was a role model for local youth, he had a job and a girlfriend and served as a father to her four-year-old daughter. Castile’s life approach, described by a longtime friend, was always “‘play it by the books.’ ”

Dashcam video revealed Castile as attentive and respectful toward the officer when he was pulled over, and showed he proactively informed Yanez of the presence of a gun which he was fully licensed to carry. Mere seconds later, Yanez opened fire, unloading seven rounds into the car, five of which hit Castile.

Conservatives who’d always found reason to justify previous deaths of black men at the hands of police, but who decried the officer’s acquittal in this case, were able to find common cause with Castile largely because of the Second Amendment aspect. That moral frame forced them to see not a black man—someone who was “other”—but a fellow patriotic American whose black life should have mattered.

That’s no small revelation. And yet, while many champions of police reform welcomed the conservative advocacy, some couldn’t help but fall back on the call-out/shame cycle, admonishing for “not listening” to what the black community had long been saying.

While frustration is understandable, scolding someone you’ve been trying to reach for making real progress—no matter how delayed—is ultimately self-defeating. What’s more important here: self-righteous point-scoring, or welcoming an ally from the other side to help work toward a now-common goal?

There is courage in admitting to beliefs which could be deemed a moral shortcoming. Making oneself vulnerable in order to become a better person is a harder choice than it ought to be. Making that choice an impossible one—by always greeting honest effort with hostility—guarantees an end to progress. There is also tremendous bravery in responding with compassion when, throughout life, you’ve been afforded none. Though it seems unfair that the bulk of effort to counter harm rests with the those who’ve borne the brunt of it, that’s what social justice activism is about: to persuade those who feel they have nothing to gain by challenging an injustice, to see themselves in the cause, and join it.

You cannot force someone’s change of heart. But you can lead in a way that might entice one.

 

She’s someone.

For the Ottawa Citizen on October 12, 2017

In the wake of allegations swirling around Harvey Weinstein, a powerful, dominant figure in Hollywood, where the emerging picture suggests decades of sexual predation, many women are finding their voice in this rare window for candid dialogue and raw confession.

The response from some of Hollywood’s leading men, however, has been a standard refrain, one that helps maintain the power dynamic which allows abuse to happen. When Matt Damon claims “as the father of four daughters,” Weinstein’s alleged behaviour is the sort of thing  “that keeps me up at night,” he offers no hint of understanding the root of the problem.

On Wednesday, writing in The New Yorker, Jia Tolentino explained how “one of the cruellest things about these acts is the way that they entangle, and attempt to contaminate, all of the best things about you … a powerful man sees you, a woman who is young and who thinks she might be talented, a person who conveniently exists in a female body, and he understands that he can tie your potential to your female body, and threaten the latter, and you will never be quite as sure of the former again.”

This is a familiar, abusive dynamic which exists far beyond Hollywood and touches every industry – though the menacing behaviour may not always be sexual in nature. No matter the method, abusing one’s power at the most personal level is about eroding the agency of women, ultimately assuming control and enforcing compliance by way of threats, coercion and humiliation.

When a woman’s talent resides in her physical abilities – the abuse some female athletes experience occurs on multiple, concurrent levels – that fallout, as noted above by Tolentino, is compounded. When a woman’s value and potential depends on a body that performs above all else, the relentless pursuit of a more-perfect – stronger, faster, leaner – physique inside a sport results in a body that doesn’t fit neatly outside of it, and the degradation met from either side of that divide ultimately ends in doubting and hating every aspect of oneself.

Anyone who understands the type and extent of damage done by deeply personal mistreatment will find the now-standard refrain when abuses comes to light – she’s someone’s sister/mother/daughter/wife – completely hollow.

It’s a line that reinforces the notion of a woman’s inherent worth being dependent on another’s evaluation: In this case, her importance centres around her direct relation to another. She can be more readily humanized and related to here because she fits squarely into some female box and afforded a basic value.

