The Washington Post National Weekly - September 15, 2019

SUNDAY, SEPTEMBER 15, 2019

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IN COLLABORATION WITH

ABCDE NATIONAL WEEKLY Dangerous new hot zones are spreading around the world.

A spot off the Uruguayan coast illustrates a little-noticed trend in ocean warming —

and the potentially catastrophic effects it can bring to marine life. PAGE PAGE 12 8

Politics Bolton’s turbulent tenure 4

Nation Gun-control poll 8

5 Myths The Great Depression 23

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THE FIX

Risky attacks on Biden’s acuity BY

A ARON B LAKE

J

ulián Castro and Cory Booker went there on Joe Biden on Thursday night. Neither of them said it — that Biden is too old — but they might as well have.

Castro at one point (wrongly) accused Biden of forgetting something he had just said on the debate stage, animatedly repeating, “Are you forgetting what you said two minutes ago?”

Then Booker appeared on CNN after the debate and had this to say: “I think there were a lot of moments where a number of us were looking on the stage when he tends to go on sometimes. At one point, he was talking about communities like mine listening to record players. I don’t remember the last time I saw a record player. . . . But there are definitely moments where you listen to Joe Biden and you just wonder.”

We can debate all day whether these are veiled or not-so-veiled attacks on Biden’s age (Castro claimed after the debate he was just engaging on policy). But that’s kind of beside the point. Two of the candidates on the debate stage accused the candidate who leads almost every Democratic primary poll of lacking both mental and verbal acuity. Doing so certainly highlights Biden’s age, which is an unavoidable topic given he would by far be our oldest president and certainly has had his share of flubs and senior moments. Even if that wasn’t the intent, the effect would be similar: It calls into question his fitness to be president.

There are many things that can be papered over in a general election, as we saw in 2016 when Republican presidential candidates called Donald Trump all manner of things from “crazy” to “dangerous.” We’ve written

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MIKE BLAKE/REUTERS

Democratic candidate Julián Castro speaks during the presidential debate Thursday in Houston. He wrongly accused Joe Biden of forgetting something he’d just said on stage.

repeatedly about how ridiculous it is for Republicans to say these things and then pretend like they didn’t really mean them and/or that it was just par-for-the-course campaign rhetoric.

But were Biden to become the Democratic nominee, this is the kind of primary attack that could be difficult to shake. How do Democrats argue that a man who would be 78 years old upon his inauguration in 2021 and whom they said lacked acuity during the campaign would be a steady leader for the country? It’s easier to dismiss “crazy” and “dangerous” as overheated campaign rhetoric; what about the argument that Biden just isn’t sharp? You’re then going to tell people to trust him to make life-or-death

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decisions?

Democrats will dismiss this by pointing to the man in the White House. They have long suggested there are signs of deterioration with Trump, who is also in his 70s. Trump’s speech certainly meanders, and he either doesn’t process basic facts or doesn’t care about misstating them.

But the more they suggest Biden may not be a steady leader capable of “carrying the ball across the line” in the campaign, the more difficult it will be to draw that contrast with Trump. Democratic Party leaders have to be scared about the direction in which this is going. n

CONTENTS POLITICS THE NATION THE WORLD COVER STORY HEALTH BOOKS OPINION FIVE MYTHS

4 8 10 12 17 18 20 23

ON THE COVER An empty yellow clamshell rests on the beach in Barra del Chuy, Uruguay. Clam harvests have plunged 95 percent from the peak of 220 tons in 1985.

Photo by CAROLYN VAN HOUTEN of The Washington Post

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Winners and losers from the debate BY

A ARON B LAKE

T

he Democrats met Thursday in Houston for the third Democratic debate of 2019, this time all on one night. After nearly three hours of sparring among the 10 candidates who qualified, here’s who won, who lost and what it means moving forward.

Winners The Democratic Party: Given this was the first time the cream of the Democratic crop was all on the same debate stage, it took on added significance. And the field was better than it has been.

The candidates, including Joe Biden — though he still had his poor moments — and Sen. Kamala D. Harris (Calif.), who fell apart somewhat in her closing statement, were generally sharper than they have been.

Party leaders should be more encouraged by what they saw Thursday.

Elizabeth Warren: She was not dominant, but of the three front-runners, she had the best performance and, more important, the fewest tough moments.

Warren appears to come into these debates with a clear gameplan, lots of ideas and seems almost impossible for her opponents to attack. If that continues, she reaps the rewards from Biden and Sen. Bernie Sanders (Vt.) taking hits. She’s also the only candidate with sustained upward momentum in this race.

Pete Buttigieg: Buttigieg has been solid and even impressive at basically every debate, and although he may not have wowed anyone or knocked down his opponents, he was good again. The crowd loved it when he said that on public education, he would “appoint a secretary of education who actually believes in public education.” They might have been prepared lines, but they didn’t come off as such. Buttigieg is routinely and unfailingly prepared, and his closing answer on coming out as gay came off as genuine and had a real point behind it.

ROBYN BECK/AGENCE FRANCE-PRESSE/GETTY IMAGES

Who did well in the third debate, who didn’t do so well and what it means moving forward Barack Obama: The previous Democratic president has found himself something of an unlikely villain at the first two debates. But Thursday night, in the first debate at a historically black college since 2007, Obama got more than his share of love. We knew that would come from Biden, who launched a campaign ad shortly before the debate hailing his achievements with Obama. However, the other candidates also repeatedly embraced the Obama legacy.

Losers Castro’s big attack on Biden: The former housing secretary clearly came ready to go at this debate, and he went hard at Biden. But his biggest optical win didn’t have substance to back it up. He accused Biden of saying that the former vice president’s plan would not automatically enroll people in the public-healthcare option. When Biden denied it, Castro was apoplectic. “Are you forgetting what you said two minutes ago?” he said repeatedly, in

what was perhaps a not-so-subtle jab at Biden’s age.

