So, this is weird, on a purely linguistic level: Donald Trump, commenting on yesterday’s Senate testimony about the Brett Kavanaugh sexual assault allegations, allowed that Christine Blasey Ford, the accuser, was a “very credible witness”, and that Brett Kavanaugh was “incredible”. I know, words acquire nonliteral meanings. But still…
Archive for September, 2018
Senator Lindsey Graham has lamented the chaotic way that old accusations of sexual abuse are resurfacing to derail men’s careers.
“If this is enough – 35 years in the past, no specifics about location and time, no corroboration – God help the next batch of nominees that come forward,” he told reporters. “It’s going to be hard to recruit good people if you go down based on allegations that are old and unverified.”
I think we can all agree that the current haphazard approach to reporting, investigating, and punishing sexual violence from the distant past, with mores changing and memories fraying, is not ideal, not for the victims, not for justice.
Ultimately, I think what we need is a Sexual Truth and Reconciliation Commission (STaR Commission). As in post-Apartheid South Africa, the Commission would be empowered to offer amnesty to offenders in exchange for confession of all sexual offenses, and full and frank accounts of the facts from the period of the War on Women.
Of course, before we can have the Truth and Reconciliation, we need first to overthrow the old regime of gender-apartheid and hold free and fair gender-neutral elections. That will be some time yet. By that time, we can hope that computer technology will have progressed to the point that it will be possible to store and distribute the complete record of the crimes.
Obesity to eclipse smoking as biggest cause of cancer in UK women by 2043
That’s pretty sensational. I was intrigued, because the mortality effects of obesity have long intrigued me. It seems like I’ve been hearing claims for decades, loudly trumpeted in the press, that obesity is turning into a health crisis, with the mortality crisis just around the corner. It seems plausible, and yet every time I try to dig into one of these reports, to find out what the estimates are based on, I come up empty. Looking at the data naively, it seems that the shift from BMI 20 to BMI 25 — the threshold of official “overweight” designation — has been associated in the past with a reduction in all-cause mortality. Passing through overweight to “obesity” at BMI 30 raises mortality rates only very slightly. Major increases in mortality seem to be associated with BMI over 35 or 40, but even under current projections those levels remain rare in nearly all populations.
There is a chain of reasoning that goes from obesity to morbid symptoms like high blood pressure and diabetes, to mortality, but this is fairly indirect, and ignores the rapid improvement in treatments for these secondary symptoms, as well as the clear historical association between increasing childhood nutrition and improved longevity. Concerned experts often attribute the reduction in mortality at low levels of “overweight” to errors in study design — such as confusing weight loss due to illness with healthy low weight — which has indeed been a problem and negative health consequences attributable to weight-loss diets tend to be ignored. All in all, it has always seemed to be a murky question, leaving me genuinely puzzled by the quantitative certainty with which catastrophe is predicted. Clearly increasing obesity isn’t helping people’s health — the associated morbidity is a real thing, even if it isn’t shortening people’s lives much — but I’m perplexed by the quantitative claims about mortality.
So, I thought, if obesity is causing cancer, as much as tobacco is, that’s a pretty convincing piece of the mortality story. And then I followed up the citations, and the sand ran through my fingers. Here are some problems:
- Just to begin with, the convergence of cancers attributable to smoking with cancers attributable to obesity is almost entirely attributable to the reduction in smoking. “By 2043 smoking may have been reduced to the point that it is no longer the leading cause of cancer in women” seems like a less alarming possible headline. Here’s the plot from the CRUK report:
- The report entirely conflates the categories “overweight” and “obese”. The formula they cite refers to different levels of exposure, so it is likely they have separated them out in their calculations, but it is not made clear.
- The relative risk numbers seem to derive primarily from this paper. There we see a lot of other causes of cancer, such as occupation, alcohol consumption, and exposure to UV radiation, all of which are of similar magnitude to weight. Occupational exposure is about as significant for men as obesity, and more amenable to political control, but is ignored in this report. Again, the real story is that the number of cancers attributable to smoking may be expected to decline over the next quarter century, to something more like the number caused by multiple existing moderate causes.
