Vera Wilde

Excited to announce the publication of a critique of the research literature on antidepressants in pregnancy. “Dubious Science: Downplaying the Risks of Antidepressants in Pregnancy,” runs today on Mad in America: Science, Psychiatry and Social Justice. The post explores methodological problems in science that starts out with evidence of substantial possible risks, and launders them through faulty and nontransparent means into purported evidence of no risk.

 

I’ve been fantasizing about starting a method series for a long time, and finally am! Join me on Substack (of course) for my writing at least twice a month exploring the intersection of science and activism.

Here’s a personal introduction to Wilde Truth: Research Methods for Revolution. 

This is a response to the American Academy of Pediatrics’ August 2022 “Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation,” published by Alex R. Kemper, MD, MPH, MS, FAAP; Thomas B. Newman, MD, MPH, FAAP; Jonathan L. Slaughter, MD, MPH, FAAP; M. Jeffrey Maisels, MB BCh, DSc, FAAP; Jon F. Watchko, MD, FAAP; Stephen M. Downs, MD, MS; Randall W. Grout, MD, MS, FAAP; David G. Bundy, MD, MPH, FAAP; Ann R. Stark, MD, FAAP; Debra L. Bogen, MD, FAAP; Alison Volpe Holmes, MD, MPH, FAAP; Lori B. Feldman-Winter, MD, MPH, FAAP; Vinod K. Bhutani, MD; Steven R. Brown, MD, FAAFP; Gabriela M. Maradiaga Panayotti, MD, FAAP; Kymika Okechukwu, MPA; Peter D. Rappo, MD, FAAP; Terri L. Russell, DNP, APN, NNP-BC in the journal Pediatrics.

New guidance from the American Academy of Pediatricians on managing jaundice in newborns normalizes dangerous complications of accidental starvation from breastfeeding, appears not to consider numerous possible iatrogenic harms from phototherapy, and does not compare the relative benefits and risks of the simplest strategies for treating neonatal jaundice and preventing its progression — namely, supplemental formula feeding before and during phototherapy. 

Starvation is the root cause of modal neonatal jaundice. Underfeeding worsens jaundice of all origins. Jaundice severity, in turn, increases risks including death and permanent brain injury. Preventing and treating starvation jaundice is literally as easy as giving a bottle.

Modern misconceptions about “exclusive breastfeeding” — a modern, Western intervention introduced without safety monitoring —commonly lead to insufficient milk intake in the days before mothers’ milk usually comes in, days or weeks before supply is established, and whenever insufficient milk persists or presents. This is a frequent occurrence and the cause of common, fully preventable harm. Current consensus normalizes signs of complications from resultant starvation including the appearance of pink uric acid crystals, excessive weight loss and crying, and jaundice. There is nothing normal or necessary about starving newborns.

The empirical literature links neonatal jaundice with possible substantial increases in neurodevelopmental harm including autism. It also links phototherapy with such risks. Of many jaundice-autism studies, the new AAP guidance authors cite only Wu et al 2016 — who estimate in line with other such studies that both jaundice-autism and phototherapy-autism effects may be quite substantial. This forms part of a body of evidence troubling the notion that phototherapy protects infants from harm, and suggesting that, rather, phototherapy may be associated with even more preventable harm than jaundice itself. This finding in the phototherapy-autism literature has been widely under-reported due to rampant misuse of statistical significance testing, a mistake denounced by leading methodologists. 

Before phototherapy, early modern healthcare providers advised breastfeeding moms to switch jaundiced babies to formula. The evidence still supports that treatment. Formula-fed newborns have greater bilirubin clearance than breastfed ones. Phototherapy efficacy hinges on excretion. Insufficient milk intake from breastfeeding likely first contributes to jaundice and its progression, and then compromises phototherapy efficacy. Phototherapy should be used as a second-line treatment after formula-feeding whenever possible, to minimize iatrogenic risks. Complementary formula supplementation should be standard with phototherapy.

Before breastfeeding’s modern resurgence in the mid-1970s, formula-feeding was the norm, and early modern societies lost generations of knowledge about safe breastfeeding. So reformers who brought breastfeeding back didn’t know what they didn’t know: All previous advanced civilizations had a safety infrastructure ensuring infants got enough to eat despite common breastfeeding insufficiencies. Prelacteal feeding traditions, shared nursing practices, and well-organized wetnursing professions were their common features. In most contemporary foraging societies today, newborns are breastfed by another lactating mother in the full 48 hours before their own mothers’ milk usually comes in. Starving newborns in the service of breastfeeding promotion is a well-intentioned but tragic, recent mistake. Treating jaundiced, breastfed babies with phototherapy may compound the permanent harm of this accidental neonatal starvation. It’s also not a humane response to hungry newborns.

Excited to announce the publication of the Springer volume Diagnoses Without Names: Challenges for Medical Care, Research, and Policy, ed. Michael D. Lockshin, Mary K. Crow, and Medha Barbhaiya. The book explores circumstances surrounding uncertain diagnoses, different stakeholder uses of diagnosis, and the importance of challenging prevailing norms to accept uncertainty as part of the diagnostic process.

My chapter, “Shame, Name, Give Up the Game? Three Approaches to Uncertainty,” builds on my experiences as a family member of a then-undiagnosed lupus patient and later as the head of a lupus patient support group chapter, as well as my later dissertation research on a diagnosis decision support tool (among other case studies in AI) that these experiences informed. 

Tom Chivers’s inews.co.uk article “Baby formula shortage: I’m ashamed I encouraged my wife to breastfeed exclusively, despite the pain” — featuring some of my criticisms of “exclusive breastfeeding” — is out today. 

Delighted to announce my new peer-reviewed article on the neonatal jaundice-autism link, published today: “Neonatal Jaundice and Autism: Precautionary Principle Invocation Overdue.” (Free full-text here.)

And a fitting poem from E.E. Cummings’ Misanthropic Moods: 

pity this busy monster, manunkind, 

not. Progress is a comfortable disease:
your victim(death and life safely beyond)

plays with the bigness of his littleness
–electrons deify one razorblade
into a mountainrange; lenses extend

unwish through curving wherewhen til unwash
returns on its unself. 

                                            A world of made
is not a world of born — pity poor flesh

and trees,poor stars and stones, but never this
fine specimen of hypermagical

ultraomnipotence.    We doctors know

a hopeless case if — listen:there’s a hell
of a good universe next door;let’s go

This year I published a peer-reviewed article and got a book chapter accepted in a forthcoming book. The article, “Breastfeeding Insufficiencies: Common and Preventable Harm to Neonates,” is indexed in PubMed and the full-text is available here. The book chapter, “Shame, Name, Give Up the Game? Three Approaches to Uncertainty,” is forthcoming in Diagnoses Without Names: Challenges for Medical Care, Research, and Policy, ed. Michael D. Lockshin, Mary K. Crow, and Medha Barbhaiya, with Springer. 

I also made many more lovely postcards from home, this time with additional assistance. 

Here’s to a happy, healthy 2022. 

“I Heard a Bird Sing”

I heard a bird sing
     In the dark of December
A magical thing
     And sweet to remember. 

“We are nearer to Spring
     Than we were in September.” 
I heard a bird sing
     In the dark of December. 

                                –   Oliver Herford

 

Ann-Kathrin Nezik’s Die Zeit article “Falsch geblinzelt,” featuring some of my criticisms of next-generation “lie detection” tool iBorderCtrl, is out this week.

Here are some of the postcard paintings and poems for dear ones that I’ve been making and revisiting lately.

I paint postcards
that are too beautiful and fragile to mail,
and then I mail them.
Something about the kindness of strangers.
Something about watching the ocean take back what it gave.

“Ladder”
By Jane Hirshfield

A man tips back his chair, all evening.

Years later, the ladder of small indentations
still marks the floor. Walking across it, then stopping.

Rarely are what is spoken and what is meant the same.

Mostly the mouth says ones thing, the thighs and knees
say another, the floor hears a third.

Yet within us,
objects and longings are not different.
They twist on the stem of the heart, like ripening grapes.

“All Souls’ Day”
By D.H. Lawrence

Be careful, then, and be gentle about death.
For it is hard to die,
it is difficult to go through the door,
even when it opens.

And the poor dead, when they have left
the walled and silvery city
of the now hopeless body
where are they to go, Oh where are they to go?

They linger in the shadow of the earth.
The earth’s long conical shadow is full of souls
that cannot find the way across the sea of change.

Be kind, Oh be kind to your dead
and give them a little encouragement
and help them to build their little ship of death
for the soul has a long, long journey after death
o the sweet home of pure oblivion.
Each needs a little ship, a little ship
and the proper store of meal for the longest journey.
Oh, from out of your heart
provide your dead once more, equip them
like departing mariners, lovingly.

“God’s Grandeur”
By Gerard Manley Hopkins

The world is charged with the grandeur of God.
It will flame out, like shining from shook foil;
It gathers to a greatness, like the ooze of oil
Crushed. Why do men then now not reck his rod?
Generations have trod, have trod, have trod;
And all is seared with trade; bleared, smeared with toil;
And wears man’s smudge and shares man’s smell: the soil
Is bare now, nor can foot feel, being shod.

And for all this, nature is never spent;
There lives the dearest freshness deep down things;
And though the last lights off the black West went
Oh, morning, at the brown brink eastward, springs —
Because the Holy Ghost over the bent
World broods with warm breast and with ah! bright wings.

“Hypocrisy”

You would think I’d be better, for how ill I suffer fools.
But to build and to destroy seem to require different tools.

“Help”

I am trapped inside 
a small mammal
on an open plain

a small gazelle
a wide, grassy plain

“The Shrine Whose Shape I Am”
By Samuel Menashe

The shrine whose shape I am
Has a fringe of fire
Flames skirt my skin

There is no Jerusalem but this
Breathed in flesh by shameless love
Built high upon the tides of blood
I believe the Prophets and Blake
And like David I bless myself
With all my might

I know many hills were holy once
But now in the level lands to live
Zion ground down must become marrow
Thus in my bones I am the King’s son
And through death’s domain I go
Making my own procession

Welcome to my country,
where we never run out of fear
and the danger of other people
is outweighed only by the danger
of being too much alone.
Make yourself at home.

You don’t need to know
everything about light
to be a passenger
on the boat of light.

You don’t need to know
everything about fire
to carry a torch
and pass it on.

Cease this constant weighing of life,
as if you knew what it was made of,
what it was meant for,
and how to measure its worth.

“Habits”

Everything has momentum.
Once you are breathing,
it’s hard to stop.