Well, we checked the tape, and Castro was wrong. Biden did say that “anyone who can’t afford it gets automatically enrolled in the Medicare-type option we have, et cetera.”

Prosecutors: Harris and Sen. Amy Klobuchar (Minn.), as former prosecutors, faced brutal questions about their records — particularly when it comes to racial justice. Harris responded to reservations about her tough-oncrime record by saying, “I made a decision that if I was going to have the ability to reform the system, I was going to have to do it from the inside.” But she admitted she had not done enough.

Klobuchar was asked about an American Civil Liberties Union official who said she showed no interest in racial justice as Hennepin County, Minn., prosecutor.

She did okay with the question, pointing to how she had prosecuted the killers of black children. But it was anecdotal, and it

From left, Sen. Bernie Sanders (IVt.), former vice president Joe Biden and Sen. Elizabeth Warren (D-Mass.) participate in the third Democratic primary debate of the 2020 presidential campaign season.

Warren was not dominant, but she had the best performance of the three front-runners.

wasn’t great. We knew this was a hurdle, especially for Harris. That was certainly the case on Thursday.

The “guys, stop arguing” line: One of the cheapest attempted applause lines at these debates is when candidates complain about their opponents arguing too much. Yes, certain types of attacks can go too far. A couple of candidates tried to pull this out when there were real, substantive debates about big ideas. When Medicare-for-all was at issue, Harris said, “Frankly, I think this discussion is giving the American public a headache.” Andrew Yang tried to make a similar point when Castro cut in and said, “That’s called a debate.” He was right. You’re supposed to disagree, especially about subjects as significant as potentially spending $30 trillion in government funds on health care and the complete revamping of the system. Embrace the debate.

Harris’s zingers: Harris seemed to enjoy her “yes, we can” line a lot more than the crowd and laughed pretty heartily. It wasn’t the only time she did. At one point, she compared Trump to the Wizard of Oz. (Warning: Spoiler ahead.) “When you pull back the curtain, it’s a really small dude,” Harris said. ABC’s George Stephanopoulos responded, “I’m not even going to take the bait.” Harris responded, again laughing, “It wasn’t about you!” (Stephanopoulos seemed to be referring to something besides his own small stature.) This is not exactly disqualifying, sure, but the risk in this stuff is that it won’t exactly land.

Yang’s gimmick: Yang previewed before the debate that he would be doing something unprecedented. It turns out, that was giving his proposed universal basic income ($1,000 per month) to 10 lucky people who visited his website. But that may run afoul of campaign finance laws. It also seemed to draw patronizing laughter from his opponents.

Yang is a serious candidate. He doesn’t really need to do that kind of thing. n

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POLITICS

A long list of grievances boils over Bolton fired as national security adviser ALEX WONG/GETTY IMAGES

BY K AREN D E Y OUNG, J OSH D AWSEY AND J OHN H UDSON

O

ver a turbulent 17 months, President Trump and national security adviser John Bolton had disagreed on a variety of issues, from North Korea to Venezuela to Iran.

But Trump finally decided to remove his top security aide after a heated discussion in the Oval Office, following accusations by other officials in the administration that Bolton had leaked to the news media, tried to drag others into his battles with Secretary of State Mike Pompeo over Afghani-

stan, and promoted his own views rather than those of the president, according to people familiar with the matter.

Trump called Bolton to meet with him Monday afternoon as he prepared to leave for a campaign rally in North Carolina.

Bolton was seen by some in the administration as the source of a media report that Vice President Pence and he were allies in opposing a Taliban peace deal,negotiated by Pompeo’s State Department. Trump had tweeted that it was “Fake News,” designed to “create the look of turmoil in the White House, of which there is none.”

Bolton denied the charge, but the Afghanistan issue turned out to be a tipping point.

Among accumulated grievances that had been building for months, the president was annoyed that Bolton would regularly call on members of Congress to try to get them to push Boltonpreferred policies on Trump, according to a senior official who, like others, spoke on the condition of anonymity to discuss internal deliberations. Many on Bolton’s handpicked staff were seen as unnecessarily confrontational with other parts of the national security bureaucracy.

Trump had been inundated

Ousted National Security Adviser John Bolton listens as President Trump speaks to reporters during an August meeting in the Oval Office.

with complaints, officials said.

Pence and acting White House chief of staff Mick Mulvaney found Bolton increasingly abrasive and self-promoting.

Pompeo and Treasury Secretary Steven Mnuchin had told Trump that his national security adviser was not helping him, officials said. Bolton had even refused, in recent weeks, to go on television and defend the president’s policies on Afghanistan and Russia. Bolton, the president felt, wasn’t loyal. He wasn’t on the team.

After Trump made his views known, Bolton offered to resign.

Trump, Bolton later insisted, said

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POLITICS they would discuss it the next day.

It was the last time he saw the president.

On Tuesday morning, Bolton handed a two-sentence letter to an aide for delivery to Trump, and left the building. “I hereby resign, effective immediately...” There was nothing about spending time with his family, no praise or wellwishes for the president.

But just before noon, Trump stole his thunder, announcing in a tweet that he had fired his third national security adviser. “I disagreed strongly with many of his suggestions, as did others in the administration,” Trump wrote. “I will be naming a new National Security Advisor next week.”

A known hawk In the wake of Bolton’s departure, a number of senior administration officials and Republicans close to the White House — all of whom spoke only on the condition of anonymity — offered long lists of those who would not mourn him. They included first lady Melania Trump, Pence, Mulvaney, Pompeo, Mnuchin, countless Defense Department officials and international leaders.

But at the time of Bolton’s appointment, after Trump fired Lt. Gen. H.R. McMaster in April of last year, abrasiveness appeared to be what the president was looking for — a more in-your-face figure to replace McMaster’s military-like organization .