- Breast cancer makes up a huge part of women’s cancer risk, hence a huge part of the additional risk attributed to overweight, hence presumably makes up the main explanation for why women’s additional risk due to overweight is so much higher than men’s. The study seems to estimate the additional breast cancer risk due to smoking at 0. This seems implausible. No papers are cited on breast cancer risk and smoking, possibly because of the focus on British statistics, but here is a very recent study finding a very substantial increase. And here is a meta-analysis.
- The two most common cancers attributable to obesity in women — cancer of the breast and uterus — are among the most survivable, with ten-year survival above 75%. (Survival rates here.) The next two on the list would be bowel and bladder cancer, with ten-year survival above 50%. The cancer caused by smoking, on the other hand, is primarily lung cancer, with ten-year survival around 7%, followed by oesophageal (13%), pancreatic (1%), bowel and bladder. Combining all of these different neoplasms into a risk of “cancer”, and then comparing the risk due to obesity with that due to smoking, is deeply misleading.
UPDATE: My letter to the editor appeared in The Guardian.
I was in high school when the Hitler diaries flashed across the media firmament, and I was fascinated by the eagerness with which so many responsible people accepted as plausible what were quickly unmasked as transparent frauds. An important selling point was the observation that the diaries never mentioned the extermination of the Jews, and I remember very specifically an article in Time magazine that teased the possibility that Hitler himself may not have known of the extent of the Holocaust, with speculation by historians that underlings may have acted on their own. I had an insight then about what would motivate people to seek out evidence that someone they “know” — even if knowing them only by their reputation as a famous monster — was innocent of an important crime. Just by learning about a historical figure we inevitably develop some psychological identification with him, he becomes one of our acquaintances, and then to mitigate the cognitive dissonance we are attracted to exculpatory evidence, even better if it is such as tends to diffuse responsibility rather than creating other specific monsters.
The writer Richard Marius once told me that after he had written his biography of Thomas More, where he had to come to some resolution on the purported crimes of Richard III, and decided that Richard was guilty of everything, he got harassed by people calling themselves Ricardians. They insisted that the criminals were Henry VII, or Edward Tyrell, or some anonymous unknowable others. Again, Richard III is a famous villain, but since he is famous, people identify him, and want to believe him not such a villain.
The French aphorism tout comprendre c’est tout pardonner goes deep. Bare familiarity is enough to create a motivation to pardon everything.
I see a connection to the way conservatives jumped at the theory that Christine Blasey Ford had indeed been sexually assaulted, but that she had mis-identified Brett Kavanaugh as the perpetrator. This doesn’t change anything about the number of evil people in the world, but it renders them anonymous. (Ed Whelan crossed a line when he went full Ricardian and accused a specific classmate of Kavanaugh’s. In principle, this serves all relevant purposes of the free-floating accusation, but by libelling a specific private citizen it created too many other complications and even, dare I suggest, moral qualms.) (more…)
There is an amazing interview in the newest Spiegel with the 99-year-old Traute Lafrenz, the only survivor of the Munich student anti-Nazi resistance group, the White Rose. She has been living in the US for 70 years, and has apparently never spoken publicly about her war experience. (The journalist simply showed up unannounced. When he phoned from the airport she informed him “Frau Lafrenz is no longer living. She died very suddenly.”)
I was struck by one exchange, about a teacher she had, in Hamburg, who was arrested by the Gestapo and threatened with execution for “premeditated corruption of youth”. She was commenting on her disappointment with a fellow student — who happened to be the later Chancellor Helmut Schmidt! — who declined to speak up for her.
Lafrenz: Ab 1935 veranstaltete sie heimliche Treffen mit uns. Während das Land im Gleichschritt marschierte, entartete Kunst und verbotene Bücher verbrannte, lud sie uns ein, genau diese Bücher mit ihr zu lesen. Tucholsky, Kafka, Erich Kästner. Das war, wie gegen das Böse geimpft zu werden.
SPIEGEL: Kulturelle Bildung hat Sie immun gemacht?
Lafrenz: Auch Adolf Hitler war Büchernarr. In seiner Privatbibliothek standen 16 000 Werke, er konnte Shakespeare oder Nietzsche verehren und trotzdem Millionen Menschen vergasen lassen… Vielleicht braucht man Empathie, damit Schönheit etwas in einem auslöst. Je mehr Bücher ich las, desto mehr machten sie Front in mir.