And once you’ve stopped?
Even harder, then,
to start back up again.

“May Day”
By Sara Teasdale

A delicate fabric of bird song
Floats in the air,
The smell of wet wild earth
Is everywhere.

Red small leaves of the maple
Are clenched like a hand,
Like girls at their first communion
The pear trees stand.

Oh I must pass nothing by
Without loving it much,
The raindrop try with my lips,
The grass with my touch;

For how can I be sure
I shall see again
The world on the first of May
Shining after the rain?

We’ve been busy for the past few days on Covid @ Home. It’s in a state where people can look at it now. Would love comments, especially if you know any doctors or nurses who would like to take a look. Translations to some other major languages are next.

Jake Bittle’s MIT Technology Review article “Lie detectors have always been suspect. AI has made the problem worse,” featuring some of my criticisms of next-generation “lie detection” tool iBorderCtrl, runs today.

There is no record of my first attempts to sketch to paint a homunculus for my dear friend Hanka the reproductive biologist, which is doubly lucky. First because they were hideous, misshapen, golem-like creatures. That’s the whole point, homunculi being strange, distorted miniatures. Think of the Mayan origin story of the first attempted humans—made of mud, so flimsy they dissolved in water. Think lumpy, living bits of clay, with hugely over-long arms or legs, lips or noses, like troll dolls or Gumby, but less friendly.

And second because that was the wrong and lesser idea of a homunculus, aesthetically and conceptually. Hanka kindly took my first sketches in stride and pointed me to Hartsoeker’s superior version, a late 17th century microscope inventor’s envisioning of how perhaps a whole human being was holding his knees already inside a single sperm—a poetic, visual version of Monty Python’s “Every Sperm is Sacred.“

I liked Hartsoecker so much, I tried being faithful to him at first…

But while I could get the feel right in the strokes, and execute on color, graphically they were all wrong.

When wrong, one reads. Carol Rumens had a lovely poetry piece in The Guardian recently that mentioned Bentley and Chakravatrula’s research on cell behavior making

“a good case for the hypothesis that cell activity is ‘a perception-action process.’ In other words, that cells engage in a process ‘analogous to a human moving their eyes or their heads or their bodies to create and interact with variables in optic flow.’ Cells make decisions!”

I took this as a mandate to give a sperm an eye.

Hanka disapproved. She said the eye was creepy. And also that it would be more accurate to give them noses instead.

But as sperm cannot swim as well with noses, I cut off the nose to right the chase.

Something new and different was needed. Visions of double helices danced in my head. This may have something to do with Hanka’s recommendation of Jeremy Narby’s Cosmic Serpent, an Amazon anthropologist’s rendition of a DNA origin story, and how it jibed with what Shulgin theorized about the origins of life in TiKHAL (along the lines of panspermia and with a delightfully cheeky critique of evolutionary theory as faith), as well as the no less trippy stuff on horizontal gene transfer relayed in David Quammen’s The Tangled Tree. Hartsoeker’s error seems less quaint in light of Darwin’s.

Mirrors were lying around, and the art vortex began pulling them in.

At last, Hanka liked what I made. The hypothetical homunculus had become real art. And that’s the magic of creation.

Not sure if this is still just a layer… But here is some Gabriela Mistral, trans. Ursula K. Le Guin.

“Hymn to the Tree”
For Don Jose Vasconcelos

Brother tree, who grappled
to the earth with your dark hooks,
yet lift up your bright brow
in an intense thirst for heaven:

give me patience with the dross,
the clay, that nourish me,
yet let the memory not sleep
of the blue land I come from.

Tree, you who let the traveler know
the sweetness of your presence
by your cool, ample shade
and the halo of your fragrance:

let my presence be revealed
in the fields of life,
the mild, warm influence
of a creature blest.

Tree ten times productive,
of rosy apples,
of wood to build with,
of sweet-scented breeze,
of sheltering foliage,

of emollient gums,
and miraculous resins,
full of laden branches
and melodious throats:

make me opulent in giving,
so I can be as fecund as you are,
make my heart and thought
as vast as the world!

“Paradise”

A sheet of beaten gold
and on the golden level
two bodies like skeins of gold.

A body of glory listening
and a body of glory speaking
in the field where nothing speaks.

A breath that goes to a breath
and a face that quivers to it
in a field where nothing quivers.

To remember the sad time
when they both had Time
and lived under its yoke,

in the hour of the stroke of gold
when Time’s left on the doorstep
like a dog without an owner…

“Last Tree”
A Oscar Castro

This solitary margin
that has been mine from birth,
that goes from side
to burning side of me,

and runs from my forehead
down to my fevered feet:
this Island of my blood,
this scrap of monarchy,

I bring it in my arms,
I give it back, complete,
to tamarind or cedar,
the last of my trees.

For if in a second life
I don’t get what I was given
and miss the cool
and silence of this haven,

and pass through the world
running, flying, in a dream,
I don’t want doorsteps of houses
for my refuge, but a tree.

I’ll leave it all I had
of ashes and the sky,
and the wordy side of me,
and the silent side,

the loneliness I chose,
the loneliness I got,
and the tithe I paid the glory
of my sweet, tremendous God,

my game of give and take
with clouds and winds,
and my trembling knowledge
of hidden springs.

O my true Gabriel,
so near my trembling arms,
ever before me
with branch and balm!

Maybe it’s already born, and I
haven’t the grace to know it,
or it’s the nameless tree
I carried like a blind child.

Sometimes I feel the descent
of a fresh, soft air
and see rise around me
the round trunk—there—

But maybe my dream’s already
clothed in its leaves,
and I’m dead and don’t know it,
singing under my tree.

mumok in Vienna has a lovely, ludic Op Art exhibit on (reviewed at Delicious Line).

In my PhD and previous postdoctoral work on lie detection, I’ve often gestured at the importance of protecting a sort of sacred space of personhood in these contexts. Now there is a post that starts to flesh out why that really matters: Protecting Sacred Space: Real “Lie Detection” Would Threaten Human Rights As We Know Them, on iBorderCtrl.no.

Last month I made some art in dialogue with anti-Cartesian push-back, The Anti-Cogito. Now that thinking is extended in philosophical form—Good Logic, Bad Life: Decision-Making Neuroscience Suggests AI Decision-Making’s Weaknesses, on iBorderCtrl.no.

I love the idea of cosmetic x. It started with the suggestion of cosmetic psychopharmacology as a lipstick in pill form that you can put on the pig of a despairing brain:

Cosmetic psychopharmacology is not unlike cosmetic surgery. As more women get breast implants, the rest of us feel flat chested. And so it is with more women taking antidepressants and antianxiety medications. Suddenly you’re the odd one out if you aren’t like your friends, taking something to ‘take the edge off’ or give you a little lift to withstand the slings and arrows on your journey.

Dr. Julie Holland, *Moody Bitches: The Truth about the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having & What’s Really Making You Crazy* (p. 17).

Of course there’s not only cosmetic psychopharmacology, but also cosmetic psychology—a term I’m surprised it doesn’t seem anyone has yet applied to positive psychology. Positive psychology is the American-dominated field seeking to convince people with shitty quality of life in a failing empire (or two) that making gratitude lists is their salvation. (Some of its major players are known for being embroiled in contentious politics beyond that as well, to say the least.)

And then there’s cosmetic politics, the make-believe choice of legitimate government in a regime that is not.

In 2014, political scientists Martin Gilens and Benjamin Page, in a study published in Perspectives on Politics, empirically established how average U.S. citizens are almost completely ignored by U.S. governmental authorities in terms of public policies. Reviewing U.S. public opinions of policy issues, along with examining 1,779 different enacted public policies between 1981 and 2002, they determined that ‘even when fairly large majorities of Americans favor policy change, they generally do not get it. They conclude, ‘The central point that emerges from our research is that economic elites and organized groups representing business interests have substantial independent impacts on U.S. governmental policy, while mass-based interest groups and average citizens have little or no independent influence.”

When dissent—be it through public opinion polls, protest demonstrations, or otherwise—becomes impotent in changing policy, this is an indicator of living under authoritarian rule.

Bruce E. Levine, *Resisting Illegitimate Authority: A Thinking Person’s Guide to Being an Anti-Authoritarian—Strategies, Tools, and Models,* p. 238

You could call this form of government plutocracy (rule by the wealthy) or kleptocracy (rule by corrupt, self-enriching networks)… And you could call the elections that ostensibly validate it as somehow democratic (in spite of the evidence to the contrary), masturbation (as George Carlin does) or kabuki theater (as American pundits often do). But really the appearance of ritualized consent in the form of electoral process to legitimate fundamentally anti-democratic systems of power is cosmetic politics. It just seems more correct and less innately derogatory than the other terms. It’s not the real exercise of power; it’s the lipstick. You don’t need insults, obscure referents, or Marxist terms like false consciousness, to describe it.

And to say something is cosmetic is not innately an insult. All personification in literature is cosmetic. “I bowed my head, and heard the sea far off / washing its hands”—James Wright, At the Slackening of the Tide. “It was not Night, for all the Bells / Put out their Tongues, for Noon”—Emily Dickinson, “It was not Death, for I stood up.” And still another, all from the same source:

“The yellow fog that rubs its back upon the window-panes,

The yellow smoke that rubs its muzzle on the window-panes,

Licked its tongue into the corners of the evening,

Lingered upon the pools that stand in drains,

Let fall upon its back the soot that falls from chimneys,

Slipped by the terrace, made a sudden leap,

And seeing that it was a soft October night,

Curled once about the house, and fell asleep.”

(T.S. Eliot, The Love Song of J. Alfred Prufrock)

Mary Oliver, *A Poetry Handbook: A Prose Guide to Understanding and Writing Poetry*, p. 103-4.

Something that is cosmetic is on the surface and improves the appearance but not the substance—definitionally. Maybe such a thing does not really exist in people and societies though, because organisms react to stimuli (see all of Stimulus-Organism-Response psychology and physiology, e.g., Porges)… Maybe even purely cosmetic acts tend to have substantive feedback loops, and so not be purely cosmetic at all. Certainly in literature and art, the medium is the message; the surface is part of the substance in a way; and the idea of anything in poetry being “cosmetic” seems odd, like a modernist misunderstanding of why we make useless pretty things.

There is something useful in humanity, self-expression, truth that is also beautiful, the right shade of lipstick with a nice dress. Although I will be the last person to defend cosmetics in the psychopharmacology, psychology, and political contexts, I seem now to have put myself in the position of admitting (at least) that we live with them. We co-exist with those who alter appearances to maintain unhealthy and unfair status quos—and we are even, in some ways, the same. Unless we manage to actually change things.