Trump could hardly have been unaware of what he was getting with Bolton. A take-no-prisoners official in the administration of George W. Bush, where he strongly supported the 2003 Iraq invasion and used a seat as United Nations ambassador to push a hard line foreign policy, Bolton had spent the wilderness Obama years as a conservative think tanker and Fox News pundit. He advocated regime change in Iran, a preemptive strike against North Korea, and the severing of U.S. ties to international agreements and organizations he viewed as weak and accommodating.

His appointment, coinciding with that of Pompeo to replace the out-of-favor Rex Tillerson as secretary of state gave a new muscularity to administration foreign policy. By the end of the year, the turnover was complete with the resignation of former defense secretary Jim Mattis.

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about sanctions policy deliberations appeared in neoconservative outlets such as the Washington Free Beacon. The distrust between Pompeo and Bolton’s team led the top diplomat to instruct his aides against consulting with Bolton’s team on Iran.

ANDREW HARNIK/ASSOCIATED PRESS

Even as he began grumbling privately about Bolton in recent months, and surveying other advisers and friends about possible replacements, Trump publicly praised his pugnacious qualities.

“He has strong views on things, but that’s okay. I actually temper John, which is pretty amazing,” Trump said in May. “I have different sides. I have John Bolton and other people that are a little more dovish than him. I like John.”

Divisions over policy Within a week after Bolton came aboard, Trump authorized a missile strike against Syria. A month later, he withdrew the United States from the Iran nuclear agreement. Both were seen as signals of Bolton’s arrival.

But Bolton also lost a lot of battles over a year and a half in office — among them, Trump’s outreach to North Korean leader Kim Jong Un; his abrupt decision to withdraw troops from Syria and accommodate Turkish concerns over America’s Kurdish Syrian allies; his friendly relationship with Russian President Vladimir Putin; the president’s professed willingness to meet with Iranian President Hassan Rouhani; and the Pompeo-led negotiations with the Taliban that began in October.

Whether Bolton was responsible for the leaks — he has insisted he was not — word of his views

always managed to be publicly revealed, even as Trump and others grew suspicious and started to work around him, most visibly on North Korea.

Trump came to view Bolton as a potential spoiler for a landmark nuclear deal with the isolated country and repeatedly excluded him from important meetings.

During Trump’s second summit with Kim in Hanoi, Trump ordered that Bolton not be included in a dinner meeting with senior U.S. and North Korean officials.

When Trump made a surprise visit to the demilitarized zone in June, Bolton left early out of concern that his presence could hurt initiatives, officials said.

U.S. officials said Bolton never believed Kim would surrender his nuclear arsenal and hoped the talks would collapse so that the United States could return to a maximum pressure campaign.

Worsening relations between the United States and Iran also created tensions between Trump and Bolton. In June, after Trump decided against ordering a military attack on Iran after it downed a U.S. drone, Bolton was “devastated,” said one U.S. official familiar with the matter.

Bolton’s consistent advocating for harder economic sanctions against Iran rankled U.S. allies and went beyond the desires of Pompeo. State Department officials grew frustrated when leaks

National security adviser John Bolton and Secretary of State Mike Pompeo in the Oval Office with President Trump during a signing ceremony. Pompeo and Bolton were often at odds. Most recently, Bolton was unhappy with the decision to negotiate with the Taliban over an Afghanistan peace deal and was particularly disturbed that Pompeo had been given the lead role.

Afghanistan as catalyst Bolton’s own frustrations with Trump had simmered in recent weeks as he became vexed by what he saw as the president’s policy indecision. The two men got along well on a personal level but Bolton began to tell friends that he had deep philosophical disagreements with Trumpand they weren’t fixable.

Although he saw his exit as the culmination of problems rather than something out of the blue, Afghanistan was the catalyst.

Never happy with the decision to negotiate with the Taliban over a peace deal, Bolton was particularly disturbed that Pompeo had been given the lead role.

Under Pompeo, U.S. envoy Zalmay Khalilzad had changed the parameters of U.S. policy on the issue. Trump’s insistence that he wanted to withdraw troops from Afghanistan, and a conclusion that there would be no military victory by either side there, had led Pompeo and Khalilzad to believe that the United States should negotiate its own exit directly with the Taliban, even while using that leverage to force eventual inter-Afghan talks.

By summer, it was clear that a deal was in the making, and late last month, Khalilzad came to Washington to report that agreement had been reached to withdraw about 5,000 of the 14,000 U.S. troops, in exchange for a Taliban agreement to sever ties with al -Qaeda and ensure that no terrorist attack on the United States would ever again be launched from Afghanistan. Talks with the Afghan government, and a cease-fire, would come later.

Bolton thought it was a bad deal, as did many others.

But as that plan came under criticism across the board, the president began to look for a way out, Prodded by Bolton and others opposed to the negotiations, he decided to cancel the deal altogether. When news stories Sunday and Monday depicted Bolton as victorious, his demise became just a matter of time. n

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WORLD

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More migrants seek refuge in Mexico B Y M ARY B ETH S HERIDAN in Tapachula, Mexico

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he idea was to reach the United States. But when the Honduran mother arrived in Mexico, with only a handful of pesos and a 4-yearold in tow, she realized how difficult that had become. So she came up with a new plan.

“The American Dream is costly, very costly,” lamented Iris, 32, sitting on a curb outside the Mexican refugee office in this southern city. She spoke on the condition that only her first name be used, for fear of harm from gang members in Honduras.

“That’s still the dream. But if they give me Mexican papers, I’ll stay here.”

Iris is one in the soaring number of migrants seeking refuge throughout the Americas. And while the United States remains the world’s top recipient of asylum petitions, countries such as Mexico, with much smaller asylum systems, are seeing far greater increases.

President Trump complains of the sharp rise in applications for asylum in the United States, which more than tripled in seven years to 254,000 in 2018, according to global statistics compiled by the U.N. refugee agency.

