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'Heartbreaking': Medical standoff leaves man with cerebral palsy stranded at hospital for weeks

By Theresa Vargas
'Heartbreaking': Medical standoff leaves man with cerebral palsy stranded at hospital for weeks
Helena Talbot, Scott's mother, holds a photograph of him when he was 4 or 5 years old. MUST CREDIT: Katherine Frey, The Washington Post.

Alex Scott cannot speak.

If he could, he might be able to answer a crucial question that has pit the people who speak for him against one another and left him stranded in a Northern Virginia hospital for three weeks.

At issue: Does the 45-year-old with cerebral palsy need a feeding tube?

Scott's relatives say the group home where he has lived for two decades told them it would not take him back without a feeding tube. His family says the medical procedure is unnecessary and would benefit group home employees more than him.

The struggle over the feeding tube, advocacy groups say, illustrates what can happen to people with disabilities when caregivers disagree about what is best for them.

The family has filed a complaint with the U.S. Department of Justice and contacted the Office of Human Rights within Virginia's Department of Behavioral Health and Developmental Services.

In the meantime, Scott remains at Inova Loudoun Hospital, with his sister, Samantha Tunador, cataloguing each day on social media with the hashtag #takeAlexhome.

"Day 11," Tunador wrote on Facebook on April 10. "I promise you Alex, we are doing everything we can to get you out of the hospital and back to your home."

"End of Day 12, and no confirmation that Alex is going home. This just sucks."

"Day 20," she says in a video that has been viewed 1,800 times. "We really are not much further."

As of Friday, Scott had spent 23 days in the hospital. He arrived at the end of March with a slight fever and possible bronchitis and was supposed to be discharged a few days later, his family said.

Margaret Graham, director of the Loudoun County Department of Mental Health, Substance Abuse and Developmental Services, which oversees the group home, said her agency has been in contact with Scott's family but, because of privacy concerns, could not discuss the matter publicly.

"We can tell you that as in any situation, [the agency's] group home providers are committed to promoting health and wellbeing through the provision of individualized supports," Graham wrote in a statement. When a person is hospitalized, the staff works together to come up with a discharge plan, and, in that planning, "must ensure that an individual's required support and medical assessment can be safely met in a group home setting. "

Tunador said the family fears that if Scott is unable to return to the group home, the hospital will find a nursing home for him that will offer less social stimulation and may be farther from his relatives in Loudoun.

"People keep saying to me, 'Why do you want him to go back to this group home, where the problem is?'" Tunador said. "That's his home. That's what he knows. It's where his friend are. It's where he's happy. And the unknown is scarier."

While Scott cannot speak, Tunador said he has been clear about what he wants - to leave the hospital. A video of Scott shows him in bed, shaking his head and screaming. Tunador posted it on Facebook and wrote alongside it that he wanted the nurses to remove his IVs so he could go home: "He has lived in a Loudoun County group home for 20+ years. He has not changed and his level of care is the same. They have changed and it is not fair!"

Tunador said she was worried that by sharing her brother's story, along with videos of him, she would face criticism for exposing him. But the response, she said, has been overwhelmingly positive, with thousands of people rallying behind Scott and sharing their own stories of aging parents and loved ones with disabilities.

"Underneath all of this is the same principle of how do we make decisions for and on behalf of people?" said Tina Campanella, the executive director of the D.C.-based nonprofit Quality Trust for Individuals with Disabilities.

In Scott's case, she said, a feeding tube can help if he is at risk of aspiration, but, at the same time, he would no longer be able to taste food.

"If eating is clearly a pleasurable experience for him" Campanella said, that should be taken into account in the decision-making process. "Conversely, if he didn't care, and he was in distress during the eating process, that might be a piece of evidence that a feeding tube could add quality to his life."

Tunador said her brother eats in a way that might be jarring to someone observing him the first time. He holds his head back and makes a gurgling sound. It can also take him 30 minutes to finish a meal. But he has eaten that way his entire life, she said, and he loves food, especially anything soft and chocolate flavored.

His teacher from high school Susan Walker recently visited him after learning about his situation through Facebook. He looked the same, she said. He weighs less than 100 pounds, but he was always thin.

"Other than the gray hair he's starting to get, it's the same old Alex," Walker said. "I think it's heartbreaking that they won't take him back."

Scott's father, Robert Scott, said his son was one of the early residents of the group home and that in his two decades there he has formed "wonderful relationships." But in the last few years, the family had begun to notice changes in his care, including questionable hospitalizations and "made-up problems like malnutrition and worsening of swallowing." When the family started collecting medical records, they also found reports they hadn't seen, including one that read, "Family in denial."

"Our family position is that we have always welcomed any surgical procedure that solves a serious problem like eating or bloating or fecal waste management," Scott wrote in a letter outlining his son's situation, which he sent to county officials. "But the experts have ultimately advised against surgery. It is our opinion that Alex has changed little in his lifetime. So much is difficult today just as it was when he was a child. But he is a happy and mostly healthy guy."

Curt Decker, executive director of the National Disability Rights Network, said Scott's civil rights are at stake.

"What might seem like,'We'll just give him a feeding tube, what's the big deal?" he said, opens the way to more interventions. "What's next that they will come up with?"

All too often caregivers are willing to prioritize the ease of a person's care over that person's quality of life, Decker said. He pointed to the "Ashley Treatment," which was coined for a girl born in 1997 in Seattle who, at her parents' bidding, received hormones to limit her growth, underwent a hysterectomy and had her breast buds removed.

Robert Scott shared parts of his son's medical records with The Washington Post. In a report from last April, a doctor wrote that Alex Scott was accompanied by his caregivers, mother and sister for an evaluation for a possible feeding tube placement.