Of course, this is only what artists and humanists always do. See a bogeyman and relate to him, and try to drag others along, too. The paradox of liberal democratic societies: accidental corporatist empathy edition…

My extension of Ioannides’ classic analysis of why most published research findings are likely to be false is live now: “Why Most Published iBorderCtrl Research Findings Are Likely to Be False,” on iBorderCtrl.no.

It’s been a while since I painted Rilke…

“Initial”
By Rainer Maria Rilke
From The Book of Images
Translated by Edward Snow

Let your beauty manifest itself
without talking and calculation.
You are silent. It says for you: I am.
And comes in meaning thousandfold,
comes at long last over everyone.

“Initiale”

Gieb deine Schönheit immer hin
ohne Rechnen und Reden.
Du schweigst. Sie sagt für dich: Ich bin.
Und kommt in tausendfachem Sinn,
kommt endlich über jeden.

“The Voices”
Nine Leaves with a Title Leaf
RMR

Title leaf

The rich and the fortunate can well keep quiet,
nobody wants to know what they are.
But the destitute have to show themselves,
have to say: I am blind
or: I am about to become so
or: nothing on earth works out for me
or: I have a sick child
or: right here I am pieced together…

And perhaps even that won’t suffice.

And since otherwise people pass by them
the way they pass things, they have to sing.

And the songs you hear there can be really good.

True, human beings are strange; they’d rather
hear castrati in boys’ choirs.

But God himself comes and stays a long time
whenever these maimed ones bother him.

“Die Stimmen”

Titelblatt

Die Reichen und Glücklichen haben gut schweigen,
niemand will wissen was sie sind.
Aber die Dürftigen müssen sich zeigen,
müssen sagen: ich bin blind
oder: ich bin im Begriff es zu werden
oder: es geht mir nicht gut auf Erden
oder: ich habe ein krankes Kind
oder: da bin ich zusammengefügt…

Und vielleicht, daß das gar nicht genügt.

Und weil alle sonst, wie an Dingen,
an ihnen vorbeigehn, müssen sie singen.

Und da hört man noch guten Gesang.

Freilich die Menschen sind seltsam; sie hören
liber Kastraten in Knabenchören.

Aber Gott selber kommt und bleibt lang
wenn ihn dieseBeschnittenen stören.

An illustrated poem apropos yesterday’s anti-cogito…

“Letting You”

What I think is a burning candle.
What I feel is its other end.
Also burning.

Depression is a big deal. Over 300 million people are affected globally, it’s THE leading cause of disability globally, and it affects lots women more than men (2x for unipolar depression). Being depressed is bad for your physical health as well as your quality of life, although we still don’t understand a lot about the reasons for the inflammation that characterizes depression and its physical health correlates like heart disease. Sad. Let’s turn depression off.

Pregnancy is also a big deal. It carries a lot of serious health risks and costs, and then at the end of it you have this whole new person to keep alive for quite some time, and they are basically the worst room-mate ever but you can’t legally kick them out. Tough. Let’s prevent pregnancy.

Ok, so we’re turning depression off cos it’s sad and preventing pregnancy (at least until we don’t wanna prevent it anymore) cos it’s intense. You’d think preventing pregnancy might even help turn depression off, since not being able to do the whole baby thing perfectly seems like it could be quite stressful, and no one can do it perfectly. (Plus the not knowing if you’re pregnant can also be quite stressful.) Stress gone, mental health better! Right?

Wrong. Or at least, that’s not what you see in the wonderful world of birth control…

The Paradox of Birth Control and Depression

Birth control should be good for women’s mental health because it relieves stress by reliably preventing pregnancy. Yet studies link birth control (in the form of hormonal contraceptive pills) to depression in some women. These studies are observational and that annoys me. Now here are three useless paragraphs on why I find that so, so very annoying.

Experiment Better, Dammit: An Annoyed Interlude

There is no readily apparent reason why we don’t have better data on this and lots of other things that people experiment with by themselves all the time. It’s just because no one has yet bothered to code, fund, and organize a platform to allow people to set up and run their own experimental studies or participate in other people’s. Then we could turn lots of individual experiments into much more scientifically powerful experimental data. All this good experimenting is going to waste! Stop that. Experiment in a structure with other people, with basic infrastructure for things like open data in place from the start. Please?

Probably the results couldn’t be published in many peer-reviewed journals or presented at conferences. But independent researchers work outside of those constraints all the time. If you want to measure a genocide in a war zone through snowball sampling, or some other risky project no IRB would approve, then your best bet is probably to go do it and then take the results public. We live in a world where, for better and for much, much, worse, people can put whatever they want on the Internet (limited time offer, some restrictions may apply). And you know what? Making citizen-scientists the experimental practitioners and putting the data out there automatically might prevent a lot of fraud (or just bad science) that results from perverse incentives in academia and publishing (not that industry is any better). Most published research findings are false, but a truly open science platform could help change that.

It’s not quite so simple as “the truth will out” (cf fake news). But we could and should have a big open platform where people can just do good science together including experiments on lifestyle, diet, birth control, and these sorts of things. Otherwise we end up with only observational data on these really important issues for everything, and that’s dumb. But the platform solving this problem doesn’t exist and I can’t code it. That’s why we’re faced with this ongoing depression-birth control mystery among others…

The Antibaby Pill Blues

In Germany, they call “the pill,” the anti-baby pill. I love this because it is so German. It says what it means that Americans (indeed most Anglophones) would never come out and say. Are you anti-baby? Fine. Take this pill. It’s an antibaby pill. You know what it does. Done.

In Scandinavia, they do data. The state tends to collect a lot on citizens from birth to death. So their medical databases are awesome. Thus, when you see this Danish observational study linking antibaby pills (or rather, hormonal contraception) and depression, you know these people are serious and this is good data. Not experimental data (twitch, twitch). But good data. And this is basically the finding you see in a lot of studies, but this one is methodologically the strongest of the lot afaik.

But wait, the plot thickens. Not every study on birth control and depression reaches the same conclusions. For instance, an American study found no association between taking the antibaby pill and depression among adolescents. But this study relied on self-reports, unlike the Danish study which used data from registries. So respondents could have lied or, with deference to Harper Lee, been mistaken in their minds. That would be especially true if the effect size at issue were small, and so a small measurement error could make it disappear.

The effect size at issue is small. Some estimates put the rate of depression caused by the antibaby pill at 1%. It also might be relatively difficult to measure this small effect size in a smaller sample. And indeed, the sample size in the American study is under 5,000, versus over a million in the Danish study.

Ok, so there are discrepant findings from observational studies. But overall it seems like the risk of hormonal birth control causing depression is small but real. So in terms of statistical significance, it’s not surprising that smaller studies on subgroups are missing the effect; that’s probably why you see some discrepant findings. But practically, that 1% still matters. Hormonal birth control is really commonly used, and 1% of a million is 10,000. Those 10,000 women’s mental health matters. It matters that a common medication/birth control practice could be contributing in a non-negligible way to one of the world’s biggest public health problems. And this is also just really bad news for women in general, if basically their best birth control option (for a lot of people for a lot of reasons) carries a risk of screwing up their brains, quality of life, and bodies (to the extent that depression is really a total-organism problem featuring chronic low-grade inflammation).

But wait, there is a conspicuous problem here.

It’s the Hormones, Stupid

Depression is a mental health problem that sometimes creates or contributes to mental health crises that sometimes result in psychiatric in-patient admissions. That is a proxy measure of people who are not just depressed but in freefall (and not willing/able to talk their way out of it, or too socially isolated to be plugged into help, or whatever). And there is a big fat under-discussed gender effect on that subgroup of bad outcomes within bad outcomes.

In Ayelet Waldman’s A Really Good Day, she mentions that the majority of female in-patient psych admissions happen during the week prior to menstruation. (And this is the first time I’ve seen this discussed in public, illustrating how her work is so taboo-shattering and important.) Hormones can really, really fuck you up.

This is not only a female problem. We know that boys and men tend to be more violent and experience more violence from other men as well (in the form of things like assault and homicide; clearly the gender numbers change with things like domestic violence and sexual assault). We know that testosterone is a contributing causal factor in these patterns of violence. It also seems to contribute to the much higher successful male suicide rate. I am too lazy to link to all these findings, but by all means look them up yourself using the Force, Luke.

So hormones cause big problems for all of humanity, but… That’s not cool to say. Seriously. Talking about how hormones (especially sex hormones) influence behavior and mental health is still, somehow, largely taboo.

The weirdly obvious problem in the studies I’ve seen so far linking hormonal birth control to depression is that they ignore this cyclical nature of women’s mental health. Studies on birth control and depression need to assess whether women are seeking treatment for depression more outpatient (which makes it look like they have 1% higher depression risk or so on the anti-baby pill)… Rather than having in-patient admissions. Or if there is some other story with respect to the intensity of the problem (in-patient admission or not) versus the persistence. There are a few possible stories.

Cry Me a Quiverful

To be more precise, there are three categories of possible stories here.

1. Women on hormonal contraception are more depressed than women who are not.
2. Women on hormonal contraception are not more depressed than women who are not.
3. Women on hormonal contraception are depressed in a different pattern than women who are not. That pattern may or may not reflect a qualitative difference in depression type or presentation which would make it hard to characterize in a binary way (i.e., antibaby women are or are not more depressed than other women).

If the first is true (antibaby pill depresses a small % of women who take it), we don’t only want to confirm it. We want to know why that is. Here are a few hypotheses.

A. The scientific literature is suggestive that maybe there are differences across the menstrual cycle in how stable, smart, and creative women are. (More on this later and thank you, Frau Doktor Obvious.) So naturally there is probably fluctuation in functioning across various important arenas that keys into fluctuation in hormones. Perhaps hormonal antibaby measures help to level out higher cognitive-emotional highs and lower lows. So women on birth control who are depressed experience a more even (and thus possibly more persistent, depressed) state than their non-hormonally medicated counterparts who would sometimes feel great but at other times feel bad enough that they get admitted to the psych ward. (That would be measurable if you asked women how they were doing while tracking their cycles, which existing fertility tracking apps are capable of doing… except usually women on the pill don’t use those apps, and anyway it’d be better to get experimental than observational data if possible.) Let’s call this the boom and bust hypothesis.

B. Could also be that some women are sensitive to the synthetic hormones used in hormonal birth control in a neuropsych context. They could have a kind of inflammatory, autoimmune, or allergy-related reaction. We know depression is characterized by chronic low-level inflammation, and not much more about that facet of it. But that could be a hint of a mechanism linking birth control and depression. Call this the inflammation hypothesis.