But asylum petitions in Mexico shot up more than 3,500 percent over the same period. They could nearly triple this year alone, to around 80,000.

The surge stems from a cascade of crises: the implosion of Venezuela, a crackdown on dissidents by the government of Nicaragua, and agricultural disasters and gang violence in El Salvador, Guatemala and Honduras.

Now, Mexico is dealing with another cause: steps by Trump to tighten the U.S. border, which are driving people to seek alternatives to the United States — and causing a bottleneck to the south.

The change is redefining the way Mexico sees itself. For decades, it was Mexicans who were the ones migrating, typically to the United States. This year, Mexico could become one of the

MARY BETH SHERIDAN/THE WASHINGTON POST

As the U.S. accepts fewer refugees, Latin American nations struggle with soaring asylum requests top 10 recipients of asylum applications in the world.

“It’s become more and more a country of destination for Central Americans,” said William Spindler, the Latin America spokesman for the U.N. High Commissioner for Refugees.

This past week, the U.S. Supreme Court allowed the administration to deny asylum requests from migrants who travel through Mexico or another country without seeking protection there, one of multiple tools immigration officials have deployed to prevent entry by families and others fleeing Central America .

The Trump administration had been hoping to send more migrants to Latin American countries with agreements that would oblige them to take in asylum seekers who cross their territories in hopes of reaching the U.S. But both Mexico and Panama have balked at signing the “safe third country” accords.

In Panama, like Mexico, asylum applications have surged, reaching 10,778 last year — a ninefold increase in five years, according to UNHCR. In addition, the country of 4 million is now home to more than 60,000 Venezuelans. Thousands more migrants and asylum seekers have traveled across Panama this year hoping to reach the United States.

“We already have more than enough” migrants, Panamanian President Laurentino Cortizo, said last month after meeting with Kevin McAleenan, the acting secretary of homeland security.

The Mexican city of Tapachula, around 10 miles from the Guatemalan border, offers a glimpse of the drastic change in migrant flows. By 7 o’clock one recent morning, scores of Central Americans, Haitians and West Africans had lined up outside a low-slung, unmarked building. It was the office of the Mexican refugee commission, known by its Spanish

Migrants line up Aug. 20 outside the Mexican refugee office in the southern city of Tapachula, about 10 miles from the Guatemalan border.

initials, COMAR. Around twothirds of the country’s asylum applications are processed here.

Edwin Edgardo Rivera, 32, a bartender and clothing store employee in Honduras, was among those seeking a new life in Mexico.

He said he fled Honduras after receiving death threats from a gang angered by his refusal to help them collect extortion payments.

He initially thought of heading to the United States. “But it’s very tough,” he said.

That’s partly because Mexico, under U.S. pressure, is detaining and deporting many more unauthorized migrants.

The spike in asylum applications has nearly crushed Mexico’s tiny, cash-strapped refugee commission. Its 2019 budget was slashed 20 percent, to $1.2 million, under a sweeping austerity program introduced by President Andrés Manuel López Obrador.

COMAR is doing its best, said Andrés Ramírez, head of the refugee commission — but “we are always on the edge, almost collapsing.”

With only 48 officials nationwide authorized to sign off on asylum approvals, the commission managed to process just 5,700 of nearly 30,000 applications last year.

UNHCR has stepped up its assistance, lending over 100 contractors to COMAR. Mexico’s government also recently agreed to provide more staff.

But the number of applicants is expected to continue climbing as the U.S. government takes measures to discourage asylum seekers from arriving. Under a program known as “Remain in Mexico,” the Department of Homeland Security has returned tens of thousands of asylum applicants to violence-plagued Mexican border cities to await hearings scheduled weeks or months later.

Another measure is the recently signed safe third country agreement with Guatemala. If implemented, it could force thousands of asylum seekers who crossed the country to go back there. n

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‘Maybe this is how Vietnam vets felt’ B Y D AN L AMOTHE in Statesville, N.C.

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yan Clay and Anthony “Rocco” DePrimo were in different places in life when they met as Marines more than 12 years ago.

Clay was a combat instructor who already had seen war in Afghanistan and Iraq, where he earned a Purple Heart.

DePrimo was fresh out of high school and boot camp, a self-described former “pretty-boy dude” who followed in his father’s footsteps to become a Marine.

They would later serve together in the largest single battle of the Afghan war, in which more than 15,000 U.S., British, Afghan and other coalition troops fought to take control of the Taliban stronghold of Marja nine years ago.

That was before they lost brothers in arms together. Before DePrimo struggled with transitioning out of the military and drinking too much, and Clay survived an explosion that knocked him off his feet in Afghanistan and later a stroke.

Now the two are friends and part of a generation of war veterans who are waiting to see how the United States’ longest conflict might end.

Some 775,477 U.S. veterans and service members have deployed to Afghanistan since the U.S. war there began after the 9/11 terrorist attacks 18 years ago this past week, including 28,267 who have gone five or more times, according to Pentagon statistics released to The Washington Post. Nearly 2,400 American troops have died there, including 16 in combat action this year, and more than 20,000 have been wounded.

The span of the conflict has prompted some veterans to question what has been accomplished.

The nonpartisan Pew Research Center reported in July that 58 percent of veterans it surveyed said the war in Afghanistan was not worth it.

“There’s a lot of mixed feelings, and just feeling, ‘I don’t know how I feel about it,’ ” DePrimo said.

“Maybe this is how the Vietnam

EAMON QUEENEY FOR THE WASHINGTON POST

Americans who fought in Afghanistan wait to see how the longest conflict in U.S. history ends vets felt. I’d like to think that’s possibly true — having the same feelings.”