"His caregivers are most concerned about the episodes of abdominal distention and possible decrease in by mouth intake," the report reads. "His mother and sister believe that the abdominal distention is no different than his baseline, report he is not losing weight and believes his by mouth intake is at baseline."

The doctor found that he was "well-developed, well nourished, in no acute distress."

She wrote: "I cannot strongly recommend a feeding tube at this time, and though everyone clearly has Mr. Scott's best interests in mind there is disagreement between his mother and caregivers."

On day 22, Tunador did not post an update about her brother. Instead, she linked to pictures of dish towels bearing slogans about the pleasures of eating.

"Food tastes better when you eat it with your family," read one.

"Eat more of what makes you happy," read another.

As scientists erupt in protest against anti-science voices, a volcanologist runs for Congress

By Sarah Kaplan
As scientists erupt in protest against anti-science voices, a volcanologist runs for Congress
Phoenix holds her campaign sign a day before announcing her run for Congress. MUST CREDIT: Washington Post photo by Alice Li

LOS ANGELES - Volcano scientist Jess Phoenix is in her element in the otherworldly landscape of Vasquez Rocks. She points out the way the rock formations jut at a steep angle toward the sky - evidence of the earthquakes that have rocked California - and the texture of the burnt orange sandstone, which was laid down during a long-ago flood.

"There's hundreds of thousands of years of history here," she says, recalling the lessons she was taught when she visited this site as a geology student more than a decade ago. "You learn to look at the evidence and figure out what happened."

Vasquez Rocks still ranks among her favorite places in California's 25th Congressional District, a diverse region north of L.A. that encompasses wealthy suburbs and farming towns. Soon Phoenix will return here to do something she never imagined as a student: declare that she's running for Congress.

For now, she surveys the site, searching for an appropriate spot from which to make her announcement, and considers what's she's about to give up: trips to volcanoes in Iceland and Hawaii; work with her nonprofit, Blueprint Earth, which brings minority college students to the Mohave to study desert ecosystems; time with her husband, with her horses, by herself.

But then she thinks about her district, which has seen droughts, wildfires and a natural gas leak in recent years. Phoenix feels that its current representative, Republican Steve Knight, has mishandled environmental problems and disregarded the science needed to address them. Meanwhile, the Trump administration has moved to roll back environmental regulations and cut funding for research.

"The whole thing is really hard to just sit there and watch," Phoenix says. "That's why I'm like, okay, it's time to get to work. Because if not scientists, if not people who really understand what's at stake, then who is going to step up?"

She's not the only scientist asking that question. Researchers have traditionally shied away from politics, worried that the appearance of partisanship could taint the objectivity of their work. But lately, alarmed by an election cycle that popularized the terms "fake news" and "alternative facts," galvanized by an administration that casts doubt on the scientific consensus on climate change and vaccines and has proposed to cut billions of dollars of federal funding for research, and inspired by the groundswell of activism that's emerged in recent months, scientists are leaving their labs and jumping into the political fray.

Rallies have been added to the schedules of major scientific conferences. Groups of researchers have collaborated to preserve government climate data that they fear might be deleted. Several scientists, including Berkeley evolutionary biologist Michael Eisen, are among the hundreds of people with nontraditional backgrounds who have announced they're running in elections that won't be held for another 18 months. Sterling Clifford, a veteran democratic consultant working on Phoenix's campaign, said he's never seen this much interest in congressional races this early.

And on Saturday, a predicted 75,000 people will flood Washington for a March for Science; hundreds of thousands more have said they'll attend one of 500 satellite demonstrations around the world. Phoenix is scheduled to speak at the rally in L.A.

"I've never seen anything like it," said physicist Rush Holt, chief executive of the American Association for the Advancement of Science and a former Democratic representative from New Jersey. Holt said he used to get one or two inquiries a year from fellow scientists interested in entering politics. But in the past five months, more than a dozen people have reached out. "I want to do something," they all tell him.

"There's a widespread and deep concern that there is an eroding appreciation of science. That didn't start in November," Holt said, "but now it's reached a crescendo."

This same concern drove the political action committee 314 Action to launch a new initiative to get scientists to run for office. The group is named for the first three digits of pi (3.14159. . .) and bills itself as an "Emily's List" for people with backgrounds in STEM. The goal is to connect researchers with consultants and donors so they have a better shot of getting elected.

"Politicians have shown us that they are unashamed to meddle in science," 314 Action founder Shaughnessy Naughton said. "I think the way to combat that is to get a seat at the table."

In January, 314 Action put a form for interested candidates on their website, expecting a few dozen people might fill it out. Instead they heard from more than 4,000. One of them was Phoenix.

Phoenix could be a character out of a comic book: a red-haired volcanologist whose last name is a mythological bird born in fire. She wears her hair long and shaved on the sides, and for special occasions - like a dinner of the Explorers Club, of which she is a member - she fashions it into a mohawk. Her wardrobe consists largely of jeans and science-themed T-shirts. "They're just going to get dirty," she says with a geologist's practicality.

Phoenix isn't the stereotypical introvert scientist. Her research has taken her to volcanoes in the depths of the Pacific and the heights of the Andes. She has worked in coal mines in Australia - the only woman among dozens of men. In her spare time, she rescues and retrains former racehorses. She's given a TED Talk and appeared on TV. The week before declaring her candidacy, Phoenix was on a boat in Hawaii filming a volcano-themed special for the Discovery Channel's "Shark Week."

And unlike many of her colleagues, Phoenix entertained notions of running for office before Nov. 9. Both her parents were FBI agents, and she majored in government in college. The impulse to run strengthened during crises in her community, like when natural gas began leaking from the Aliso Canyon storage facility in 2015, triggering health problems and prompting the evacuation of several thousand residents of the district. Knight didn't respond quickly enough, Phoenix says, and she's disturbed that regulators are considering allowing the facility to reopen when they still don't know what went wrong. Another leak was discovered at the site during an inspection last month.