C. Could also be that mimicking pregnancy (which hormonal birth control does in a way) without actual pregnancy makes women sad cos their bodies / brains know they’re not really pregnant. I don’t know how this would work, it’s just an idea. Organisms are not stupid and this hypothesis could also include super-simple mechanisms like the obvious psychological one—some women really want kids but take birth control anyway, and that’s depressing. Call this the missing pregnancy hypothesis.

D. Come to think of it, could be that delaying/preventing pregnancy overall changes the modal state of fertile adult women from pregnant/lactating (majority of the time) and fertile (minority of the time due to pregnancy/lactation), to non-pregnant and non-fertile. That changes a lot of things, not just the stuff the birth control itself directly rejiggers. For instance, it changes lifetime exposure to estrogen, and it looks like that affects Alzheimer’s risk. (Pregnancy appears to be protective against Alzheimer’s— so this story might also jibe with the inflammation hypothesis. Since inflammation is implicated in depression and Alzheimer’s alike, although we don’t begin to know the causal arrows in either case.)

So… How many women’s doctors have told them that the pill increases some cancer risks as well as depression? How many women’s doctors know that decreasing lifetime fertility can adversely impact Alzheimer’s risk? With rare exceptions, these things are just not discussed in general care settings. We have been engaging in a big medical-social experiment without fully informed consent. This is outrageous. Except this happens all the time and it’s called modern medicine.

Most people would probably still make the trade-off between their best birth control method today, and fewer kids in 1, 5, and 10 years. But that’s not a trade-off we’ve explicitly made. The lifetime medical implications for women of having effective birth control may be non-negligible even as the lifetime professional and personal implications for women and society of women having effective birth control are so staggering that we don’t need to do the math to know the score. It’s not fair but it’s true, and no one talks about it. The impact of that silence is that we don’t get more needed research on what in the world is going on here.

Anyway, let’s say previous female generations’ greater cumulative lifetime pregnancy exposure was protective against depression, or inflammatory processes that correlate with and might both cause and be caused by it, or something else that matters here. Call this the my once-starving Romanian great-grandmother was perfectly healthy after having seven kids without ever being offered a condom, but I’m allergic to everything despite having great medical care, hypothesis. Wait, that’s too long. Ok, the cumulative pregnancy exposure hypothesis.

That’s plenty of hypotheses. But those only deal with the depression effect if it’s real. What if it’s not?

What if women on the pill are just more plugged into medical care, and so it looks like they’re more depressed cos they get more depression diagnoses and treatment cos they’re getting more medical care? The healthcare access hypothesis.

What if women on the pill just think they’re more depressed for some reason even though they’re not? Could be a nocebo effect, and this is not without precedent in this context. Lots of women believe that hormonal birth control causes weight gain, when really the passage of time correlates with weight gain (we think). They are just looking for a reason for the weight gain, or a visible effect of the birth control, or both. Could also be women on the pill think they’re more depressed but are actually not, because they’re just thinking about themselves and their mental states more because of some sort of self-selection that underpins the decision to take antibaby measures. Or they just expect bad effects, so they see them (expectancy effects). So this is the something is wrong with me hypothesis… or, perhaps snappier but less politically correct, the hysterical women hypothesis.

I dislike this hypothesis precisely because it keys into stereotypes about hysterical women making up problems. But… There is some support for it in the literature. But that support contradicts other findings in the literature. Hormone levels do so affect cognitive and emotional functioning according to lots of research. (It’s also obviously true.) So it’s really weird to come across papers denying that.

What’s up with this apparent scientific support for the idea that hormonal birth control’s apparent deleterious psychological effects on some women are psychogenic or psychosomatic? And if this question was settled back in 2004 at the latest, then why does research to the contrary persist? The review article in the penultimate link says:

Seven small randomized-controlled trials were found in a review of the literature which studied this hypothesis [i.e., emotional side-effects of hormonal contraceptives come from pharmacologic versus psychological mechanisms] in a direct way. They do not support the origination of these side effects being from the pharmacological properties of hormones. No association was found between hormone levels and emotional functioning in females.

Stephen A. Robinson, Matt Dowell, Dominic Pedulla, and Larry McCauley, “Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?” *Medical Hypotheses*, Vol. 63, No. 2, 2004, p. 268-273

Wait… What? What exactly were those studies saying that hormone levels don’t affect women’s emotional functioning? Who funded them? How many subjects did they have? Is there any clue about why their findings apparently contradict a lot of other research out there, while supporting the hysterical women hypothesis that psychological effects of hormonal birth control are all in women’s heads?

Luckily, these questions are easy to answer because when you go from the marvelous free database that is PubMed to the publisher’s website for this article, the relevant PDF is available for purchase from ScienceDirect for $35.95. Because academic publishers are evil and Aaron Swartz is dead. It’s almost like one set of institutions (academic publishing) colludes with another (academia) to hold a grip on information the public has mostly already paid for (with tax money to science and education), because profit is all they care about.

Hey, I know. Maybe women on the antibaby pill are more depressed than women not on it because they spend less time worrying about getting knocked up or finding non-toxic fingerpaints, and more time thinking about the state of the world.

Moving on, what if the depression effect is real but not? What if antibaby women’s depression is just occurring in a different pattern than that of women who aren’t on hormonal birth control? This possibility is almost the same as the very first, the boom and bust hypothesis. It’s just a little more generally formulated, and it recognizes that the hypothesis doesn’t necessarily belong in the “this link is real” hypothesis category. That categorization assumes too much. But for simplification purposes let’s just going to collapse this last possibility into the first and move onto theoretical moorings and empirical possibilities for testing these hypotheses.

Theoretical Support

One could think of additional theoretical support for each of these hypotheses. But that would take way too long for a random blog post. Instead I brainstormed ways to test each hypothesis instead because that’s fun.

It’s also arguably logical here because any information we glean about possible causal mechanisms supporting one theory over another from experiments testing each theory is bonus; any new information about this mystery is valuable. It is so crazy that we have been running this huge social experiment of hormonal birth control for roughly half a century… And don’t have some of these really basic questions answered about how it affects mental health.

Experimental Fantasies

Recap: In the world in which the depression-birth control link is small but real, we need to consider the boom and bust, inflammation, missing pregnancy, and cumulative pregnancy exposure hypotheses. In the world in which it’s not, we need to consider the healthcare and hysterical women hypotheses. There is an in-between world in which the link is qualitative, the real story is about different patterns or manifestations of depression rather than quantitative changes in depression incidence itself. But we are ignoring that world because it kind-of fits into the first world alright for now, under boom and bust.

These are my favorite study ideas for moving this puzzle forward in as compact and comprehensive a fashion as possible. They run from observational to experimental and easier to harder, and ideally one would do it all. But in reality, probably no one will do any of these things.

First, one would want to test inflammation by comparing serum levels of standard inflammation markers like ESR and CRP in hormonal birth control and non-hormonal birth control groups containing depressed and non-depressed women. Ideally this would be experimental data, but in practice you’re getting observational data and it already exists. Someone just needs to look at the Danish registries’ data again, or another Scandinavian state work of data art. It would be really interesting to include in the study some autoimmune response markers if possible, even just the most general ANA. Since inflammatory, allergic, and autoimmune responses share correlates, might exist on a spectrum in some ways, and are all seemingly increasing in modern life, particularly in the realm of autoimmune diseases for women.

(It might also be interesting to see if there are “time capsule” samples one could cross-reference to check changes in these markers over time—like was done to show rising incidence of celiac, to test for changing base rates of inflammatory markers. But that’s less likely to be possible in women’s health research specifically, since women weren’t well-represented in the armed forces 50 years ago—the celiac samples came from the Air Force… And female subjects who can at all possibly get pregnant are still not all that well-represented in medical research studies today. Women’s bodies are considered riskier and so research on women’s health suffers… At least until more women are in charge of it in a way that lets them freely choose to experiment on themselves.)

Another cool thing one could do with good, big observational data like this is look at cumulative pregnancy exposure and related outcomes broadly conceived, like depression diagnosis, suicide (an extreme proxy measure of depression, one might say) and some pre-determined hunk of problems associated with inflammation (qua depression correlate). This would go some way towards testing the inflammation and cumulative pregnancy exposure hypotheses.

The remaining hypotheses seem like they would be best tested through experiments. To see what’s in the realm of possible there, I looked back at this great study on mifepristone (aka the abortion pill). Researchers studied the effects of low-dose mifepristone on the endometrium of 90 women for six months. They found mostly suppressed ovulation and menstruation. No menstruation is a huge health benefit for most women.

They also found no pregnancies. That is a high efficacy rate for birth control, although of course more research would help better assess how effective and under what conditions compared to which alternatives this method really is.

And they found “Because follicular development is maintained, the endometrium is exposed to estrogen for prolonged periods unopposed by progesterone.” I’m not sure what that means, but it sounds like it involves overall less tinkering with natural hormonal balance than any hormonal birth control. That could be good, could be bad, we don’t know yet (afaik).

But we do know a few useful things from this awesome study that has probably not gotten enough play just because people are afraid to try new things and mifepristone/misopristol are associated with (gasp!) abortion. First, there is already a viable alternative to hormonal contraception that appears to be equally effective, non-invasive, temporary, and safe. It’s just not in wide use at all, and it’s not clear why.

Second, six months apparently qualifies as long-term on PubMed (… but not on OkCupid).

And third, it’s now ok to call amenorrhea (the medical condition of not getting your period) a health benefit. This seems like some form of progress. It’s often said that their creators put a dummy week in earlier hormonal birth control pills in order to reassure women they weren’t pregnant by giving them withdrawal bleeding. But now we have easy access to early pregnancy tests, we know regular periods are not necessary for women’s health, and it’s become ok to say in a scientific journal that not getting regular periods would be great, would be a health benefit, without hedging about the valence of this. So that seems cool. Medicine tricks women less, women’s quality of life improves, and one more gender taboo shatters.

Why not build on this mifepristone research by pitting low-dose mifepristone against low-dose progesterone-only hormonal birth control (the best tolerated and least risky for most subgroups of current antibaby pill formulations) in a randomized controlled double-blind trial to see how depression incidence compares across groups? That’s not a meaningless rhetorical question. It’s actually a really important one. Because holy shit, mifepristone has also shown promise in rapidly reversing psychotic depression.

This finding might make sense as an inverse corollary to the antibaby-depression relationship, since most hormonal contraception uses (at least) progesterone, while mifepristone’s mechanisms include progesterone receptor antagonism. So progesterone and mifepristone are sort-of opposites in one of the ways they work on hormones. So it makes sense that if progesterone causes depression in 1% of women, then a chemical that screws with progesterone receptors could similarly decrease depression in some small percentage of women.

The prevalence of depression with psychotic features is also in the neighborhood of 1%. That fits. So we really want to see low-dose mifepristone and low-dose progesterone pitted in an RCT to see if depression, and especially psychotic depression, decrease in the former at about the same rate that they increase in the latter. Because that would potentially solve the puzzle in a mechanistic sense while also solving it in a practical sense. Or at least, it would strongly suggest that women who do poorly on progesterone should try mifepristone instead—and that instead of making their lives worse (more depression) while making them better (antibaby), it might make their lives better (less depression) while making them better (antibaby). Isn’t that what medicine is supposed to do?

I hope I’m wrong about the politics of all this, and this experiment has already been done or is in progress / planning. But I’m afraid we’re not getting this mifepristone v. progesterone RCT. Probably it hasn’t happened yet because people are afraid of new things and “the abortion pill” is controversial. That is stupid and wrong.

You might say well, the design is perfectly feasible, the idea is promising, and so this will probably be executed somewhere abortion is less controversial in the next 10-20 years. But then you would not be looking then at mifepristone’s history of being pulled from the German market for not being profitable. For all the wrong reasons, there is not good current access to and further research on “the abortion pill,” which probably should be better known as “the birth control pill that doesn’t occasionally give you depression or cancer.”

Here is a less feasible mifepristone RCT design: Treatment group gets standard hormonal contraceptive, control group gets no active birth control but takes a dummy pill instead. Plus everyone gets a nice dose of mifepristone/misopristol to induce abortion every month in the event of pregnancy. This would test the missing pregnancy hypothesis that it’s fooling the body/brain/organism into thinking it’s pregnant when it’s not that makes some women depressed on the antibaby pill. Because they would actually be probably pregnant, but aborting every month (or every three months on average), instead of discovering it.

On one hand, if you see no increase in depression in the pregnant and aborted group, but you do see increased depression in the hormonal birth control group, then it looks like support for this hypothesis. On the other hand, this is a terrible idea. Are blindly, temporarily pregnant women really the right control group here? There’s not a better option. But it also seems obvious that the hormonal changes of early pregnancy will be more depressing than the hormonal changes of being on hormonal birth control. So you can’t really test the missing pregnancy hypothesis with this design. Maybe you can’t test it adequately with any design. You also can’t test the cumulative pregnancy exposure theory adequately with this design, cos month 1 of pregnancy repeated represents a different cumulative hormonal exposure than months 1-x repeated. (There might also be a few minor ethical issues in a study that intends to let some women get pregnant and then quietly give them abortions without informing them at any step per se, nbd.) 

A more feasible (but still not terribly feasible) RCT design: women are randomized to be on and off hormonal birth control, with the control group blinded with dummy pills. They do daily (or maybe 3x/weekly is enough) real-time cognitive and emotional check-ins regarding mood and body temperature to test the boom and bust theory. Everyone uses a back-up, non-invasive birth control method like condoms. This seems totally possible with current tech, in terms of having a smart-phone app asking women questions regularly and getting them to answer in real-time, more or less.

This study is still not terribly feasible for two reasons. First, because no one is going to be on birth control and use condoms at the same time, right? Maybe someone would do it for science; but then again, maybe they shouldn’t. The hassle is just so much larger and the potential pay-off so much smaller than in the mifepristone v. progesterone RCT. But… If people would do it, then maybe we would learn whether hormonal birth control really causes depression or just levels out normal mood fluctuations over the cycle. Second, the real reason this study hasn’t happened and is unlikely to happen anytime soon is that no pharmaceutical company seems likely to profit from its results either way. Unless I’m missing something and it’s all been done?

One could similarly envision a study doing real-time cognition/mood checks on women using hormonal birth control and women with no birth control access. That would test the medical care access hypothesis. But it would also be hugely unethical because honestly, if you’re talking to women without birth control access, it should be to help them have better healthcare and not to study how that lack of access affects their mental health.

So what about a volunteer study running “long-term” (six months) that just asks women to let themselves be randomized to different established birth control methods? Hormonal (treatment) or other (control). If you really wanted to standardize it, you could specify low-dose progesterone and copper IUD since those are probably the least risky and most effective options in the best-established hormonal and non-hormonal groupings of options. And of course match the groups on relevant measures like prior depression. On one hand, surely this has been done. On the other hand, there is such a crazy amount of basic research that has not been done in a sound way when it comes to women’s health.

In part this is for nefarious reasons having to do with profit and sexism. But why turn to those explanations when there are also completely innocuous ones staring us in the face? Other people and institutions have been afraid to experiment on pregnant women or women who could become pregnant, for fear of doing harm. That is a good and appropriate fear. As an unintended consequence, however, this pattern harms women when we wind up with less informed choice on important medical/lifestyle issues.

But women are (in some countries and contexts) allowed to experiment on themselves. It’s possible to access both low-dose mifepristone and low-dose progesterone in a lot of places. And it’s possible to participate in a study with other people who can access them, too. So the best study I can think of to address the birth control-depression paradox is unlikely to be run in the usual way anytime soon, but maybe it can happen anyway…

I didn’t mean to come back to this, but now it makes the most sense as a closing. I really hope some badass, somewhere, someday will code an open science platform that helps more people design and participate in more research. (Or does this already exist?) It would be like Reddit for methodologists, or an interactive XKCD for nerds. (Oh wait, that’s XKCD.) There are just too many unanswered questions, and too many smart people out there willing to help answer them… with a little (structured) help from their friends.

It’s spring, and I’m so happy for the light… Moving again in my studio… Making like a happy animal with the season.

One of my first book-rewards (beginning the obligatory post-publication binge) was Derek Walcott’s Omeros. Still rereading favorite passages…

1. Reversible World

“I re-entered my reversible world. Its opposite
lay in the autumnal lake whose trees kept still
perfectly, but where my disembodied trunk split

along the same line of reflection that halved Achille,
since men’s shadows are not pieces moved by a frown,
by the same hand that opens the willow’s fan to the light,

indifferent to who lifts us up once we are put down,
fixed in hierarchical postures, pawn, bishop, knight,
nor are we simply chameleons, self-dyeing our skins

to each background.”

—DW O, Chapter XLI, II

2. Days When

“There are days when, however simple the future, we do not go
towards it but leave part of life in a lobby whose elevators
divide and enclose us, brightening digits that show

exactly where we headed, while a young Polish waitress
is emptying an ashtray, and we are drawn to a window
whose strings, if we pull them, widen an emptiness.

“We yank the iron-grey drapes, and the screeching pulleys
reveal in the silence not fall in Toronto
but a city whose language was seized by its police,

that other servitude Nina Something was born into,
where under gun-barrel chimneys the smoke holds its voice
till it rises with hers. Zagajewski. Herbert. Milosz.”

—DW O, Chapter XLII, I

3. Rain Lost Its Reason

“He had never seen such strange weather; the surprise
of a tempestuous January that churned
the foreshore brown with remarkable, bursting seas

convinced him that ‘somewhere people interfering
with the course of nature’; the feathery mare’s tails
were more threateningly frequent, and its sunsets

the roaring ovens of the hurricane season,
while the frigates hung closer inland and the nets
starved on their bamboo poles. The rain lost its reason…”

“… and behaved with no sense at all. What had angered
the rain and made the sea foam? Seven Seas would talk
bewilderingly that man was an endangered

species now, a spectre, just like the Aruac
or the egret, or parrots screaming in terror
when men approached, and that once men were satisfied

with destroying men they would move on to Nature.”

—DW O, Chapter LX, I

Omeros, published in 1990, was obviously speaking to climate change in this passage. The rest of the chapter speaks to the biodiversity crisis and overfishing. It is disconcerting to remember not just that scientists have been warning us about all this for a long time. But that artists were making beauty of the warnings. So that did not work and we cannot really address reality by making art celebrating beautiful nature, warning of its destruction, or both… But then what do artists do? (Ok, tautology: Artists make art. But we still have to think what engagement looks like in this context.)

4. That Other Sight

“O Sun, the one eye of heaven, O Force, O Light,
my heart kneels to you, my shadow has never changed
since the salt-fresh mornings of encircling delight

across whose cities the wings of the frigate ranged
freer than any republic, gliding with ancient
ease! I praise you not for my eyes. That other sight.”

—DW O, Chapter LIX, II

Idea-seeds take the time they take (and maybe they, too, need the spring light to poke through). I read Walcott in October and just painted one thing I sort-of like (this last one, of all the above) from/with/to/for those favorite passages.

Similarly, I’ve been thinking about Chagall’s “Atelier de Nuit“—made when he was 93!—since visiting Cologne last winter attempting to pitch galleries… And managing only to review Rosenquist et al and pick up some free art books instead (thanks, Galerie Boiserée).

Then in October, after a conversation with a friend who wants to “change the system from within,” I had an idea… and sketched a chicken eating a worm flying out of Baba Yaga’s chicken-legged house’s chimney while a Chagall-inspired nocturnal woman-spirit flying out of the house’s top level watches. I couldn’t have painted it a day sooner, although the sketch has been lying around all this time. The spring light is so good…

Except for its terrible habit of fading at the end of the day.

“Yes, we can!”—sometimes be bothered to eat a few more salads when the future of humanity is at stake. But should we?

“The world needs your salads,” said fair Hanka during the awful summer heat, and the recent EAT Lancet report on healthy nutrition within planetary limits proved her right. So here again are a few of my favorite gluten-free, dairy-free recipes this season.

Almost-pudding breakfast cocoa

If you stop doing normal things, like the young climate activists who have stopped going to school on Fridays , perhaps the world stops spinning (at speed) towards its hypernormalised disasters. Even going to school to prepare for a future marred by climate change. Even staying up late before drinking coffee first thing in the morning. You cannot overthrow the government in the age of mass surveillance, but you can change your daily life. Thus the current wave of climate diets promoting mainly less or no animal product consumption (low-Moo and no-Moo, if you will)—under the auspices of advancing individual and planetary health.

Go to bed early before rising in the pre-dawn darkness to play the piano and make cocoa. In a roughly bathtub-sized mug (holding about 1 3/4 cups), mix a stirring spoon and a half of honey with five spoonfuls of unsweetened cocoa and a dash of cinnamon. Heat a shy, small cup of unsweetened almond milk plus a splash of rice milk (to sweeten) for about a minute and forty seconds in the microwave. Then dissolve honey-cocoa paste in warm (not hot) milk. The idea is to make it warm enough for comfort, but cool enough to not destroy the honey’s enzymatic magic. (Acacia, manuka, chestnut, and other honeys have anti-microbial and cytotoxic activities.)