‘My nightmare’ On a cold morning in February 2010, Clay, DePrimo and the rest of their unit — the 3rd Platoon of India Company, 3rd Battalion, 6th Marines — landed in helicopters near Marja, in the southern province of Helmand. The rural, largely desert area was home to hundreds of Taliban fighters and fields divided by muddy canals and fields that grow opium poppies in the spring.

In March, the platoon was assigned to take over a dilapidated yellow schoolhouse, which was inside a walled courtyard the size of a football field in northern Marja.

Clay, a staff sergeant, was put in charge of operations on site, while his platoon commander, 1st Lt. Jackson Smith, led another part of the unit nearby.

The attacks began immediately.

Squads of Marines, including one

led by DePrimo, a corporal, were repeatedly ambushed with machine guns, rifles and rocketpropelled grenades a few hundreds yards from their base.

By the end of the deployment in August, nine Marines in the battalion had been killed. At least 86 earned Purple Hearts for being wounded in combat.

Coming home When the unit returned home to Camp Lejeune in North Carolina, the Marines began scattering.

DePrimo left the military in May 2011, disillusioned with his options. He bounced around community colleges in South Carolina and Florida and learned to operate a crane in Georgia, though by the time he finished training he didn’t want to do that anymore.

He also drank too much, to the point that he eventually quit hard alcohol, he said.

Clay continued his career and graduated from drill instructor

Ryan Clay, left, and Rocco DePrimo, right, former members of India Company, 3rd Battalion, 6th Marines, pose together for a photograph in Statesville, N.C. Clay and DePrimo served together in Marja, Afghanistan, and now, almost a decade later, live down the street from each other.

school in Parris Island, S.C., in June 2011 with DePrimo watching.

But a few weeks later, his life changed.

While barking orders to recruits, he felt a “pop” in his head and crushing pain. He was having a stroke.

For six weeks, Clay underwent physical therapy, walking with a cane and learning how to do basic tasks. He recovered, but his Marine Corps career was over. Doctors told him the explosion in Marja could have been responsible.

Back in Marja, violence was plummeting, but the war raged on in other parts of the country.

In 2011, Sgt. Ian McConnell, 24, another Marine who served at the schoolhouse, died by suicide in California. Afghanistan weighed on him heavily, said his sister, Meg Schellinger, of Eagan, Minn.

“Even today, I’m still shocked,” she said. “Yeah, he’d been pulling back and not really talking with me as much lately, but it just wasn’t Ian, you know?”

As the years passed, Marja again largely fell to the Taliban.

‘Times have to change’ DePrimo and Clay settled near each other and took jobs in Statesville, N.C., a small city north of Charlotte with an old-fashioned downtown.

DePrimo, who turns 31 this month, married a woman from his hometown of Lake Wales, Fla., becoming a stepfather to three girls before having a son in 2018. He sold cars for a while, and moved on recently to taking horticulture classes and farming. He’s proud of what he and the Marines he served with did in Afghanistan.

Since leaving the military, Clay, 36, has found happiness after divorce and remarrying, he said. He became a patrol deputy and dog handler with the Iredell County Sheriff’s Department, and is quick to tell those he served alongside that he loves them.

“The sacrifices that were made, it’s not that they were made in vain as long as they’re not forgotten,” he said. “That’s the best way to put it.

Things have to change. Times have to change.” n

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Jose Rocha examines a clam in Barra del Chuy, Uruguay. Clam harvests have plunged as the ocean has warmed.

PHOTOS BY CAROLYN VAN HOUTEN/THE WASHINGTON POST; GRAPHIC BY JOHN MUYSKENS

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Dangerous ocean hot zones are spreading around the world B Y C HRIS M OONEY AND J OHN M UYSKENS in La Coronilla, Uruguay

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he day the yellow clams turned black is seared in Ramón Agüero’s memory.

It was the summer of 1994. A few days earlier, he had collected a generous haul, 20 buckets of the thinshelled, cold-water clams, which burrow a foot deep into the sand along a 13-mile stretch of beach near Barra del Chuy, just south of the Brazilian border. Agüero had been digging up these clams since childhood, a livelihood passed on for generations along these shores.

But on this day, Agüero returned to find a disastrous sight: the beach covered in dead clams.

“Kilometer after kilometer, as far as our eyes could see. All of them dead, rotten, opened up,” remembered Agüero, now 70.

“They were all black, and had a fetid odor.”

He wept at the sight.

The clam die-off was an alarming marker of a new climate era, an early sign of this coastline’s transformation. Scientists

now suspect the event was linked to a gigantic blob of warm water extending from the Uruguayan coast far into the South Atlantic, a blob that has only gotten warmer in the years since.

The mysterious blob covers 130,000 square miles of ocean, an area nearly twice as big as this small country. And it has been heating up extremely rapidly — by over 2 degrees Celsius (3.6 degrees Fahrenheit) — or 2C — over the past century, double the global average. At its center, it’s grown even hotter, warming by as much as 3 degrees Celsius (5.4 degrees Fahrenheit), according to one analysis.

The entire global ocean is warming, but some parts are changing much faster than others — and the hot spot off Uruguay is one of the fastest. It was first identified by scientists in 2012, but it is still poorly understood and has received virtually no public attention.

What researchers do know is that the hot zone here has driven mass die-offs of clams, dangerous ocean heat waves and

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algal blooms, and wide-ranging shifts in Uruguay’s fish catch.

The South Atlantic blob is part of a global trend: Around the planet, enormous ocean currents are traveling to new locations. As these currents relocate, waters are growing warmer. Scientists have found similar hot spots along the western stretches of four other oceans — the North Atlantic, the North Pacific, the South Pacific, and the Indian.

A Washington Post analysis of multiple temperature data sets found numerous locations around the globe that have warmed by at least 2 degrees Celsius (3.6 degrees Fahrenheit) over the past century. That’s a number that scientists and policymakers have identified as a red line if the planet is to avoid catastrophic and irreversible consequences.

But in regions large and small, that point has already been reached.

