Rahm Emanuel's Party

White House Chief of Staff Rahm Emanuel does not have a reputation for being a very nice guy. President Obama's fixer—or "Rahmbo" as he's known—was of course at the center of recent controversy after calling a group of liberal activists "fucking retarded." Sarah Palin, whose son has Down's syndrome, denounced his use of "the r-word" and called for him to resign. While Emanuel may not really connect the word with the developmentally disabled, no one says Emanuel—who is also known for calling Republicans "knucklefucks"—is particularly sensitive to the feelings of others. But a spate of sympathetic profiles have come out suggesting that he is the one person in the administration who knows what he's doing.

In The Washington Post, Dana Milbank wrote that "Obama's first year fell apart in large part because he didn't follow his chief of staff's advice on crucial matters." Dismissing the rest of Obama's advisors as naive and "blinded by Obama love," Milbank wrote that that Rahm Emanuel was arguably "the only person keeping Obama from becoming Jimmy Carter." Another Post reporter, Jason Horowitz, suggested that Emanuel "may be the White House voice of reason" and quotes an anonymous House Democrat who said, "I don't think the White House has listened to him enough." Noam Scheiber's profile in The New Republic is more nuanced—and of the three, the most worth reading—but also portrays Emanuel as the pragmatic insider Obama needs to help him avoid some of the mistakes of the Carter and Clinton administrations.


These articles—whether engineered by Rahm Emanuel himself or one of his allies—smack of spin and score-settling. The reaction on the left, where Emanuel is seen as "Obama's Dick Cheney," was immediate. Dan Froomkin called Emanuel "the chief of sabotage." Emanuel, after all, has opposed many things dear to the Democratic base. He pushed a smaller health care bill without a public option, opposed closing Guantanamo, and opposed trying Khalid Sheikh Mohamed in a federal court—which now looks like a battle he might win. Emanuel may have been right in the sense that the Democrats could have avoided some controversy if they had followed his advice more closely—although he has largely gotten his way on most of these issues. But it's not clear that avoiding controversy is in the Democrats' best interest. It certainly hasn't stopped the Republicans from attacking them. The Democrats' reluctance to challenge Republican attacks may in fact have encouraged Republicans to amp up their rhetoric.

The truth is that Rahm Emanuel's strategy—although sharply at odds with Obama's campaign rhetoric—has been the Democratic playbook since September 11. Froomkin calls Emanuel a "Bush Democrat" in the sense that like most Democrats under President Bush, he "operates on a battlefield as defined by Republicans, where the terrain is littered with the specter of imaginary but profoundly terrifying GOP attack ads. His reflexive approach is the strategic retreat." And the "political fiascos" Milbank says Emanuel helped the Democrats avoid are what many on the left would have called "accomplishments." Closing Guantanamo and passing health care reform aren't tactical objectives. They were campaign promises, the precise things many of Obama's supporters voted for him to do. To many of his followers they were moral imperatives. But to Emanuel, they were less important than staying in power.

Rahm Emanuel's signature accomplishment exemplifies the Democrats' strategy. In 2006 he helped the Democrats win a majority in the House by backing conservative Democrats in contested districts. The fruit of his strategy was a substantial, but relatively conservative Democratic majority, which has generally been too timid to take any stand that might open it up to attack. While it may be better to pass the health care bill before Congress than to pass nothing at all, it's not at all clear that a more polarizing, controversial bill might not have been more popular in the long run. At least it would have made someone happy. As it is, the Democrats are still getting attacked by the Republicans, even though they have done very little of what they were elected to do.

'Upstreamism': Your zip code affects your health as much as genetics

Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."

Sponsored by Northwell Health
  • Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
  • Patients from low-income neighborhoods are most at risk of negative health impacts.
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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

Dubai to build the world’s largest concentrated solar power plant

Can you make solar power work when the sun goes down? You can, and Dubai is about to run a city that way.

Photo credit: MARWAN NAAMANI / AFP / Getty Images
Technology & Innovation
  • A new concentrated solar plant is under construction in Dubai.
  • When it opens next year, it will be the largest plant of its kind on Earth.
  • Concentrated solar power solves the problem of how to store electricity in ways that solar pannels cannot.
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19th-century medicine: Milk was used as a blood substitute for transfusions

Believe it or not, for a few decades, giving people "milk transfusions" was all the rage.

Photo credit: Robert Bye on Unsplash
Surprising Science
  • Prior to the discovery of blood types in 1901, giving people blood transfusions was a risky procedure.
  • In order to get around the need to transfuse others with blood, some doctors resorted to using a blood substitute: Milk.
  • It went pretty much how you would expect it to.
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