In the now-empty smaller cup, heat half the creamy top of a can of coconut milk for about a minute. Add to cocoa bath. Stir smooth.

Enjoy warm and feel empowered to assist in making the world a better place. Although, like many vegetarian recipes, making this for breakfast regularly might increase your consumptive production of nefarious waste materials including plastic, because it’s hard to buy non-dairy milk in paper or glass containers. (So you’ll just have to eventually experiment with making your own, which turns out to also cut climate costs by holding out water and thus involving lighter shipping.) A regular cocoa habit also might increase your contribution to deforestation—which in turn contributes to climate change. So if a good measure of your daily caloric intake comes from cocoa, then you’re probably among those with flexitarian, vegetarian, and vegan diets who manage to have worse environmental impacts than some omnivores. (On the other hand, if much of your daily caloric intake comes from cocoa, maybe you need it for medical reasons.)

So climate diets show both ying and yang of simple, everyday disruptions as political actions. Yes, we can change the world: You can taste it. And as Paul O’Neill’s work has shown, sometimes successfully disrupting one small set of habits can actually lead to much larger-scale transformations. Once we see for ourselves the evidence that we ourselves can really affect change—well, we can change.

At the same time, trying to eat vegan often shows people how hard it is make dietary choices that are good for our bodies and the planet. Not everyone adjusts (digestively speaking) to diets reliant for protein and other nutrients on seeds, nuts, and beans. Not everyone has the time or inclination to puzzle out how to keep buying local over factor-farmed (which reduces climate impact as well as having other merits), when the obvious meat replacements like tofu tend to come wrapped in plastic from much farther away than the local commune. Actually looking at the environmental life cycle of the goods and services we consume and how they affect our health—and questioning why our consumer choices seem to exist in a defection-rich, information-poor decision environment oddly divorced from politics—is much harder than embracing simplistic, individualistic decision rules. The marketplace of grub, much like the marketplace of ideas, is neither transparent nor ideology-free.

And satisficing simply does not work here. Just eating less animal products is not good enough because you must also avoid single-use plastics. Just eating local is not good enough because you also need to worry about the impacts of what you consume on the soil, the surrounding ecosystem, and the atmosphere. There is a whole Calder-esque mobile of concerns to evaluate in a constant learning process. As a stationary resolution with simple decision rules, one might be forgiven for writing off the whole enterprise. Climate diets are a good and noble idea in theory, but they can easily fail in nutritional, planetary, and political practice where the reality of making (and digesting) dinner begins.

And yet: It is corporate interests that set them up to fail. Human (and other animal) health and planetary interests demand that we fail again, fail better in the learning process of being good stewards of ourselves, one another, and our home planet. For this to be fun, we have to see it as a process, like having better infosec, or adulting.

William Blake once wrote: “I must create a system, or be enslaved by another man’s.” We must create a system of assessing and limiting (including by causing corporations to limit) lifecycle environmental costs. One that does not, like calls to binary and increasingly tribalistic decision rules, reduce the complexity of this task beyond its utility. The movement to address global environmental crisis with consumer diet and lifestyle choices distracts from the larger structural issues in play. Keep the empowerment and toss the myopia like a bit of skin that has formed on top of an otherwise perfect cup of cocoa.

Ingredients

5 spoonfuls unsweetened cocoa
1.5 spoonfuls honey
dash cinnamon
shy cup unsweetened almond milk
splash rice milk
1/2 the cream plus a little liquid from a can of coconut milk (i.e., one can’s worth of coconut cream yields two cups of cocoa plus some leftover milk, useful in things like vegan café au lait and amaranth-coconut porridge)

Amaranth-coconut porridge (aka cream of wheat for weaklings)

Amaranth is a tasty grain that won’t kill you if you’re medically allergic to gluten. Coconut is a tasty milk that won’t kill you if you’re medically allergic to milk. Put them together, and you get cream of wheat that won’t kill you if you’re allergic to cream and wheat, in which case you’re a weakling who will probably be among the first to die in the coming end times we’re not to call that because apocalypse is somehow the domain of right-wing nutjobs even as climate scientists, biologists, and other witnesses of the current harbingers of global ecosystem collapse are screaming. Comfort foods are important.

Combine 1 cup amaranth with 2 1/2 cups coconut milk in a medium-sized pot with a lid. If you’re using a normal can of coconut milk, skim and save the cream off the top make creamy, almost-pudding breakfast cocoa, mashed potatoes, or veggie mash later.

You could use a commercial non-dairy milk (“mylk”) preparation instead, but… These will tend to be sold in plastic-containing containers as opposed to cans (avoid plastic). They will tend to be less rich than coconut due to lower fat content. Relatedly, they’re also typically more processed, and higher in added sugar in one form or another—all factors that can lead foods to contribute to overweight/obesity since they correlate with less food value and less satiety alike. So unless you have real food allergy / intolerance issues, real milk in moderation is probably better for you than mylk, and less-processed non-dairy alternatives are similarly probably better for you than more-processed ones.

In this and other contexts, veganism is more complicated as a personal and planetary health strategy than it might seem at first glance. Given baseline food security, it would probably be better for both individuals and the planet for people to simply fast more / eat less, than to embrace a particular diet such as veganism that seems quite vulnerable to corporate cooptation and that, done wrong, can easily harm people and the climate alike. There’s a broad array of suggestive evidence for the individual health benefits of fasting and calorie restriction, to say nothing of the power of hunger strikes, boycotts, and other forms of directed non-consumption to help people affect political change—most famously in the cases of Gandhi and Rosa Parks and the Montgomery Bus Boycott.

So the satisficer’s climate diet looks more like fasting or calorie restriction than veganism, and the radical’s climate diet looks more like organizing collective boycotts of the worst environment offenders at whatever level works best politically than individual non-consumption. You could argue this boycott of the worst is sort-of already what climate diets do, since livestock make huge amounts of greenhouse gasses. But, because it is hard to calculate full environmental life-cycle costs of meat and dairy alternatives, eating less period makes more sense than eating different things. Harnessing that to a non-violent resistance strategy such as the hunger strike would maximize the strategy’s efficacy by framing it in explicitly collective, political—as opposed to individual, personal terms.

But that then requires slightly more organization and communication than simply making breakfast. Bring amaranth-coconut mixture to a boil on high heat. Add a dash of cinnamon and salt. Cover, turn down to medium-low heat, and simmer until grain absorbs liquid and the consistency is softer, like cream of wheat (about 20 minutes). Remove from heat and let sit to thicken and cool (10 mins).

As with any bowl of grains, there are many ways to dress this up. Some people like cream of wheat and its allergen-free subsidiaries (“cr34m %f wh34t?”) with a bit of butter and sugar—by which is meant here deforesting palm oil-free, non-dairy butter that you have magically procured without consuming plastics, and a lower glycemic-index sweetener like maple syrup or coconut sugar. Another alternative is breaking up pecans and walnuts with diced dried fruit (figs, apricots, cherries) and cocoa nibs on top. Hot berry compote or fresh berries can be used in place of dried fruit, too.

To make hot berry compote, throw your favorite berries in a pot. Frozen berries are a good year-round staple, as (especially in winter) fresh ones can come from too far away to be environmentally responsible. Shipping contributes to ever-rising greenhouse gas emissions. So at least until environmental impact information is listed on foods for consumers to evaluate and compare, just like nutrition facts labeling, one will be forever juggling and imperfectly weighing guesses of emissions contributions including greenhouse gas production (cattle burp—a lot), greenhouse gas use in transit (shipping from afar versus buying local adds up), and other factors.

Frozen produce can often be had from closer to home even out of season. It’s also (usually) cheaper than fresh, and is supposedly among the highest-nutrient you can buy (since produce that’s fresh-frozen can maintain more nutritional value than produce that’s been transported long distances without refrigeration).

Boil fruit on high heat briefly, until it bubbles. Then turn down the heat and stir frequently until the mixture becomes thick and smooth (10-15 minutes). Pour compote over porridge and enjoy.

Serves two, or keeps a day on the counter / four days in the fridge. Vegan fare tends to be easy like that—less temperature-sensitive and prone to spoiling. So at least weaklings like me will know how to cook breakfast without refrigeration when collapse comes. Does anyone know how to make a fire?

Ingredients

1 cup amaranth
2 1/2 cups coconut milk (buy a few cans and save the cream off the top for later)
water
dash cinnamon, salt

(optional)
vegan butter, maple syrup, crumbled nuts, dried / frozen / fresh fruit, cocoa nibs

Quinoa is the new PB&J

[Note: It has been brought to my attention that PB&J is an American delicacy with which few Europeans are familiar. It stands for “peanut butter and jelly,” a popular sandwich type in which processed “peanut butter” composed mostly of trans fat, salt, and sugar is wiped down one side of a slice of “bread” (so-called although its substance is entirely different from that of bread in the rest of the world) while “jelly” or “jam,” a form of colored sugar sold in jars decorated with matching fruit pictures, is wiped down one side of another slice. Then the wet sides are stuck together and the creation is eaten for lunch—just like a regular sandwich made of actual food, but while corporations make more money.]

Rinse quinoa in a sieve. Then mix 1 part grain to 1.5 parts water (e.g., 1 cup quinoa to 1.5 cups water) in a medium-sized pot. Bring the mixture to a boil with a bit of salt. Turn down to medium-low heat, cover, and let simmer until the water is absorbed (20 minutes). Remove from heat.

Spoon a portion into a bowl. Top with your favorite nut butter (the less processed and fewer ingredients, the better). Add salt or white miso paste to taste.

Yes, white miso paste. Look: If you can’t have (glutenous) Vegemite, white miso paste plus margarine on toast is a close second. If you can’t have salted caramel chocolate (dairy), white miso paste plus molten dark chocolate on French toast is what you can have. And it is frickin’ delicious. Did you think this was all about saving the world? Fine. Only joy makes people kind and strong enough to save the world. White miso paste and dark chocolate are joyful. Ergo, white miso paste with melted chocolate is essential to saving the world.

Break up some of your favorite chocolate on top of the hot quinoa and nut butter mixture. Mixing unsweetened and 75% dark forms a nice, bittersweet complement to the sweetness of the hot berry compote (see previous recipe). Serve hot.