The Post analyzed four data sets, and found: Roughly one-tenth of the globe has already warmed by more than 2 degrees Celsius (3.6 degrees Fahrenheit), when the last five years are compared with the mid- to late 1800s. That’s more than five times the size of the United States.

About 20 percent of the planet has warmed by 1.5 degrees Celsius (2.7 degrees Fahrenheit), a point at which scientists say the impacts of climate change grow significantly more intense.

The fastest-warming zones include the Arctic, much of the Middle East, Europe and northern Asia, and key expanses of ocean. A large part of Canada is at 2C or higher.

Some entire countries, including Switzerland and Kazakhstan, have warmed by 2C. Austria has said the same about its famed Alps.

The percentage of the globe that has exceeded 2C varies depending on the time periods considered. Over the past five years, 8 to 11 percent of the globe crossed the threshold, The Post found, while over the past 10 years, the figures drop slightly to between 5 and 9 percent. Considering just the past five years increases the area by roughly 40 percent.

These hot spots are the scenes of a critical acceleration, places where geophysical processes are amplifying the general warming trend. They unveil which parts of the Earth will suffer the largest changes.

Extreme warming is helping to fuel wildfires in Alaska, shrink glaciers in the Alps and melt permafrost across Canada’s Northwest Territories. It is altering marine ecosystems and upending the lives of fishermen who depend on them, from Africa to South America to Asia.

It is making already hot places in the Middle East unbearable for outdoor workers and altering forests, lakes and rivers in the United States. It has thawed the winters of New England and transformed the summers of Siberia.

For Uruguay, a small and politically liberal country of fewer than 4 million, the key vulnerability is in the oceans.

change in a very short time.

In 2017, a record-setting ocean heat wave caused mass fish die-offs and a dangerous algal bloom, forcing beach closures in Montevideo. Such events are becoming more common and more severe. What the clammers along the coast near Brazil experienced decades ago is spreading and becoming harder to ignore.

Uruguay is trying to help them, but that effort underscores the possibilities — and the limits — of adapting to extreme climate change.

Above: Scientists Omar Defeo, left, and Diego Lercari, second from right, listen as brothers Ramón, center, and Arturo Agüero talk about learning to gather clams, at their home near Barra del Chuy.

Right: Yellow clams pile up in Monte Hermoso, Argentina, in November 1995, when huge numbers of them died.

PHOTO BY SANDRA FIORI

Uruguay is famous for its laid-back former president, who lived on a humble flower farm rather than at the mansion occupied by his predecessors, as well as its cattle and sheep, which outnumber Uruguayans by a factor of six. But it’s also known for its tourism and beaches.

Nearly half of Uruguayans live in the coastal megacity of Montevideo. Meanwhile, international tourists flock to the beaches of Punta del Este, a stylish resort where a major Trump Organization property, the Trump Tower Punta del Este, is under construction.

But waters have warmed by 1 degree Celsius (1.8 degrees Fahrenheit) in just 20 years in the estuary of the Rio de la Plata, where the vast river spills into the ocean, and in the common offshore fishing area shared

by Uruguay and Argentina. That is a very fast

‘The new normal’ Over the past five years, Earth has passed a significant threshold. The planet is now more than 1 degree Celsius (1.8 degrees Fahrenheit) warmer than it was in the mid- to late 1800s, before industrialization spread across the world.

The Post’s analysis relied upon four separate temperature records from the U.S. government and scientific researchers. Variations in the data sets themselves, and how they were analyzed, produce somewhat different assessments of the extent of the planet that has warmed by 2C. Because the Earth goes through a number of natural cycles, climate scientists consider long periods, of multiple years, to analyze temperature change. The Post’s analysis considered two “preindustrial” periods — the 50 years from 1850 to 1899 and the 20

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COVER STORY years from 1880 to 1899.

It also considered two end periods, the past five years and the past 10, which were compared with the two preindustrial periods to determine the amount of warming that has taken place.

The past five years are by far the hottest — and display the most numerous and expansive 2C hot spots. And while five years may be a brief period in climatic terms, 2019 is already following the same ultrawarm pathway.

Barring some dramatic event like a major volcanic eruption — which can cause temporary global cooling by spewing ash that blocks the sun — scientists expect this to continue and steadily worsen.

“We’re not going to really cool down much in the future, so the last five years are indicative of the new normal,” said Zeke Hausfather, a researcher with Berkeley Earth, which produces one of the data sets The Post analyzed.

While the global data sets do not agree about what is happening to every stretch of the Earth, they show unmistakable patterns.

For instance, an intriguing group of ocean hot spots appears again and again. One cause? The tropics are expanding.

Straddling the equator, the tropics are already hot because they receive the most sunlight. As the sun hits the tropics, enormous columns of air rise skyward and then outward. But as greenhouse gases trap more heat, those columns of air are pushed farther toward the north and south poles.

Air that rises in the tropics falls back down over the middle latitudes. With a warming planet, though, the air is falling in different places.

One region where that air sinks is the South Atlantic Ocean, where the tropical expansion has led to a southward shift in the location of a gigantic counterclockwise circulation of winds. These winds, in turn, drive key ocean currents, including a warm, salty, 60-milewide stream called the Brazil Current, which is being pushed even farther south.

Near Uruguay, the Brazil Current collides with the cold and nutrient-rich Malvinas Current that flows north from waters off Argentina. Where the two currents meet — what is known as the “confluence” — features sudden temperature contrasts and fosters rich fisheries.

But that zone, too, is on the move. Research suggests it is shifting southward at a rate of more than 40 miles per decade.

The result has been a stunning temperature change off the Uruguayan coast.

“The southward displacement of warm waters creates a very strong signal,” explains oceanographer Alberto Piola, a professor at the University of Buenos Aires.

The hot spot emerges most dramatically in The Post’s analysis when the most recent five years are compared with the last two decades of the 19th century. By this standard, it has only recently crossed the 2C threshold.