A representative for Knight rejected the charge that he mishandled the disaster, pointing out that Knight wrote a bill establishing federal safety standards for gas storage facilities in the wake of the incident.

Phoenix already had a career that she loved. There were field trips for Blueprint Earth to plan, new volcanoes to explore. Any thoughts of jumping into politics were set aside for "someday."

But then Donald Trump was elected president. Two months later, Phoenix turned 35, the age at which a person can legally hold any office in the land. "There was no more waiting for someday," she said. "I realized there is no better time than now."

Phoenix started attending city council meetings and reaching out to activist groups. A few weeks after she filled out the 314 Action form, she got a call from Erik Polyak, the group's director of campaigns. The group is interested in trying to unseat three Republican members of the House Science Committee it considers "anti-science," including Knight, committee chair Lamar Smith, Texas, and Dana Rohrbacher, Calif. Knight has called California's actions to mitigate climate change "rash" and has a zero percent rating from the League of Conservation Voters.

In response to a request for comment, Knight's representative said that he welcomed Phoenix to the race and was confident that his views match those of his constituents.

Naughton called Knight's stances "incredibly problematic."

"He has a record of not using the scientific consensus to influence policy," she said.

It's a common refrain in the scientific community. Asked what they hope for as a result of their recent activism, most researchers will respond, "evidence-based policymaking." As a catchphrase, it doesn't exactly roll off the tongue. But evidence is the foundation of all science, and the leaders of 314 Action think they can make the idea appeal to voters as well.

Which is why they were excited to hear from Phoenix. Though the California 25th has been held by a Republican since 1993, Hillary Clinton won the district by seven points last November. The 25th was considered one of the most competitive congressional districts in the country in 2016, and it's exactly the type of seat Democrats need to win if they want to take back the House in two years. Naughton and Polyak want to flip it.

Did Phoenix think she was ready for that, Polyak asked at their first meeting.

"Well, yeah," she recalls answering. "Go big or go home."

Phoenix is not the only Democrat with the same idea. One candidate has already declared her intention to challenge Knight for the seat, and Bryan Caforio, who lost to Knight in November, is considering another run.

When asked whether she's nervous about the possibility of a crowded primary and a long and bruising campaign, Phoenix brushes it off.

"I walk into active volcanic eruptions," she says. "Congress? Come on."

During a tour of the district the Saturday before her announcement, Phoenix offers a scientist's perspective on nearly every issue facing her region. On L.A.'s smog problem: "That's why you need regulations." On drilling and mining in the district: "I think it's possible to balance the way we deal with natural resources." She says there's a need to draw the movie industry back to the area: "'Star Trek' was filmed here, did you know?"

But then the conversation veers toward the less exciting aspects of a political campaign: hiring consultants, fundraising, learning to ease off the bad geology puns ("tough schist"). She mentions that friends keep asking her if she'll have to grow her hair out. Briefly, her bravado falters.

"I'm me. I'm not a politician," Phoenix says. "I know when I call people to ask for donations I'm going to have to say the same thing over and over again. I get it. And that's fine. . . . I will take a certain amount of polish because you need it. You need it to be professional. But it also is nice to be like, 'Yeah, I'm a person.' "

She pushes her hand into her hair and shakes her head. "I'm sure it's going to be worth it, but it's going to be intense."

The day of the announcement dawns cloudy and cool. Phoenix sends her husband, Carlos, ahead of her to Vasquez Rocks, so she can drive out alone. Along the way, she says later, she practices giving her speech to the empty car: "Hi, I'm Jess Phoenix, I'm a scientist who studies volcanoes . . . "

By the time Phoenix arrives at the rocks, a small group of friends and a few local reporters are waiting for her. The wind has picked up, and Carlos is attempting to keep her sign from blowing away by tying it to a boulder.

"This is science, this is how we solve problems," she jokes.

A friend shows up astride an impressive brown mustang, and Phoenix immediately walks over to say hello. The friend asks Phoenix if she wants to ride.

"I guess I have to ask the campaign staff," she says. "I have to ask people to do things now."

She doesn't ride the horse.

Phoenix's speech is short and earnest. She hits all her main points. The weights that Carlos jury-rigged for her sign hold steady.

Once it's over, the reporters pack up their equipment. The friends congratulate Phoenix, then scatter. Under any other circumstances, she might go for a walk among the towers of rock and sweet-smelling creosote bushes.

But Polyak reminds Phoenix she has meetings to attend, fundraising calls to make. She's officially a candidate now.

---

Video: Jess Phoenix, a volcanologist running for local office in California, is part of a growing movement of scientists turned politicians hoping to combat the Trump administration. (Alice Li/The Washington Post)

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The Swedish six-hour workday could help you live longer

By Thomas Heath
The Swedish six-hour workday could help you live longer
Workers make their way to the Farragut North Metro station in Washington during the evening rush hour on April 20, 2017. MUST CREDIT: Washington Post photo by Robert Miller.

WASHINGTON - Forget diets, fitness centers and employee wellness programs. U.S. companies may find shorter workdays are the route to reducing health-care costs.

That's one suggestion from a controversial experiment in Scandinavia - the cradle of worker-friendly capitalism - that's gaining wide notice for questioning Sweden's eight-hour workday.

Work-life balance has become an international issue. French Conservative presidential candidate Francois Fillon wants to end that nation's 35-hour workweek and return to 39 hours.

"Given the attention in international media this small pilot project in Gothenburg has received, it is clear that it's an issue that attracts broad interest," said Gothenburg deputy mayor Daniel Bernmar, who helped promote the study.

A 23-month study at an elderly care facility in Gothenburg, Sweden's second-largest city, found that nurses - considered a high-stress profession - were happier, healthier and more energetic when working six-hour days instead of eight hours.