Lafrenz: From 1935 she held secret meetings with us. While the land was marching in lockstep, burnt forbidden books and deviant art, she invited us to read precisely these books. Tucholsky, Kafka, Erich Kästner. That was like being vaccinated against the evil.
SPIEGEL: Cultural education made you immune?
Lafrenz: Even Adolf Hitler loved books. There were 16000 works in his personal library. He could worship Shakespeare or Nietzsche, and still have millions of people gassed… Maybe you need empathy, before beauty can have an effect on you. The more books I read, the more they created a conflict for me.
It’s unusual to have an ambush that has been so comprehensively announced in advance. Fortunately, to help unravel it we happen to have a transcript of the top secret radio communications that preceded this ambush:
UK: Maybot here. We’re coming through the Chequers Pass.
EU: Don’t come this way. We have a big force, 27 strong, blocking the way. We can’t let you pass through here.
UK: No, we have to go through here. If we turn back our own rearguard will shoot us.
EU: We don’t want to attack you, but the Chequers Pass leads into dangerous territory. We can’t let anyone through.
UK: Maybot, approaching Chequers Pass.
EU: There are multiple other passes. Please take one of them.
Warning shots are fired.
UK: Ambush! Treachery!
When the onus is on some party in a negotiation, the point is to say which of several possible parties really needs to make a move. People have been pushing the onus back and forth in the Brexit negotiation:
But now Theresa May has announced at an EU summit that
the onus is now on all of us to get this deal done.
While I grant that her claim seems orthographically undeniable — onus = on us — I wonder what the prime minister could possibly be talking about. There literally are only two parties to the Brexit negotiation, the UK and the EU, so who else could the onus be on? Or is “us” her fellow heads of government in Salzburg, who have the responsibility to take the decision out of the hands of the bumbling bureaucrats of Brussels?
The name of the Republican Party derives ultimately from the Latin res publica, meaning “public matters”. Which suggests a posture diametrically opposed to that which Senate Republicans have taken to the Kavanaugh sexual assault accusation. It seems obvious that, from a public policy perspective, there are broadly three possible stances you could have toward these allegations: 1) They are facially incredible; 2) They are credible but irrelevant to his fitness to serve on the Supreme Court; 3) If true they may (or certainly do) disqualify him from the Supreme Court, so it is essential to take pains to ascertain their truth or falsity. (I suppose there is a fourth as well, the mirror of (1): We believe the accuser, so the nomination simply needs to be withdrawn.)
Republicans seem to have settled bizarrely on the first part of (3), but then veered off into personal pathos. The accuser, Christine Blasey Ford, has requested that an independent investigation determine some essential facts before her testimony, and that other witnesses be called. Republicans have rejected this, and seem generally to represent her testimony as a personal favour to her, to assuage her suffering.
We don’t know if she’s coming or not but this is her chance. This is her one chance. We hope she does.
Why is it “her chance”? Presumably it is the nation’s chance to avoid having an attempted rapist and perjurer on the Supreme Court. I understand that the disposition of a crucial witness is important, but surely that cannot affect the need to resolve the matter before an irrevocable decision is taken. Senator Bob Corker:
I just felt that it was important that if she had these types of serious allegations that she ought to have the opportunity to be heard. And I hope she is going to take advantage of that. If she doesn’t — that’s a whole other thing.
Majority Leader Mitch McConnell:
Dr. Ford has talked to the Washington Post, indicated she wants to talk to the committee, and we’re going to give her that opportunity on Monday.
Pseudo-centrist and sometime feminist Susan Collins is particularly concerned about Brett Kavanaugh’s feelings:
I think it’s not fair for Judge Kavanaugh for her not to come forward and testify.
The subtext is, if she doesn’t help us, we’ll just have to move ahead and confirm him. Which suggests that they really don’t think this is important, raising the question, why are they inviting her to testify at all? Surely the Senate Judiciary Committee is not the place for a public therapy session, particularly when the witness will be bringing great public opprobrium on herself, regardless of how the hearings turn out.
To adopt for a moment the president’s rhetorical style: