A Little Advice From Someone Studying Extremist Groups: If Youre In A Social Media Environment Where

A little advice from someone studying extremist groups: if you’re in a social media environment where the daily ubiquitous message is that you have no hope of any kind of future and you can’t possibly achieve anything without a violent overthrow of society, you’re being radicalized, and not in the good way.

It's honestly crazy that discussion around testosterone HRT skews so much towards the beginning stages of it (to the point that you have dozens of guys thinking their transition is "failed" if they don't pass by like a year in lol) and what the initial changes of the first couple of months to years look like, like the classic laundry list of those early basic changes like bottom growth, voice drop, etc, when IMO literally none of that compares remotely to the depth and intensity of the long term total masculinization you start to experience like 3-5+ years in.

Hi. I've started writing a semi-weekly TB Newsletter, if you're interested in that kind of thing. Here's the second letter--about public-private partnerships, leprosy, and my forthcoming big announcement about expanding access to tuberculosis care. You'll hear more about that on Thursday. Anyway, here's the newsletter. You can sign up here.

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In advance of the Big Announcement this Thursday, I made a vlogbrothers video today on how we end TB–with the comprehensive care plan often known as S-T-P, which is short for “Search, Treat, and Prevent.” But one thing I didn’t discuss in that video is the downstream benefits of comprehensive TB care.

Once you’ve hired community health workers to screen for TB, it becomes much easier to screen for other illnesses like diabetes, high blood pressure, and non-TB lung issues (especially lung cancer). TB is notoriously a disease of vicious cycles–a disease of malnutrition that makes malnutrition worse, a disease of poverty that makes poverty worse, and so on–but addressing TB can be a story of virtuous cycles: TB survivors become TB advocates, as I’ve seen with my friend Henry in Sierra Leone. More effective TB treatment leads to less stigmatization of the disease, as communities come to see the disease as curable and survivable rather than terrifying and deadly. And better access to TB care leads to a stronger overall healthcare system, because more community health workers are better connected to more primary healthcare clinics, which allows communities to better address all kinds of health problems.

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Mycobacterium tuberculosis is not the only bacteria of its family that causes a lot of human suffering; there is a closely related species called mycobacterium leprae that causes the disease known as Hansen's Disease, or more commonly leprosy. There are still around 200,000 cases of leprosy diagnosed each year around the world, and while the disease is curable, it also remains–especially if not caught and treated early–a significant driver of suffering and disability in our world. 

There are many connections between TB and leprosy: Not only are the bacteria that cause these illnesses very similar, but patients have often expressed similarities in experience. TB patients who were encouraged or forced to live in sanitariums often compared themselves to lepers. One disheartening parallel between the diseases is that in both cases, those living with these illnesses are often abandoned by their families and must make new social connections within the new community of “leper” or “consumptive.” Also, both Hansen’s Disease and TB continue to exist largely because of systemic failures rather than due to a lack of knowledge or technology.

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I really recommend Dr. Salmaan Keshavjee’s TED talk about how we ended TB in the U.S., and how we can end it using the same strategy around the world.

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Last link from me today: I’ve been thinking a lot about the complex intersection between public and private investment (for reasons that will be clear on Thursday!) and I keep coming back to one infographic in an excellent paper (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256883) about the public money that was poured into the creation of the GeneXpert Machine, which can quickly and accurately test for TB. The GeneXpert machine has created a lot of profit for Danaher’s shareholders, and it has also created some societal benefit, but it could create a lot more societal benefit if it created less profit for Danaher’s shareholders. This tension seems to me one of the defining features of 21st century life. Anyway, here is the infographic:

That’s the money–over $250,000,000 of it–that came from taxpayers (mostly in the U.S. and Europe) to fund the creation of the GeneXpert Machine. And yet, this tech largely funded by the public is controlled entirely by private enterprise. I’m troubled by that model of value allocation, even if I still believe that private money and private enterprise have important roles to play in fueling innovation. But taking a quarter billion dollars of public money and then claiming total ownership over a technology, and using that ownership to deny the technology to the world’s poorest people, seems like a deeply flawed system of resource distribution to me.

I’ll see you on Thursday. I’m nervous and excited.

DFTBA,

John

People against piracy fail to realize that no, I can’t just ‘buy it.’ They stopped making DVDs and Blu-Rays. They’re barely offering digital copies for download. I am not spending money I could use for food or bills to pay for a subscription service just so I can always have access to a beloved piece of media. Especially not when the service will remove media on a whim without concern for how the loss of access to that piece will make its artistic conservation nigh impossible.

For example, I recently learned that Disney+ had an original film called Crater. It’s scifi, family friendly, and seems cool - I would love to buy it as a holiday gift for my little brother! But: it’s exclusive to D+ and THEY REMOVED IT LITERALLY MONTHS AFTER ITS RELEASE.

The ONLY way I can directly access this film is through piracy. The ONLY available ‘copies’ of this film are hosted on piracy websites. Disney will NEVER release it in theaters, or as something to buy, and it may NEVER return to the streaming service. It will be LOST because we aren’t allowed to purchase it for personal viewing. If I can’t pay to own it, I won’t pay for the privilege of losing it when corporate decides to put it in a vault.

So yes, I’m going to pirate and support piracy.

I have a friend who's always telling me their stories like that. It's awesome.

I don't know if someone needs to bear this, but sometimes it's alright to not write everything down, to just enjoy the dream worlds and epic storylines even if they won't last forever. Paper won't either, might still be forgotten. But the story will have lived either way <3

New idea: instead of writing the fic, you come over to my house and I tell you the entire plot while I pace my tiny kitchen. There’s a cup of tea, warm in your hands. The words don’t stop and the affection never leaves your expression.