The purpose of the trial was not to measure worker health.

Its primary goal was to gauge the effects that a reduced work day had on the productivity of 68 full-time nurses and on the care they provided to their 72 patients. The nurses received their full pay during the trial - it was not cut because of the reduced hours.

The $1.3 million trial, conducted from February 2015 to December 2016, was also designed to illuminate the effects a shorter workday (and 30-hour week) had on employee quality of life and local employment.

"There was also a feminist agenda," Bernmar said of the study, which included only women. "A six-hour workday will increase the ability of women to achieve economic independence. A shorter workday means that female part-timers will be translated into full-time jobs."

The nurses working six hours took 4.7 percent fewer sick days and fewer work absences than when they worked eight-hour days. A comparative group of nurses working eight hour days actually increased the number of sick days during the trial by more than 60 percent.

Maria Ryden, a Conservative Party member of the city council and a former registered nurse, said the study was flawed.

"Who wouldn't work better if you only had to work six hours?" Ryden said. "But somebody still has to pay for it. It's crazy and irresponsible."

Ryden said the study was politically motivated by the Left Party as a way to reduce the length of the workweek.

"The results should have been so much better as a result of so much money and all this effort," Ryden said. "I would have expected much better results than a 4.7 percent improvement in sick leave."

One important takeaway that both sides may agree on suggests that there are health savings to be mined if employees' work hours are reduced.

Perhaps not surprisingly, the number of nurses who had energy when they left work after six hours increased from 1 in 5 to more than half compared to when they worked eight hours.

Having the energy to spend the rest of your day productively may have also led to a 24 percent improvement in the level of physical activity.

"Less tiredness and more physical activities is the major improvement," said Bengt Lorentzon, one researcher on the study.

Being tired at the end of the day means "not being able to do anything and just sitting on the couch and looking at the television."

The study reached other conclusions as well: the six-hour nurses overall were more active, less sick, less stressed and had less back, neck and shoulder pain than nurses working eight-hour shifts.

Lorentzon and other experts said the 23-month experiment was not long enough to prove that reduced hours can save on health costs.

Eduardo Sanchez, chief medical officer for prevention at the American Heart Association, said his examination of a summary of the Swedish study points toward a six-hour day being beneficial to one's health, "but I wouldn't go so far to say that's absolutely the case."

Sanchez said if the study had been longer than 23 months, "it might have concluded that, actually, the six-hour workday doesn't cost more because the cost of more employees would be offset by the lower cost of less sick says and a more productive workforce that doesn't utilize medical care as much."

"They might have extended the study a little bit to understand the effect," Sanchez said. "Did they look at all the factors that might have better answered the question of, 'Is this a good thing? Is this a neutral thing? Or is this not so good a thing?' "

A 2014 study of 10,000 employees of the Baptist Health South Florida system concluded that good cardiovascular health translated into annual health-costs savings of $4,000 to $6,000 for healthy hearts compared to employees with higher risk profiles.

In Gothenburg, "we found workers were more efficient in six-hour days than eight-hour days," Lorentzon said. With fewer hours, the nurses better managed their duties, including spending more time with the residents.

"They would go the extra mile for the inhabitants," Lorentzon said. "They had more time to sit down and listen, read a book, look at a newspaper with them, play a game or comfort some of the inhabitants not feeling so good."

In the United States, nearly all health-care facilities use a 12-hour shift schedule for nurses, which often ends up being 13 hours.

"We don't really know what the effect of a six-hour work schedule for U.S. nurses would be because it has not been studied here," said Jeanne Geiger Brown, an expert on nurse work schedules and dean of Stevenson University in Baltimore. "It's possible that patient care would improve because nurses would be less fatigued and more satisfied with their jobs. On the other hand, it would increase the number of handoffs in patient care, and each patient would have to adjust to four nurses a day rather than two."

Annie Perrin, a partner at Leaders' Quest, a nonprofit leadership development organization, said improving the work lives of nurses could reduce burnout, keep good nurses on staff longer and improve the experience of patients with better care and compassion.

"It may be in the short term more expensive around certain metrics," Perrin said. "Over the long haul, they might get a really good return."

"Retraining new nurses is very expensive," Perrin said. "The other metric in health care is the direct relationship between staff and customer experience. The two things that tend to differentiate health institutions in attracting top talent is geography and the staff experience. If a hospital wants to be more competitive in attracting talent, one of the key ways to do that is to have a really great work environment and employee experience."

Gothenburg spent $1.3 million on the study, which paid for hiring 15 more nurses to make up for hours that the full-timers lost to the shortened workday. The study ended when the funding ran out.

The city's experiment is unlikely to end the heated political discussion over wages, employment and work-life balance in Sweden and elsewhere.

"Of course the study is controversial," Bernmar said. "The opponents want us to work more not less and only focus on short-term economics. This trial has showed the opposite, that working less can be a key factor to a more sustainable working life."

Pulitzer-winning opinion from the most respected voices in the world.

Trump’s critics are playing into his hand

By michael gerson
Trump’s critics are playing into his hand

EDITORS: Note nature of quoted material at the end of the 7th graf.

WASHINGTON -- For those of us convinced that Donald Trump’s defects of character, lack of knowledge, encouragement of social division and disregard for democratic norms outweigh any good he may do -- the rough definition of being #NeverTrump -- these are confusing and challenging times.

Trump’s solid basis of support is relatively homogeneous. It is fed up with foreigners, with foreign entanglements and with the political class as a whole. Its worst temptation is dehumanization -- reducing migrants, refugees and Muslims to threatening types.

Trump opponents, in contrast, could hardly be more ideologically diverse -- from conservatives (like me), to libertarians, to the hardest of the hard left. We have little in common but a hashtag. And our worst temptation is also dehumanization -- turning Trump supporters into threatening types. It is a habit of mind that may help consolidate Trump’s control of the GOP and thus his prospects for re-election.