When Ben Affleck, in response to the allegations against Weinstein, (hypocritically) says he is “saddened and angry that a man who I worked with used his position of power to intimidate, sexually harass and manipulate many women over decades … we need to do better at protecting our sisters, friends, co-workers and daughters,” he is suggesting women are simply in urgent need of defending.

His response maintains the hierarchy and imbalance of power that fuels abuse, one where men reign supreme and women are always regarded as the lesser, weaker beings: easy prey.

The “she is someone’s” framing fails to recognize women as worthy of dignity and respect in their own right. Each woman is something apart from her body.

She is someone – period.

Women are doctors, lawyers, teachers and mentors. We are athletes and builders, academics and scholars. Yes, women are daughters and mothers and sisters; we are friends and partners, too. But we are fierce, capable individuals independent of any given familial, professional or intimate relationship.

Daughters don’t need a future of white-knight defending, they need an environment where their ideas, abilities and potential are allowed to stand or fall on their own merits. That requires effort from men in teaching their sons to do and be better than they were, while challenging fellow men, and toxic cultures, to change.

Rather than seeking ways to humanize women, men should ask why that effort is necessary at all, then determine their role in correcting that. This isn’t so much about your mothers, wives, sisters as it is about sons, brothers and fathers.

 

 

On Charlie Gard, medical harm, and fate

For Maclean’s on July 18, 2017

It’s the most commonly cited phrase from the Hippocratic Oath, the binding document—one of the oldest in history—upon which physicians swear: “First, do no harm.” However, that four-word axiom doesn’t itself appear in the classical text of the pledge. Instead, there’s a promise to “apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.” That distinction is important: In medicine, harm can be mitigated, but it cannot be avoided. Every procedure carries risk, and the value of beginning or continuing treatment is weighed against the merits of withholding, suspending, or abandoning it. No course of action—or inaction—is free of trade-off. While harm cannot be the intent, it’s inevitable that harm, to some degree, will be done as a result.

And so physicians and surgeons, knowing the limits of their capacity as doctors and that of medicine itself, strive to achieve the best possible outcome while doing as little damage in the process. This includes situations where the “best possible outcome” means sparing a patient prolonged suffering, protecting against futile interventions sought out of desperation, and allowing death to occur as gently as possible. The modern interpretation of the oath includes a vow to “apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

This commitment to hold the patient’s best interest above all else, to practise with tenacity and skepticism in equal measure, is of particular importance when patients cannot speak for themselves—even more so when the patient is a child, and there’s denial or defiance from caregivers regarding a diagnosis, prognosis, or proposed treatment.

Which brings us to the wrenching saga of Charlie Gard, the terminally-ill British child at the centre of what’s become an international, ideological brawl over parental rights and the boundaries of intervention when caregivers and medical experts are at odds; a case which demonstrates the delicate balance between optimism and realism in both treating and coping with disease. It raises questions regarding the ethics of medical professionals who provide false hope—a practice known to be predatory and harmful—exposes the moral bankruptcy of those who so often position themselves as defenders of morality, and reveals the callous politicization of a dying child for selfish, partisan purposes.

Taken together, the push to assign blame and assume control over what’s ultimately a genetic tragedy speaks to a broad misunderstanding of disease and how it’s treated—and our stubborn reluctance to concede to the cruelty of fate.

Born Aug. 4, 2016, Charlie has lived all but the first nine weeks of his life in London’s Great Ormond Street Hospital. He inherited a rare, genetic defect which hinders the mitochondria—the powerhouse of the cell—from producing energy. Charlie’s diagnosis of infantile onset encephalomyopathic mitochondrial DNA depletion syndrome (MDDS) is incurable, untreatable, and fatal.