The peak of the 2017 ocean heat wave: Feb. 25 SOUTH AMERICA BRAZIL

URUGUAY Barra del Chuy

Atlan tic Oce an

Punta Montevideo del Este ARGENTINA

Extreme heat wave

Severe

Moderate

Mild Source: Robert Schlegel, Ocean Frontier Institute

In 2012, scientists first flagged it as one of the ocean’s fastest-warming stretches. And they’ve attributed the changes to a broad global pattern that can’t be explained just by natural climate variability.

Some other analyses suggest that a tremendous amount of change has occurred here since the late 19th or early 20th century.

Gerrit Lohmann and Hu Yang, climate scientists with the Alfred Wegener Institute in Germany, examined the Brazil Current region following an inquiry from The Post.

They found a warming of between 2 and 3 degrees Celsius (3.6 to 5.4 degrees Fahrenheit) between 1900 and 2018, with the warmest regions located farther offshore, according to a high-resolution data set of sea surface temperatures from the Hadley Center in Britain.

‘It wasn’t that way before’ Ramón Agüero was about 6 years old when his parents taught him and his younger brother Arturo how to dig for clams. The

100 MILES THE WASHINGTON POST

To Maria Celia Pereyra Ambrossi, changing winds and tides are to blame for declining clam populations in Barra del Chuy.

KLMNO WEEKLY

brothers learned to read the weather and the tides to find the richest lodes, which they collected with shovels and buckets.

Later, as the brothers grew up, it became their work as well — work that disappeared when the government banned clamming after the 1994 die-off.

Arturo Agüero had five children to feed, and had to move to Montevideo to find work.

“When they shut down the clams, I wanted to die,” he said. “Because that is what I knew how to do. I knew how to work the clams. I knew it all.”

Similar upheaval struck some 100 other clammers, many of whose families had worked these beaches for generations.

Forty years ago, marine biologist Omar Defeo, a professor at the University of the Republic in Uruguay, began studying this fishery. He thought it was a good dissertation topic, so he began making the 200-mile trip from Montevideo out to a region called the Rocha department.

It’s a place of endless cattle fields, horseback riders along the highways, and beaches that, unlike in the tourist havens far to the south, are quiet and almost empty.

But then came the huge die-offs, first along the coast of Brazil, then Uruguay and finally Argentina, wiping out clams along each coastline. Defeo’s research became much more urgent.

“In a process of more or less 10 years, the mass mortalities destroyed the populations of yellow clam,” said Defeo, who has made about 200 trips to the beaches at Barra del Chuy.

In 2008, the fishery finally reopened after a 14-year hiatus, but for an extremely small catch — just three tons. The most recent year’s allowed catch was only 10 tons — a decline of 95 percent from the peak of 220 tons in 1985.

Over decades of research, Defeo and his colleagues have chronicled the species’ downfall amid warming waters: The clams are now much smaller, rarer and increasingly contaminated by toxic red tides — making them unsafe to eat for weeks at a time. The red tides, in turn, are worsened by climate change, scientists say.

What’s more, the Rocha beaches are crawling with more tropical species, including crabs and smaller kinds of clams attracted to the warmer waters.

The upheaval matches a key prediction of climate science.

When temperatures rise 1.5 to 2 degrees Celsius (2.7 to 3.6 degrees Fahrenheit) for the globe, according to a recent report by the United Nations Intergovernmental Panel on Climate Change, one of the most severely affected ocean animals will be bivalve species — clams, oysters, mussels and their relatives.

Above 1.8 degrees Celsius (3.2 degrees Fahrenheit) or so, they face “very high risks” of population decline if not extinction, the report said.

That’s the sort of biological wreckage that

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COVER STORY

has shown up along the beaches at Barra del Chuy.

For the fishers who remain, even gathering the small numbers of clams that they’re allowed to take has gotten tougher.

On an early April day — fall in the Southern Hemisphere — driving winds from the south pushed the waves more than a football field’s length inland over the gently sloping beach.

For Maria Celia Pereyra Ambrossi, there was no way to pursue her catch. The clams, which are hard to find even on a good day, were all underwater.

“The wind in this area of the beach is always strong, and each passing year, it is stronger,” said Pereyra Ambrossi, her silver hair whipped in all directions. “It wasn’t that way before.”

Two days later, the weather had finally calmed, and the ocean had given back much of the beach.

Jose Rocha, 68, and four other family members packed into an old red Volkswagen Golf and drove straight out onto the sand.

Barefoot, Rocha walked along the shoreline, dragging his rusty shovel behind him until he found a promising spot to dig.

But the clams were sparse, and only about four pounds were gathered. After about an hour, Rocha stopped and rolled a cigarette as he leaned against the hood of his car.

“We are in a time — I do not know what’s happening — where the climate is not the same,” Rocha said. “The climate is not the same anymore.”

‘A delicate situation’ Government regulators, academics like Defeo and the fishers themselves have hatched a plan to leverage the shrinking supply of the yellow clam.

“The strategy is to catch low numbers of clams, because the stock is very reduced, to sell with a good price to restaurants and just to have this low number of fishers,” Defeo said.

The clams are commanding prices nearly double what they were just six years ago, thanks to increasing restaurant demand.

In recent years, the clam has been marketed at high-end restaurants in the tourist meccas of Punta del Este and José Ignacio, about 100 miles down the coast from Barra del Chuy. It’s become part of a trend to alter the Uruguayan diet, heavy on beef, toward healthier and locally gathered food.

The first to serve the yellow clam was Lo de Tere in Punta del Este, one of Uruguay’s most popular tourist spots. Just steps from the harbor, it serves only Uruguayan food gathered within about 100 kilometers (62 miles).