Apropos is a recent, excellent article by Caitlin Flanagan in The Atlantic, arguing that the tone and approach of liberal, late-night television are invading and discrediting a serious Trump critique. The typical monologue, as Flanagan describes, is an “excoriating, profanity-strewn, ad hominem tirade against the president (and by extension against anyone who might agree, in any small measure, with his actions).”

Flanagan recounts how late-night personality Samantha Bee set up and ridiculed a young Trump supporter (for which Bee later apologized). “Trump and Bee,” Flanagan argues, “are on different sides politically, but culturally they are drinking from the same cup, one filled with the poisonous nectar of reality TV and its baseless values. ... Trump and Bee share a penchant for verbal cruelty and a willingness to mock the defenseless.”

It is far more consequential, of course, when Trump does the mocking. But Flanagan is correct that the attitude of late-night television gets mixed up in the public mind with the mainstream media and appears to many as a monolith of cruel, establishment bias.

On the whole, people can better tolerate being shouted at than being sneered at. And the sneer of the knowledge class was clearly a motivating factor for many Trump voters. They felt condescension from the commanding heights of the culture and set out to storm its highest point. The pose of late-night television -- duplicated by many on the left -- is a continuing provocation. It is the general, obnoxious attitude in which it is somehow permissible for the Democratic National Committee to hawk a T-shirt on its website saying, “Democrats give a sh*t about people.”

This leads to a second, divisive and counterproductive tendency among anti-Trump forces. For many on the left, the energy of opposition to the president is only useful to drive an existing agenda -- and to drive the Democratic Party leftward. When women marched on the day after Trump’s inauguration, their platform included “open access to safe, legal, affordable abortion” -- as though this was the natural position for all who have deep concerns about the president. Some talk of growing discontent as a “left-wing tea party” -- as though this were finally the chance for MoveOn.org and the Occupy movement to complete their October Revolution in the Democratic Party.

Warns former Barack Obama official Michael Wear: “The Democratic Party should view Donald Trump’s takeover of the GOP as an opportunity to build a lasting majority. Instead, they view Trump as offering license to move further to the left on policy and still win.”

Consider where trends might take us. At the presidential level, there is currently no center-right party in America. With the ascendency of its Elizabeth Warren-Bernie Sanders wing, there would be no center-left party in America. The ideological and cultural sorting of the two parties would be complete, and nearly every issue would become a culture war battle.

It is safe to say that many recent presidents have been saved by the radicalism, overreach and foolishness of their opposition. Some on the right went a bridge too far in impeaching Bill Clinton and discredited themselves with conspiratorial accusations about the death of Vince Foster. Some on the left were off-puttingly feverish in their presentation of George W. Bush as an election-stealing cowboy who may have been complicit in the 9/11 attacks. Some on the right used overheated rhetoric against Obama’s supposed socialism and obsessed on his birth certificate.

A substantive, centrist response to Trump has a chance of releasing his hold on the GOP and the country. A sneering, dismissive, dehumanizing, conspiratorial, hard left leaning response to Trump is his fondest hope.

Michael Gerson’s email address is michaelgerson@washpost.com.

(c) 2017, Washington Post Writers Group

On North Korea: Bluster in search of strategy

By fareed zakaria
On North Korea: Bluster in search of strategy

NEW YORK -- Every American administration takes a while to settle into a basic approach to the world. President Trump’s team has had a rockier start than most, with many important positions in every key agency still unfilled. More worrying, the administration’s basic foreign policy is coming into view and it is not a reassuring sight -- bellicose rhetoric, hollow threats, contradictory voices and little coordination with allies. The approach is being tested on the most difficult foreign policy problem of all: North Korea.

There is a pattern to Trump’s approach so far. It begins with bravado, the repeated use of rhetoric that is not backed up by much. The president constantly insists that if China doesn’t help deal with North Korea, America will. Really? How? A military strike is close to impossible. South Korea would vehemently oppose any such move, as it would face the brunt of North Korea’s retaliation; Seoul is only about 35 miles from the border. Japan would also oppose a strike, and, of course, any military action would enrage China. Plus, a bombing campaign would be ineffective since North Korea’s nuclear sites are scattered, buried deep and, in some cases, underwater.

Trump has not been alone in his bravado. Secretary of State Rex Tillerson announced that America’s historical policy of “strategic patience” with North Korea had ended, and that the United States now had a new policy. The danger of this kind of rhetoric is that it is becoming readily apparent that Washington does not in fact have a new policy. And if it does, Washington’s key allies, especially the South Koreans, are terrified by it. Between the administration’s bluster, its mistake with the USS Carl Vinson, and Trump’s repetition of Beijing’s line that Korea was once a part of China, South Korea has become deeply uneasy.

Tough talk is supplemented by aggressive military reflexes. Whether that means using bigger bombs in the Middle East or sending ships -- eventually -- into East Asian waters, these tactics can be useful if there is a strategy behind them. So far, however, they look more like tactics in search of a strategy, the flexing of military might in the hope that this will impress the adversary. But all the shock and awe in Iraq did not help when there was a faulty plan to secure the peace. More bombs in Syria will not answer the question of how to defeat the Islamic State without abetting President Bashar Assad. Threatening North Korea without the ability to carry out that threat only makes Washington look weak.

The United States has had roughly the same strategy toward North Korea for decades. It is a policy of sanctions, threats, intimidation, pressure and isolation. And it has not worked. Even the brief effort at cooperation during the Clinton years was half-hearted, with Washington failing to fulfill some of its promises to North Korea. In any event, the rapprochement was quickly reversed by the George W. Bush administration. The results have been clear. North Korea has continued to build its nuclear program and engage in provocative tests. As isolation and sanctions have increased in recent years, Pyongyang has only become more confrontational.