Though his parents, Chris Gard and Connie Yates, insist Charlie remains responsive, his MDDS has reached the terminal phase—his body is dying—and the life support that’s artificially sustaining his existence cannot halt the natural progression of the disease. What it can do, however, is temporarily prolong the agony of Charlie’s life: MDDS starves Charlie’s muscles, kidneys, and brain of the energy needed to function, and because of his epileptic encephalopathy, Charlie also suffers from frequent seizures and has extensive, irreversible brain damage at both the structural and cellular level.

Charlie can’t communicate the extent of his discomfort. But in Britain, courts intervene when there’s a dispute between doctors and families over a proposed course of treatment, and judges help determine what’s in the best interest of the patient. And in siding with the doctors selflessly dedicated to the child’s care—ruling against his parents’ desperate appeal to the right-to-try—the U.K. Supreme Court established that Charlie “is suffering [pain] and at more than a low level … it was in his best interests for the clinicians treating him to withdraw [all life-sustaining support] and to provide him only with palliative care.” That ruling upheld decisions from the British Court of Appeal and the Family Division of the High Court of Justice, which had granted the hospital permission to “withdraw all treatment, save for palliative care, to permit Charlie to die with dignity.” The European Court of Human Rights in Strasbourg then declined to intervene.

But Yates and Gard found an American neurologist willing to subject their son to a costly, experimental therapy, and they have been fighting in court since April for the right to take Charlie to America and treat him as they see fit. The couple launched a GoFundMe campaign to finance the therapy—an effort which has raised more than £1.3 million to date—with Yates writing that Charlie “literally has nothing to lose but potentially a healthier, happier life to gain.” Problem is, when Charlie’s medical team asked for evidence of the proposed treatment’s efficacy, the American neurologist—known only as Dr. I through court documents—admitted that “there is no direct evidence, but there is a theoretical scientific basis for saying it could [help].” After learning the full extent of Charlie’s “catastrophic and irreversible brain damage,” Dr. I conceded it was “very unlikely” the experimental therapy would benefit the child in any meaningful way, which aligns with the London hospital that has always maintained the desired nucleoside therapy “would be futile and would prolong Charlie’s suffering.”

Heading into July, their legal options exhausted, it seemed Yates and Gard were finally ready to let Charlie go. “We’re making precious memories that we can treasure forever with very heavy hearts. Please respect our privacy while we prepare to say the final goodbye to our son Charlie,” Yates said on June 30, the day Charlie’s ventilator was set to be disabled. The hospital granted an extended window for goodbyes.

Enter the Pope and the Vatican, the President of the United States, and a range of conservative activists, from notorious right-to-life warriors to fervent champions of free-market health care, some referring to “death panels” blocking Charlie from accessing care in America. One week later, Charlie’s parents were again in denial, and poised to fight on; Yates credited the international attention brought by the Pope and Trump as the “single biggest factor” for Charlie’s life support remaining in place.

On July 13, Yates and Gard were back in court, again pleading their case to Judge Francis, a hearing requested after the hospital—amid intense international pressure—agreed to hear the “new evidence” the parents claimed to have. There remains no resolution, though lawyers from both sides have agreed to arrange for a meeting in Britain between Charlie’s doctors and the American neurologist, who has not yet examined the child, yet remains willing to cede to the parents’ demand for hypothetical cause to hope.

But all these intervenors continue to miss the point. The fate of the child is not open to ruling; Charlie’s genetic disorder remains his death sentence. There is no question of whether or not to discontinue the infant’s life support—that will and must be done—nor is this a matter of medical resources or “death panels.” In fact, it’s the remarkable care of Britain’s socialized health care system that has enabled Charlie’s survival to this point, and at no cost to his parents. Spending millions on private, experimental therapy will neither slow nor reverse this painfully terminal situation.

This is the fundamental, brutal truth at the heart of this case. And while Charlie’s parents believe themselves sincere in their claims—“We’re not doing this for us. He’s our son. We want what’s best for him. If he is still fighting, we are still fighting”—the fact remains that they’re not actually fighting in the child’s interest. The pain of losing their son is being prioritized over Charlie’s own sustained agony. Further, Charlie isn’t “fighting”: He’s dying. He’s not engaged in this battle. For most observers, these are difficult notions to consider; for those intimately involved, they’re impossible to admit to.