Leftover quinoa reheats well, keeps at least a week in a sealed container in the fridge, and is a nice addition to stews, casseroles, and salads—basically anything into which you might otherwise have thrown higher glycemic-index, glutenous pasta. Quinoa is cool like that. Adult lactose tolerance is normal only among some ethnic subgroups of whites, and gluten intolerance has various racial patterns as well (e.g., confirmed celiac disease is more common in Jews, and African-Americans are more likely to adopt gluten-free diets than their white counterparts even though doctors tend to be averse to calling that a known pattern of gluten sensitivity). But quinoa seems well-tolerated across populations in addition to being hardy and nutritious.

Thus quinoa seems increasingly important to the future of food security. If relatively market-dominant global grain crops suffer harvest failures due to climate change, quinoa will probably help feed the hungry world. Quinoa PB&J could really become “the new PB&J.” But with only Plumpy’Nut on top.

For now, forget Plumpy’Nut. Forget famines. Forget what you don’t or can’t have and focus on what you can. Melt more chocolate chunks on top, making a warm breakfast bowl that tastes like a combination of peanut-butter M&Ms and health-food store trail-mix. Filling, but not hopeful. Sweet, but somehow also unreal. Have another bowl while you still can.

Ingredients

quinoa
water
peanut butter
frozen berries for compote

(optional)
salt
white miso paste
part of a chocolate bar, chunked

Steckrüben stew

Steckrüben—Swedish turnip, rutabaga, pig feed, dinner. Dinner all winter long in Germany, 1916-1917, when bad weather killed grain and potato crops while wartime pressures including an Allied Blockade reduced trade and transportation, producing the Steckrübenwinter (aka the Kohlrübenwinter or Hungerwinter)—also known as the (slightly mistranslated) Turnip Winter or Hunger Winter. Hundreds of thousands starved. Those who subsisted did so on rutabagas and black-market grain mixed with straw and sawdust. Such a weak diet made for weaker people when the global flu pandemic hit in 1918, possibly helping the Allies “win” as relatively more food-insecure Germans fell ill and disproportionately died.

Although living memory of the Turnip Winter has faded, root veg remain staples of northern European winter cuisine. Today health foodies promote turnips and rutabagas as low-cal, low-carb alternatives to grains and potatoes for exactly the same reasons they contributed to mass deaths last century: they’re mostly water (and some vitamin C).

But as always with food, rutabagas are more than the sum of their nutritional parts: Steckrüben today speak of being warm inside when it’s cold out. A symbol of deprivation has become one of comfort. Especially when cooked and blended for stew.

Rinse, cut off the ends, and dice rutabagas into a roasting pan. Add the white and light green parts of a leek, some finely diced fresh rosemary, dried thyme, salt, pepper, oil, and other spices as desired. Roast on 200 C until a fork goes in easily (30 minutes).

Meanwhile, sauté peeled and minced garlic (4 cloves) and onion (1-2 medium-sized, any color), then carrot (2-3 carrots), then celery (2-3 stalks). Cook on medium heat, stirring until carmelization (browning) starts (15 minutes). Stir in a bit of beef bouillon and parsley. Set aside the mixture in an extra-large soup pot.

To that pot, add any leftovers that work well in stews (like mashed potatoes and chicken stock). Add the roasted rutabaga and leek, along with more parsley, bay leaves, other spices, and water up to about 3/4 of the pot’s depth, so it can boil without spilling. For spices, start with beef bouillon (or salt), pepper, paprika, cayenne, onion granules, garlic powder, thyme, oregano (this list so far comprising a standard cajun spice mix), cumin, curry, sage, and nutmeg. Go easy on the bouillon / salt—add a bit and taste to find what you like. Bring to a full boil, then reduce heat and let simmer until everything is soft (about 25 minutes).

Remove soup from heat and let cool a bit before blending in the blender until just smooth. Taste, adding more salt, pepper, and other spices as needed. The consistency should be thick enough to hold up a spoon—more like purée than soup.

Irony: A bland dish based on a vegetable Germans only began eating (instead of feeding it to pigs) due to wartime starvation has become a flavorful winter comfort food.

Decadence: Using this stew as a canvas for other flavors, like glazed pork chops, roasted veg, and greens, makes it even more flavorful and comforting.

More irony: One reason to preserve the memory of what to eat, how, during times of famine, is in case of future famine. Yet the inclination is to dress it up to suit the times. So the decadence helps transmit the specs of survival. Or so I like to think.

More decadence: For pork chop glaze, mix a few splashes of tamari (gluten-free soy sauce), about 1/4 fresh lemon or orange juice, a small spoonful of brown sugar, a clove of minced and smashed garlic, a tablespoon of finely diced onion, some heavy dashes of paprika, some smaller dashes of cayenne, a small dash of nutmeg, and a sprinkling of cumin, thyme, oregano, sage, pepper, and parsley on and over pork chops in a small pan. Bake on 180 C for 30 minutes.

Meanwhile, repurpose the earlier root veg roasting pan to roast diced fennel, tomatoes, and bell pepper, tossed with oil and spices. Fennel and bell pepper don’t need much more than salt and pepper—though garlic powder, onion granules, and paprika don’t hurt. Fennel and carrots are also nice with a pinch of sweet spices like fennel seed and dill; bell pepper with savory like thyme and parsley. Tomatoes and eggplant are best with their classic Italian spice pairings—basil, oregano, thyme, parsley, garlic, onion, and maybe a pinch of rosemary and sage. Lining veg up in rows with their own spicing in one pan makes for nice blending and variety of flavors. Bake on 180 C for 45 minutes, 200 C for 30 minutes, or until a fork goes in easily.

If these veg don’t call to you or you can’t find them, use something else. The humble onion—peeled, halved, and doused with oil and curry powder—roasts up into an amazing sweet but savory, mellow but pungent treat. As do apples and pears with cinnamon sugar. Or celeriac with “Scarborough Fair”: parsley, sage, rosemary, and thyme.

When the stew is fully ready to serve—blended and back in the pot, or even on the table—then wilt some dark leafy greens to serve on top. You can’t go wrong with good greens, hot oil, salt and pepper. Lots of paprika, little cayenne, and garlic powder go well with spinach (which wilts in about 5 minutes, including flipping halfway through). Confit garlic and chili flakes go well with kale (10 minutes). Leftover dark leek greens from the earlier set of roasted veg take a bit longer (20 minutes). All greens go well with the standard Southern flavoring of oil, salt, pepper, and pulled-off bits of leftover pork from the bones, especially with a bit of extra heat: chili flakes, cayenne pepper and paprika, sambal, or whatever is at hand…

After dinner, leftover porkchop bones can be thrown in the stew to flavor the rest of the pot, simmering on low heat for an hour or so before being placed outside to cool down for a few hours or overnight, so it doesn’t heat up the rest of the fridge contents. Yes, it’s true. If you eat meat at my house, it’s highly likely that I will (not even subtly) steal any gnawed bones off your plate to boil into soup later.

Restaurants do this, too; they just don’t tell you about it. Just as the ruling elite steal the gnawed bones of the former middle class’s remaining wealth to boil in the late capitalist soup of global collective action problems like the sixth mass extinction which has not yet hit the food chain long and hard enough that it has us living on rutabaga and straw. Meanwhile they get the public to believe (wrongly) that it has a choice in all this by controlling the media, universities, and all remotely governmental institutions through more or less rank corruption and authoritarianism made to look like consensual self-governance. If you don’t like it, of course, you can vote. Or eat less meat, stop flying, and take shorter showers.

But this choice set reflects a basic misunderstanding of power, making it seem as if the choices that you know you can make yourself are the only choices available. They are not. This is a facet ofmanufactured consent.

There is another way: Making large companies pay the costs of their own environmental degradation has to happen at the regulatory level to make the structural difference needed to actually cut greenhouse gas emissions. And individual self-blame for the ongoing harms of the corruption that keeps this from happening is disproportionate and self-destructive.

Discard boiled bones.

Ingredients

1-2 turnips
1-2 rutabagas
1-2 leeks
4 cloves garlic
2 onions, minced
2-3 celery stalks
fresh rosemary and parsley
dried spices: thyme, oregano, sage, bay leaves, paprika, cayenne, cumin, curry, onion granules, garlic powder, nutmeg
beef bouillon
salt, pepper
oil
water
leftovers at hand (e.g., mashed potatoes and chicken stock)

(optional, topping dishes for stew)
three pork chops
splash tamari
1/4 fresh lemon or orange
spoonful brown sugar
1 clove garlic
1 tablespoon minced onion
fennel, tomatoes, bell pepper / veg of choice
dark leafy greens
chili flakes, garlic confit, pork fat and leftover meat pulled from bones to flavor greens

Pink and purple soup and salad

Cold salads on cold days make cold hearts. But don’t despair! Salad can be hot. Salad can be sexy. Salad can be pink and purple.

Start with purple. Brush the dirt off some firm local beets. Cut off the ends and any ugly bits, and discard. Dice what remains. Dump in a steamer in a pot with water underneath, cover, and turn on high heat to boil. Check occasionally, adding water as needed, until you can stick a fork in the beet (15-20 minutes).

Meanwhile, rinse and dry a room-temp organic grapefruit. Grate the zest (just the colored part of the rind—see Zest, below). Set aside. Then finish cutting the white part of the remaining rind off the fruit flesh (if your people won’t eat it), and dice the flesh. (Or simply dice the whole remainder and try eating the white rind along with the flesh; but know, dear reader, there is a discrepancy regarding whether or not this qualifies as food.) Set aside in another separate bowl.

Remove steamed beets from heat. Mix beets, grapefruit flesh, vinegar (balsamic and red wine are nice), and a pinch of zest. Orange is a good alternative if grapefruit is too bitter.

In the beet-steaming pot, keep any leftover purple water and add about a cup of frozen blueberries and raspberries plus a fresh-diced pear or apple if you have one handy. Bubble over medium-high heat, stirring frequently, with a touch of cinnamon, until thick (10 minutes). Blend. Serve hot with pink and purple salad on the side. Always wear white while cooking beets and blueberries, or executing convicted former fossil fuels executives for crimes against humanity.

Ingredients

beets
vinegar
grapefruit and/or orange, room temperature
frozen berries
cinnamon

(optional) pear / apple

Liver pâté

Women have needs. Sometimes we need it big, thick, juicy—and full of heme iron, the more readily absorbable type found only in meat. All this talk of climate diets and ways to popularize them more widely (e.g., by making meat much more expensive) makes you wonder: When is this “need” really a medical need? At what level of low hematocrit / hemoglobin does your anemia warrant tasty treatment? Who would define that, for whom, and for what purpose? Are you going to need a doctor’s note to get a steak after your period under the Green New Deal? Surely you’ll still be allowed to do something with chicken livers, since no one else seems to want to?