In a recent essay in Foreign Affairs, John Delury wonders if it is time to try another approach. “If the United States really hopes to achieve peace on the Korean Peninsula, it should stop looking for ways to stifle North Korea’s economy and undermine Kim Jong Un’s regime and start finding ways to make Pyongyang feel more secure. This might sound counterintuitive, given North Korea’s nuclear ambitions and human rights record. But consider this: North Korea will start focusing on its prosperity instead of its self-preservation only once it no longer has to worry about its own destruction. And North Korea will consider surrendering its nuclear deterrent only once it feels secure and prosperous and is economically integrated into Northeast Asia.”

We tend to view North Korea as an utterly weird country run by a loony dictator with bad hair. And there’s evidence to support this characterization. But it is also a regime that wants to survive. I recall many similar arguments made about Iran before the nuclear deal, that it was a fanatical country run by mad mullahs. We were told they could never be negotiated with, would never accept a deal, would never disconnect their centrifuges, and would violate any agreement within weeks. So far, all these predictions have proved wrong. It might be worth trying a new policy with North Korea. It might not work. But the old one certainly hasn’t.

Fareed Zakaria’s email address is comments@fareedzakaria.com.

(c) 2017, Washington Post Writers Group

A fraternity was told it was ‘appropriating culture.’ Administrators won’t say which.

By catherine rampell
A fraternity was told it was ‘appropriating culture.’ Administrators won’t say which.

Don’t blame college students for their hostility to free expression. The fault ultimately lies with cowardly school administrations, who so often cave to student demands for censorship. Or as some now prefer to call it, “empowering a culture of controversy prevention.”

Those are the actual, Orwellian words of an official at American University.

Several weeks ago, a fraternity at AU, Sigma Alpha Mu, began planning a fundraiser for a veterans’ organization. Student groups often center fundraisers on athletic tournaments, fraternity president and sophomore Rocco Cimino told me, but all the popular sports had already been claimed. The fraternity members decided to go with ... badminton.

To jazz things up, they called their event “Bad(minton) and Boujee.” It’s a pun on “Bad and Boujee,” a popular rap song by the group Migos about being newly rich and hanging with materialistic women. Sigma Alpha Mu registered the fundraiser on American’s online scheduling system, required for all campus events.

A few days later Cimino got a strange email from the school.

Colin Gerker, assistant director of fraternity and sorority life, said the word “boujee” might be criticized for “appropriating culture.” He would not approve the event unless the fraternity changed the name.

“I want to continue empowering a culture of controversy prevention among [Greek] groups,” Gerker wrote. He advised them to “stay away from gender, culture, or sexuality for thematic titles.”

The students were perplexed.

A brief etymology, for those not familiar with “boujee”: The word originates with the Latin for castle or fortified town, “burgus.” This evolved into the French “bourgeois,” for people who live in town rather than the countryside. Town dwellers were more likely to engage in commerce and craftsmanship, and so rose over time to achieve middle-class incomes. That’s why Karl Marx later used the term to derisively refer to the class that upheld capitalism. Over time, “bourgeois” morphed into a more generic description of middle-class (and eventually upper-middle-class) materialism and obsession with respectability.

More recently, “bourgeois” was shortened to the colloquial “bourgie ,” alternately spelled “bougie” or “boujee,” used disdainfully to describe upper-middle-class or high-end tastes (driving your Prius to Trader Joe’s after yoga class, for example). The “boujee” variation is common when referring to middle-class or upwardly mobile blacks, as in the Migos song. That’s hardly this spelling’s exclusive usage, though, as is evident from its entries in the crowd-sourced slang glossary Urban Dictionary.

So, in a way, “boujee” is indeed an appropriation -- or rather an appropriation of an appropriation of an appropriation. That’s how language works. It’s fluid, evolving, constantly taking from other tongues, dialects and usages.

When the fraternity was accused of “appropriating culture,” the obvious question was: Which culture? Latin? French? Marxist? Urban hip-hop? Maybe their own? After all, if you’re wondering who best epitomizes today’s upper-middle class, bear in mind that these are college kids whose parents pay extra money on top of tuition to throw parties.

Figuring the administration misunderstood what “boujee” meant, Cimino challenged the school’s ultimatum. He explained the term, and added that this was just a regular sports tournament with a punny name. Otherwise it had nothing to do with the content of a rap song, in case that was the concern.

But Gerker ceded no ground, reiterating that the fraternity was “appropriating culture,” and added that in the interim he had received “multiple complaints” about the event title.

“I am awaiting a response from some folks on how they want to move forward with their complaints,” he wrote.

Still puzzled, the fraternity asked whether they could see the complaints lodged against them, but they never heard back. With time running short, they canceled the event and posted a GoFundMe page instead.

I reached out to the school to ask for clarification.

A spokeswoman sent a statement about how the “sequence of events did not go according to our normal process for working with student organizations.” She said the administration should not have prohibited the fundraiser and that it usually focuses on “coaching” students about how to proceed when an event “could have a negative impact and unintended consequences on campus.” But I never got an answer to what was so objectionable about the event title in the first place.

Neither did the students. In a meeting Thursday, another administrator apologized to Cimino for not following protocol and pledged to help promote a future event for the veterans’ group. Still no explanation, though, of the “cultural appropriation” accusations beyond something like “we thought it could be controversial.”

Schools were once charged with educating, challenging and setting an example for their wards. Today’s pupils must settle for controversy-prevention empowerment instead.

Catherine Rampell’s email address is crampell@washpost.com. Follow her on Twitter, @crampell.

(c) 2017, Washington Post Writers Group

Can this young prince refashion Saudi Arabia?

By david ignatius
Can this young prince refashion Saudi Arabia?