By and large, society’s grasp of death and understanding of illness is selective and flawed. Disease is presented as something to be valiantly fought against as opposed to professionally treated; when people die, they’re said to have “lost the battle,” suggesting failure on the part of the individual for circumstances well beyond their ability to influence. Medicine and doctors treat disease as best they can, but not every illness can be remedied or managed—that’s not failure, that’s nature. The need to believe one can assume control and triumph over adversity, no matter the circumstance, stems from an unwillingness to accept that, more often than not, stories of medical hardship don’t conclude in straightforward, tidy, or even satisfactory fashion. The widespread, fierce denial of the inevitable outcome for Charlie is the social issue worthy of attention in the Gard case.

Medical misfortune and dying—and the hard truths of their realities—are realities I know well. There have been two distinct periods of my own life where I endured a sustained, tortuous march toward death. The first, caused by a should-have-been manageable, inherited disease which went undiagnosed and untreated, resulting in the widespread damage and complete shutdown of a major life-sustaining organ, the intestine; the second, after proper diagnosis and years of intensive treatments and surgeries, a rare post-operative complication resulted in catastrophic, multi-organ failure, and further damage to what remained of the intestine.

It’s the second period of being alert and aware in an imminently dying body that was most physically excruciating and emotionally traumatic. There’s the “air hunger,” or chronic sensation of suffocation, which compounds the already intense state of anxiety and what’s known as terminal agitation; in addition to frightening hallucinations and intense nightmares, this second experience was also intolerably, relentlessly painful.

Every day during this period, I’d ask my doctors if I was going to die, and each horrified query was met with some form of this honest, if unsatisfactory answer: “We’re taking good care of you.” Though lacking certainty themselves, my family quietly prepared for the worst. They chose to control what they could while maintaining hope, but granted that—like before—they ultimately had no sway over my fate. There were no end-of-life discussions directly with me because everyone knew clearly that I did not want to die, and at the time, I was unable to cope with the prospect enough to properly discuss it.

I can’t say why I’ve survived impending death—twice—but I do know I cannot take credit. It remains my own medical team, and chance, that saw me though. Were my diagnosis undeniably terminal and prognosis clear, palliative care would have been the route to follow. Though I’d have been devastated, that certainty would have forced my hand on many things—including facing my mortality. Rather than cowering in death’s shadow, perhaps I’d have danced in it.

There is undeniable—though unavoidable—harm in learning that a prognosis is fatal and nothing more can be done. But that finality, however devastating in the near term, offers both patient and family some degree of control over the remaining days. It provides a meaningful window for final goodbyes or final adventures, and allows for an uninterrupted focus on quality time. These moments, down the road, are what help those bereaved find their way through the sorrow.

This long-term benefit is lost on those who, desperate to bypass immediate grief, are seduced by false hope and empty promise. In chasing what they believe to be a miracle cure, patients are robbed of time as their families are robbed financially. Those who suggest there is “nothing to lose” in seeking “alternative” treatments are not allowing themselves to see the intangible, irreplaceable things that remain, all of which they forfeit to follow a mirage. Yates and Gard are both victims of this dreadful, depressingly common, trap.

Of all those claiming to be fighting on Charlie’s behalf, it’s those who’ve been demonized—his medical caregivers, and the British courts—who’ve offered the selfless, ethical, unwavering commitment to the child. The medical fight for Charlie’s right to die is an extension of the life-sustaining treatment provided to this point.

End-of-life support is an under-appreciated element of health care; to know the excruciating experience of dying-of-illness firsthand is to appreciate the importance of preventing that sort of drawn-out agony whenever possible.