Buy a tub of raw livers (usually they’re about 400 g). Rinse and pat dry with paper towels. Getting rid of the extra liquid makes the liver pop less in the hot oil during cooking, though a metal mesh shield over the pan is also recommended for frying any kind of meat. Set aside to reach room temperature before cooking.

Mince 2 cloves of garlic. Peel and dice a medium-sized onion. Melt two spoonfuls of coconut oil on high heat in a small saucepan. Coconut oil is good for cooking because of its high smoke point (meaning it doesn’t oxidize and make carcinogenic compounds as quickly as lower smoke point alternatives). But it’s especially good for cooking decadent dishes like this—fare that is meant to be rich and heavy. Add garlic and onion to hot oil, stirring to avoid burning and turning down to medium heat until the mixture is soft enough that a fork goes it easily (8 minutes). Set aside in blender.

Melt another few spoonfuls of coconut oil and add a cored, diced apple to the pan. Sauté until it turns translucent (6 minutes). Grannysmith apples are the lowest in sugar and thus are the default choice in healthy cooking; their tartness (which some like and some don’t) doesn’t tend to impact the final flavor. Add to blender.

Melt another few spoonfuls of coconut oil in the pan. Add livers, seasoning with salt, pepper, and other spices. Celery seed and thyme are essential; dried parsley, sage, rosemary, and oregano are nice additions. Cover with the wire anti-spatter mesh and cook for a few minutes on medium to medium-high heat on each side. Liver is done when it doesn’t have a pink spot in the middle of the thickest piece. Add cooked liver to the blender and blend until smooth.

Decant into a bowl. Serve hot (or rewarmed) with crudités like celery and carrot sticks, and salad on the side. Fresh parsley leaves on top add a nicely bitter, clean complement to the pâté’s sweet richness.

Or you could just eat dirt. Clay, to be more precise. So what if liver has iron? Clay has iron. That iron is not bioavailable and clay actually inhibits iron absorption. But it sure is eco-friendly! Plus it doesn’t suffer at slaughter, not being sentient. Hell, it’s done enough damage to your granma’s sofa: Clay deserves to be eaten.

Look. If you’re going to tell people to stop eating meat without respecting huge individual variations in dietary needs… And their intersections with hugely common and consequential public health problems like iron-deficiency anemia… And the research suggesting that moderate red meat intake as part of a healthy diet helps women avoid depression and anxiety…

… Then you might as well be telling people to put down their liver pâté and eat dirt.

Ingredients

6 small spoonfuls (about 4 tablespoons) coconut oil for frying, divided in three
2 cloves garlic
1 onion1 grannysmith apple
1 batch raw chicken livers (about 400 g)freshly ground salt and pepper (about 2 and 12 grinds respectively)
spices: celery seed, thyme, etc.

(optional replacement for all other ingredients: clay)

Zest

Sounds happy, full of life, and free! And yes it is, it is SO a food! Eat it, because the future will be none of these things if we do not take decisive action to mitigate climate change now.

You know the science—and what it means for humanity and other life on earth. You’re already a flexitarian lacto ovo pescatarian, as well as an ordained Pastafarian. You even see the traps that ensnare your fellow conscientious folk: Consuming more plastic the more vegan you eat. (Save the planet, kill the oceans?) Cancelling out the positive climate impacts of your fruitarian phase by flying to New Zealand to do it. (At least the berries were local.) You’re a dedicated hipster climate activist among climate activists: Why, you were skipping school before Greta Thunberg was even born. (Like that’s hard.)

But you still make food waste, contributing an estimated 8 percent of total global greenhouse gas emissions. Not all of it from your fridge, to be sure. Still, this is one of the parts you can control, one of the things you can do, one of the small individual or household behaviors you can modify while the Saudis keep pumping 11 million barrels of oil a day. Not sure why you’re working the problem this way instead of flying planes into their palaces, but haha you can’t say that unless you’re joking, I slay me with a bone saw.

Buying less and experimenting with using every part of the animal, vegetable, or mineral is a good rule of thumb for cutting food waste. (Thumb… Cut… Damn you, Mohammed Bone Saw.) Amazing chicken or beef stocks and fish fumets come out of leftover bones and shells. The chopped-off, frozen ends and organic, rinsed peels of onions, garlic, carrots, and other veg can be boiled with leftover bones to make these broths even more flavorful and nutritious. Similarly, citrus peels and the pungent zest they yield, according to my partner, are not food; but we have our differences sometimes and we still love each other a lot.

To eat citrus peel, which is a nutritious and delicious food if you ask PubMed and me, get your favorite citrus fruit. It makes sense to buy organic for this since you are at least experimenting with eating the otherwise chemical-sprayed peel. Scrub it with a sponge, rinse, and dry. Then get out something sharp. No, not the bone saw. Put that thing away and move on like a responsible, smirkingly murderous, unaccountable royal ass.

Here you want to use something like a zester. Apparently some people use wood rasps for this, but that is weird and sweet Jesus, at least wash off the sealant first. If you only have a potato peeler, that will work (badly). But if you have one of those four-sided metallic veg slicer/shredder thingies that shreds carrots, zucchinis, and potatoes for cakes, breads, and latkes—whip it out now. This thing has a side you’ve never used, and this is that side’s moment of glory. That funky, tiny-holed side is the zester.

Zest (now in verb form!) the fruit—stopping when you’ve grated off the colorful part of the citrus rind. The white part underneath is full of fiber, and can be eaten along with the remainder of the fruit, sliced into wedges. My partner will not eat this either, this fibrous white rind remainder. So some alternatives are to juice it or cut off the flesh, discarding the remaining rind either way. Citrus rind is also often used for animal feed, zest and all, when it’s not busy killing the climate adding to food waste. But pigs, too, emit greenhouse gasses. So it’s probably your safest bet to toss the rind. Then get a pet pig to cut your food waste for the climate by eating the rind. But then kill and eat it after it’s eaten the rind and before it farts. Zero emissions?

Set zest aside in a small container to use within a week as spice, garnish, and tea. As a spice, it’s light and refreshing in cucumber, beet, or field lettuce salad with oil and vinegar. As a garnish, it’s beautiful on top of most wintry warm dishes, nicely accenting the savory (like stews) and the sweet (like roasted pears). As a tea, it distinguishes already flavorful blends like rose-melissa and earl grey with a burst of extra excitement. Maybe these uses do not qualify it as a food really, and so I must admit I also filch it by the spoonful while cooking. This may or may not qualify as pica, depending on whether or not you consider zest a food (yet).

Try lemon, orange, and grapefruit; they’re all different. Lemon is versatile, orange sweet, and grapefruit bitter like the reality of man-made climate change and our new geological era’s ongoing mass extinction event. But be afraid—be very, very afraid to try lime because limes are craaaaazy. If you let the fiesty green things take control, you have no idea what’s gonna happen! The whole kitchen could blow!! If you tried it just to see, it might change everything. And although it might literally save the world, who knows if we would really like this Green New Deal? Zest is dangerous.

Drunken lamb with Mediterranean vegetables

A Mediterranean classic with many regional variations, this dish typically involves slow-roasting a relatively tough cut of lamb, like a shoulder, with half a bottle of red wine and your veg / spices of choice—preferably in a pressure cooker for 6-9 hours, and with plenty of cinnamon. A Greek variation might be served with capers, olives, and grilled chili-studded halloumi with lime; an Egyptian—chickpeas, cumin, turmeric, and coriander; an Italian—tons of tomatoes and fresh rosemary; an Israeli—cayenne, ginger, and dried fruit in the pot, and spiced fig preserves on the side.

You got so excited about making all kinds of lamb when the hot Kiwis told you that sheep emitted less methane than cows. You’re so naive sometimes: New Zealand is a world leader in everything lamb.

Ok, so they are actively trying to breed sheep to burp and fart less in New Zealand. Nonetheless, lamb still tends to top lists of climate-killing foods. Stop buying lamb.

Rinse, dice, and roast Mediterranean vegetables for 45 minutes on 190 C with liberal olive oil, salt, pepper, and spices. Rapeseed oil and other alternatives probably oxidize less with this much heat, but Mediterranean vegetables just taste better with olive oil. Besides, there are ongoing disagreements about whether rapeseed oil, coconut oil, and butter (usually considered the best cooking oils for high heat) are healthy after all. So lighter olive oil (with less particulate to oxidize during cooking than darker extra virgin) might be your healthiest as well as tastiest bet, after all.

Classic veg in this dish include tomato, bell pepper, eggplant, potato, onion, and garlic. Classic spices: basil, oregano, thyme, and parsley. With veg and spices alike, all are nice but none are strictly necessary. Sumach also adds a nice, citrusy but subtle touch. One that you won’t be getting from that leftover wine: Alcohol is seemingly the most dangerous drug one can easily procure, and we have work to do. So give it away despite knowing that climate change is an inequality problem that cannot be adequately addressed by consumerist lifestyle tweaks. Maybe, then, all of this recipe-wrangling does nothing.

Yet: Feeling your life choices make sense and express integrity matters for you and those around you, even if it doesn’t directly change the world. That’s why, Charles Duhigg has suggested, from one keystone habit change, group changes can sometimes emerge—as in-group identity builds, discernible success builds faith, and the combination of affirmative group identity and belief in one’s own power create better conditions for meaningful cultural and political change. Thus it might be the case that climate diets “work” not by meaningfully reducing greenhouse gas emissions, but by making climate activists feel empowered to make bigger changes that do. Sneak out for kebab.

Ingredients

1 large tomato or a bunch of cherry, grape, or roma tomatoes
1 bell pepper, any color
1 potato
1 eggplant
1 onion, any color
2 cloves garlic
olive oil
salt, pepper, spices (esp. dried basil, oregano, thyme, and parsley)

(optional) running shoes

My critique of iBorderCtrl’s claims vis-à-vis its “lie detection” AI and discrimination is live now: “iBorderCtrl Automates Discrimination,” on iBorderCtrl.no.

My critique of iBorderCtrl’s claims vis-à-vis micro-expressions and lie detection is live now as the first blog post, “Biomarkers of Scientific Deceit,” on iBorderCtrl.no.

Mark Harris’s Wired article “An Eye-Scanning Lie Detector Is Forging a Dystopian Future,” featuring some of my criticisms of next-generation “lie detection” tool Converus, runs today.