RIYADH, Saudi Arabia -- Two years into his campaign as change agent in this conservative oil kingdom, Deputy Crown Prince Mohammed bin Salman appears to be gaining confidence and political clout to push his agenda of economic and social reform.

The young prince outlined his plans in a nearly 90-minute conversation Tuesday night at his office here. Aides said it was his first lengthy on-the-record interview in months. He offered detailed explanations about foreign policy, plans to privatize oil giant Saudi Aramco, strategy for investment in domestic industry, and liberalization of the entertainment sector despite opposition from some religious conservatives.

Mohammed bin Salman explained that the crucial requirement for reform is public willingness to change a traditional society. “The most concerning thing is if the Saudi people are not convinced. If the Saudi people are convinced, the sky is the limit,” he said, speaking through an interpreter.

Change seems increasingly desired in this young, restless country. A recent Saudi poll found that 85 percent of the public, if forced to choose, would support the government rather than religious authorities on policy matters, said Abdullah al-Hokail, the head of the government’s public opinion center. He added that 77 percent of those surveyed supported the government’s “Vision 2030” reform plan, and 82 percent favored music performances at public gatherings attended by men and women.

“MBS,” as the deputy crown prince is known, said he is “very optimistic” about President Trump. He described Trump as “a president who will bring America back to the right track” after Barack Obama, whom Saudi officials mistrusted. “Trump has not yet completed 100 days and he has restored all the alliances of the U.S. with its conventional allies.”

There’s less apparent political tension than a year ago, when many analysts saw a rivalry between Mohammed bin Salman and Crown Prince Mohammed bin Nayef, who is officially next in line for the throne but less prominent than his cousin. Whatever the succession proves to be, the deputy crown prince appears to be firmly in control of Saudi military strategy, foreign policy and economic planning.

The biggest economic change is the plan to privatize about 5 percent of Saudi Aramco, which MBS said will take place next year. This public offering would probably raise hundreds of billions of dollars and be the largest such sale in financial history. The exact size of the offering will depend on financial-market demand and the availability of good options for investing the proceeds, he told me. The rationale for selling a share of the kingdom’s oil treasure is to raise money to diversify the economy away from reliance on energy.

The entertainment industry is a proxy for the larger puzzle of how to unlock the Saudi economy. Changes have begun. A Japanese orchestra that included women performed onstage here this month, before a mixed audience of men and women. A “Comic Con” convention took place in Jeddah recently with young men and women dressing up as characters from “Supernatural” and other favorites. Comedy clubs feature sketch comedians (but no female stand-up comics, yet).

“We want to change the culture,” says Ahmed al-Khatib, a former investment banker who’s chairman of the entertainment authority. His target is to create six public entertainment options every weekend for Saudis. But the larger goal, he said, is “spreading happiness” in what has sometimes been a somber country.

The instigator of this attempt to reimagine the kingdom is the 31-year-old deputy crown prince. With his brash demeanor, he’s the opposite of the traditional Bedouin reserve of past Saudi leaders. Unlike so many Saudi princes, he wasn’t educated in the West, which may have preserved the raw, combative energy that is part of his appeal for young Saudis.

Mohammed bin Salman is careful when he talks about religious issues. So far, he has treated the religious authorities as allies against radicalism rather than cultural adversaries. He argues that the kingdom’s extreme religious conservatism is a relatively recent phenomenon in Saudi Arabia, born in reaction to the 1979 Iranian revolution and the seizure of the Mecca mosque by Sunni radicals later that year.

“I’m young. Seventy percent of our citizens are young,” he said. “We don’t want to waste our lives in this whirlpool that we were in the past 30 years. We want to end this epoch now. We want, as the Saudi people, to enjoy the coming days, and concentrate on developing our society and developing ourselves as individuals and families, while retaining our religion and customs. We will not continue to be in the post-’79 era,” he concluded. “That age is over.”

David Ignatius’ email address is davidignatius@washpost.com.

(c) 2017, Washington Post Writers Group

With North Korea, we do have cards to play

By charles krauthammer
With North Korea, we do have cards to play

WASHINGTON -- The crisis with North Korea may appear trumped up. It’s not.

Given that Pyongyang has had nuclear weapons and ballistic missiles for more than a decade, why the panic now? Because North Korea is headed for a nuclear breakout. The regime has openly declared that it is racing to develop an intercontinental ballistic missile that can reach the United States -- and thus destroy an American city at a Kim Jong Un push of a button.

The North Koreans are not bluffing. They’ve made significant progress with solid-fuel rockets, which are more quickly deployable and thus more easily hidden and less subject to detection and pre-emption.

At the same time, Pyongyang has been steadily adding to its supply of nuclear weapons. Today it has an estimated 10 to 16. By 2020, it could very well have a hundred. (For context: the British are thought to have about 200.)

Hence the crisis. We simply cannot concede to Kim Jong Un the capacity to annihilate American cities.

Some will argue for deterrence. If it held off the Russians and the Chinese for all these years, why not the North Koreans? First, because deterrence, even with a rational adversary like the old Soviet Union, is never a sure thing. We came pretty close to nuclear war in October 1962.

And second, because North Korea’s regime is bizarre in the extreme, a hermit kingdom run by a weird, utterly ruthless and highly erratic god-king. You can’t count on Caligula. The regime is savage and cult-like; its people, robotic. Karen Elliott House once noted that while Saddam Hussein’s Iraq was a prison, North Korea was an ant colony.

Ant colonies do not have good checks and balances.

If not deterrence, then prevention. But how? The best hope is for China to exercise its influence and induce North Korea to give up its programs.

For years, the Chinese made gestures, but never did anything remotely decisive. They have their reasons. It’s not just that they fear a massive influx of refugees if the Kim regime disintegrates. It’s also that Pyongyang is a perpetual thorn in the side of the Americans, whereas regime collapse brings South Korea (and thus America) right up to the Yalu River.