 

(Un)civil discourse

For the CBC on July 31, 2017

“It is simply impossible to overestimate the love, bordering on worship, that reporters in Washington long had for McCain, and to a great degree still do,” Washington Post contributor Paul Waldman wrote Tuesday as Senator John McCain, diagnosed with an aggressive form of brain cancer, returned to Capitol Hill to vote on the Republican effort to repeal and replace Obamacare.

“He alone is written about as though he never considers politics or his personal advancement,” Waldman continued, “but makes decisions only on the basis of his unimpeachably virtuous ideals.”

McCain’s “maverick” credentials have always been part of a carefully-crafted persona, though closer examination of his voting record reveals a predictable toeing of the Republican party line — roughly 87 per cent of the time, to be precise.

Indeed, he continued to toe that line last Tuesday, voting to move ahead with debate of the Senate’s health care bill while vowing to block any final passage of the proposed legislation unless substantive changes were made. As The Atlantic’s David Graham put it: “[McCain] delivered an impassioned critique of partisanship, haste, and win-at-all-costs legislation, just moments after casting a vote to debate a bill that exemplifies all three.”

It’s not unreasonable to suggest McCain’s calculated performance was hypocritical and largely self-serving, nor was it wrong to voice disappointment, even disgust, at the display. Pointed commentary, when offered fairly, is both necessary and constructive. Yet the viciousness of much of the Twitter backlash, in response to a vote which merely allowed a bill to proceed to debate, crossed far beyond righteous indignation.

“Would have been better off if he died in Nam. I have no reservations saying those words. Evil person, who just chose to kill thousands,” read a top response to one particularly popular tweet noting that “McCain left hospital stay paid by taxes on flight paid by taxes to remove health insurance from taxpayers.”

“Ted Kennedy fought cancer while trying to ensure healthcare for all. McCain fights through cancer to take healthcare from millions,” read another of the gentler, viral missives.

Kennedy, the Democratic senator who died in 2009 of the same brain cancer now threatening McCain’s life, considered comprehensive health care reform his life’s mission — a cause to which he remained dedicated to the end.

Those of the far-right, then — like those of the far-left now — were happy to use Kennedy’s mortality as a weapon against his political positions. At a rally against Obamacare in 2012, signs were printed to read: “Bury Obamacare With Kennedy.”

This brand of ugly, partisan warfare has become standard on Twitter, an arena where the in/out group dynamic punishes moderation and stifles same-side dissent. This serves to bolster the extremes which fuel the most savage polarization: it’s not enough to disagree — the other side must be despised, shamed and demonized, even if that means finding delight in another’s terminal cancer diagnosis.

Regardless of circumstance, those in positions of power are open to honest reproach. But this sort of conduct is abhorrent, full stop. Excusing or engaging in the very behaviour you’d never tolerate, were it directed at one of your own, directly contributes to the toxic and abusive atmosphere routinely bemoaned on Twitter.

Broader civility is cultivated through individual actions. Granted, there are times when emotion runs high and judgement falls short, and there’s plenty of room for both good-natured teasing and intense disagreement. It’s the routine, unchallenged maliciousness that’s destructive. Abuse is a choice. So is decency. Holding yourself and your allies to the higher standard will serve your cause better than dropping the calibre to meet the level of an adversary.

One of the few who gave McCain the benefit of the doubt after his procedural vote last Tuesday was Adam Jentleson, former deputy chief of staff to Harry Reid, the Democrats’ minority leader in the Senate.

“There are those rare moments when one person can alter the course of history,” he tweeted Tuesday. “If McCain is serious, he can vote for whatever amendments he likes but will vote against final passage. If (he) folds, he will end his career as a toady for Trump. But I will sleep well at night and never regret choosing to have at least a little bit of faith in an American hero.”

In the wee hours of last Friday, when it mattered, McCain cast one of three decisive Republican votes to defeat his party’s destructive health-care legislation. His credibility and legacy were always his own to lose. All the vitriol directed his way, in the end, undermined only the integrity of those from which it came. And ultimately — and ironically — that abuse helped McCain emerge as the maverick once again.