Plasma Pool

Those who deride this honor as an award of aspiration are missing the point. It’s not about what Obama hopes or intends to do; it’s about the hope and intention he inspires in others. It’s about changing the way people see the world and what the world can be and what the world can produce. There’s nothing wrong with honoring someone whose eloquence and prominence brought about a November night filled with mass gatherings of happy tears, shouts of glee, and hugs for strangers in the streets of Chicago, Kenyan villages, Indonesian hamlets, and towns across the world that see Barack Obama as a little bit of their own.

When I went to nursery school, I remember my mother folding my pancreatic enzymes, mixed with raspberry jam, between soft slices of bread, sparing me the long walk to the office for my medicine. I also remember three-hour car rides with my parents to spend 15 minutes with the most innovative doctors, crowded waiting rooms and watching a frustrated receptionist search for a translator to explain to an immigrant father that his son’s pulmonary function test might not be covered by his minimal insurance policy. By the age of six, I had a sense for health care in America.

We have a president, and irony of ironies a black one, who has been convinced that manning up on the defining civil rights issue of our age will get him evicted from the White House. Whether or not this prediction is a good one is irrelevant. Manning up is what Barack Obama was elected for. This is the job, however shabbily done by others, so he can shit or get off the pot. The longer he sits there perched without moving his bowels, the stronger the miasmic stench of his equivocating rhetoric, and the stronger his signal to Americans that with respect to gay rights, nothing has changed.

Last week, a research team from Stanford University School of Medicine and the Veterans Affairs Palo Alto Health Care System published an essay in the New England Journal of Medicine suggesting that new drugs be labeled not only with what we know about them (which they now are), but also with an accounting of what we don’t know.

The Stanford researchers’ effort to clarify the ambiguity surrounding the comparative effectiveness of recently approved drugs is laudable. But their proposal that the FDA begin labeling drugs with measures of this comparative effectiveness both ignores the realities of how pharmaceutical innovation happens today and endorses a flawed decisionmaking model that could foster false security in patients and undermine their medical caregivers—the professionals who are trained to help each particular patient discriminate among drugs of the same class in a way a label cannot. Doctors can and do disagree about what constitutes a statistically significant difference between two drugs. Giving patients a nudge in the direction of involving themselves in that decision—and the confidence to do so—without properly equipping them to make informed decisions will diminish rather than improve the overall quality of patient care.

Shortly after Caroline Kennedy withdrew her name from consideration for the vacancy in the U.S. Senate created by Sen. Hillary Clinton’s resignation, Nate Silver published a brief and provocative piece entitled “Did Caroline Ever Really Want It?” in which he analyzes Kennedy’s withdrawal in a simple and radical way: as though she were a person.