So why would the Chinese do our bidding now?

For a variety of reasons.

-- They don’t mind tension but they don’t want war. And the risk of war is rising. They know that the ICBM threat is totally unacceptable to the Americans. And that the current administration appears particularly committed to enforcing this undeclared red line.

-- Chinese interests are being significantly damaged by the erection of regional missile defenses to counteract North Korea’s nukes. South Korea is racing to install a THAAD anti-missile system. Japan may follow. THAAD’s mission is to track and shoot down incoming rockets from North Korea but, like any missile shield, it necessarily reduces the power and penetration of the Chinese nuclear arsenal.

-- For China to do nothing risks the return of the American tactical nukes in South Korea, withdrawn in 1991.

-- If the crisis deepens, the possibility arises of South Korea and, most importantly, Japan going nuclear themselves. The latter is the ultimate Chinese nightmare.

These are major cards America can play. Our objective should be clear. At a minimum, a testing freeze. At the maximum, regime change.

Because Beijing has such a strong interest in the current regime, we could sweeten the latter offer by abjuring Korean reunification. This would not be Germany, where the communist state was absorbed into the West. We would accept an independent, but Finlandized, North.

During the Cold War, Finland was, by agreement, independent but always pro-Russian in foreign policy. Here we would guarantee that a new North Korea would be independent but always oriented toward China. For example, the new regime would forswear ever joining any hostile alliance.

There are deals to be made. They may have to be underpinned by demonstrations of American resolve. A pre-emptive attack on North Korea’s nuclear facilities and missile sites would be too dangerous, as it would almost surely precipitate an invasion of South Korea with untold millions of casualties. We might, however, try to shoot down a North Korean missile in mid-flight to demonstrate both our capacity to defend ourselves and the futility of a North Korean missile force that can be neutralized technologically.

The Korea crisis is real and growing. But we are not helpless. We have choices. We have assets. It’s time to deploy them.

Charles Krauthammer’s email address is letters@charleskrauthammer.com.

(c) 2017, The Washington Post Writers Group

Condo values catching up to single-family homes

By kenneth r. harney
Condo values catching up to single-family homes

WASHINGTON -- It’s a real estate question that historically has had an easy answer: Do single-family detached homes appreciate in value faster than condominiums?

The standard answer has been: Of course single-family homes appreciate faster. They are what most Americans prefer to live in, so there’s stronger demand. They come with their own piece of land -- and we all know that land is a crucial driver of value.

Condos, on the other hand, tend to be smaller on average in square footage and more complicated. They come with boards of directors, association fees, rules and restrictions.

But hold on. New research conducted for this column by Trulia, the online realty marketing and information company, suggests that these old assumptions could be giving way to changing market trends. According to data compiled by Trulia on millions of properties in the 100 largest metropolitan areas between February 2012 and February of this year, the median appreciation rates of condos outpaced those of single-family detached houses.

It wasn’t even close. Median condo market values rose by 38.4 percent over the five-year period, while median single-family detached homes appreciated by 27.9 percent. In some local markets, especially those that have seen either significant new condo construction downtown or that have little available land suitable for detached housing, the median value of condos exceeds median values of single-family detached homes in the surrounding suburbs.

The most extreme example is metropolitan New York, where median condo values are now at 138 percent of median single-family detached home values. In Detroit, the median condo value is 125 percent of median single-family home value. Major urban areas where condos are appreciating faster than detached single-family units include Seattle, San Francisco, San Jose, Atlanta, Dallas-Fort Worth, Denver, Syracuse, San Diego, Boston, and dozens of others.

Single-family home values continue to be higher in the vast majority of markets but the gap is narrowing in many, thanks to the faster appreciation rates of condos in recent years.

Ralph McLaughlin, chief economist at Trulia, says one reason for the relative change in values is that in many urban markets, condos are “located in areas that are becoming more desirable because they are closer to amenities” -- employment, transit and other attractions.

Some metro areas, such as Washington, D.C., that have high-cost single-family homes in parts of the city and in the close-in suburbs, are seeing only slight increases in median condo values relative to single-family homes. The D.C. market has experienced modest growth in values during the past five years, but condos have appreciated a smidge faster -- 22.4 percent compared with 21 percent during the same period for detached single-family homes.

Other major metro areas, such as Chicago, aren’t seeing the pattern noted by Trulia. In the past five years, median Chicago condo values are up by 23 .3 percent, but median single-family values have risen by 25.5 percent.

Trulia’s analysis may be controversial. It derives from the massive database it maintains on millions of housing units nationwide. Using an automated valuation model that incorporates a wide range of data available on individual homes, it estimates ongoing property values both for properties that are on the market and those that are not.

Some housing economists take issue with Trulia’s conclusions on condo appreciation. The National Association of Realtors reports that based on closed sales prices-- not automated value estimates -- single-family homes appreciated an average of 4.7 percent annually between 2010 and 2016, while condos averaged 3.4 percent. Rob Dietz, chief economist of the National Association of Home Builders, says that based on construction starts of condos, which totaled just 28,000 in 2016, he does not see demand pushing up prices faster on condos compared with detached homes.

But Trulia’s McLaughlin insists that using automated estimates of value produces a more accurate picture. “Sales prices are susceptible to significant bias because of the mix” of houses on the market at any given point, he says. “We estimate the value of all houses ... and take the median of that number instead. This approach is prone to less bias than taking median sales prices.”

What to make of the new Trulia data? Clearly condos are playing a key role in some cities’ downtown revivals. In other markets, they continue to be more affordable than detached single-family homes and may be appreciating in value faster as a result.

Ken Harney’s email address is kenharney@earthlink.net.

(c) 2017, Washington Post Writers Group

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