On a recent visit, chef Nicolas Larrosa pulled several live clams out of a tub of seawater to display them before cooking. As he lifted one up, it sprayed water on the kitchen floor from both of its siphons, the tubelike structures used to filter seawater and gather nutrients.

Nicolas Larrosa plates an order of yellow clams at Lo de Tere restaurant.

The chef fries them in oil and garlic, and sprinkles them with parsley.

Larrosa filled a frying pan with oil and garlic before adding the clams, still in their shells. After the frying, he sprinkled a bit of parsley. It’s simple — and that’s the point.

“People have discovered this. And they are addicted,” said Eduardo Marfetán, who owns the restaurant with his wife and daughter. “I have one client, from Buenos Aires, he calls me, before he comes to Punta Del Este, he says, ‘You have clams?’ ” Most of the time, the answer is no. The clams are never on the menu, Marfetán said.

They are a special sold only when the restaurant has them in stock.

The deliveries arrive from Nancy Schuch and her husband, Gabriel Rocha, who buy them from the clammers off the beach. She moves the clams through a small beachside processing plant — the first of its kind in this industry. It is this innovation, paired with a marketing campaign aimed at restaurants, that has led to a new commercial life for the clam.

Plans are afoot for an even larger plant.

Schuch and Javier Vitancourt, the plant’s veterinary technician, hope to create a more state-of-the-art facility that will also be open to the public, who would be able to try the clams at any time.

That is, if the climate allows it.

Schuch said the clams — and the business — will be okay in the long term. “I’m positive,” she said.

Defeo, though, takes a cautious tone about the future.

“The resource is in a delicate situation,” he said. “The stock has not been recovered, and we need to monitor the fishery constantly just to provide early warnings.”

‘A no-analog world’ When it comes to the effects of climate change in the South Atlantic, the clams are only the beginning.

Ocean life is exquisitely sensitive to tem-

perature. In July, Defeo and his student Ignacio Gianelli published a study demonstrating for the first time that the entire Uruguayan fish catch is shifting toward more tropical, warm-water species.

Andrés Domingo, the director of Uruguay’s national oceans and fisheries agency, is worried about the changing currents.

“These conditions probably have a lot of impact on ecosystem ecology,” he said.

Harvests of the Argentine hake, traditionally the largest fish catch in Uruguay, have plummeted. The hake is a cold-water species, so it may be fleeing the warming waters. Yet given that the species has also been overfished, it’s hard for scientists to attribute the changes exclusively to warming.

Patagonia has experienced an utterly opposite trend — a dramatic explosion in the catch of Argentine red shrimp. The catch has grown from a little over 40,000 tons in 2006 to a record of 230,000 tons in 2017.

Bárbara Franco, who studies fisheries and climate change at the University of Buenos Aires, said the temperature measurements in the deeper ocean waters along Patagonia are too spotty to attribute the shrimp boom to climate change.

Climate change can make for winners and losers, especially when it comes to fisheries.

Along the U.S. coast, fast-warming waters drove lobsters away from southern New England and into the Gulf of Maine, leading to crashing fisheries in one spot and a boom in another. That could be happening here, too.

Still, the overall consequences of these oceanic changes are likely to be negative, Franco said. Fisheries in Uruguay and Brazil are projected to decline by more than a quarter by the end of the century.

That could mean major harm to any number of small-scale fisheries, far beyond the community that gathers the yellow clam.

According to the United Nations’ Food and Agriculture Organization, workers in these smaller, often local and subsistence-driven fisheries account for 90 percent of all fishery workers around the globe, largely in developing countries. In many cases, they are earning the equivalent of less than $1 per day.

Scientists say they are struggling to keep up with the impacts of a warming world, whether measuring changes in the Arctic or disappearing kelp forests in the southern Pacific.

“We’re really playing catch-up,” said marine scientist Boris Worm of Dalhousie University in Canada. “Everything we base our civilization on is based on the accumulated experience from the last 7,000 years, about how the world works, and how we can survive in this world that had an exceptionally stable climate.

“And we’re shifting away from that equilibrium at breakneck speed now. We’re living in a no-analog world that none of us has any experience with.” n

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HEALTH

KLMNO WEEKLY

Before they can walk, they climb BY

A MANDA L OUDIN

S

ix-year-old Mason Hodges can rattle off any number of plant and animal species when out in the woods, his knowledge deeper than many adults. He’s also environmentally aware and understands he should treat the Earth with respect.

His mother, 47-year-old Shanti Hodges, credits this to how he’s been hiking with her since birth.

Shanti is the accidental founder of a movement that is now well over 200,000 families strong.

Hike it Baby began right after Mason was born, when Utahbased Shanti found herself feeling cooped up indoors and out of touch with the hiking community she loved.

“When I had Mason, I knew it would feel isolating,” she says, “but I didn’t expect to feel like I had no friends or that I couldn’t get out into nature.”

Hodges knew about various active mom groups, such as Stroller Strides, but that wasn’t what she was after. “I didn’t want to work out, I just wanted to get outside,” she says. “I knew it would be good for me and for the baby.”

While the outside part was key, so too was the socialization she could find with a group of likeminded newer parents.

“You can try meetup groups, but they end,” Hodges says. “I wanted to be part of an ongoing community. When we’re out there, we help each other with the kids, our energy is lighter and we feel better after.”

The new mom got things rolling by inviting a few others to meet up with their babies and young children at a local trail. In short order, their numbers swelled. Hodges named the group Hike it Baby, started a newsletter and found her tribe. Six years in, she says, Hike it Baby has been good for both her and Mason.

“Right away, Mason was easier to manage,” she says. “He was happier, we got along better, and I was able to spend time with other adults with an appreciation for the outdoors.”

ISTOCK

New parents are taking active mom groups to a new level as hiking with babies gains a voice Research backs up what Hodges intuited — that nature is good for kids on many levels. A recent systematic review in Health Place found that immersive nature experiences for children benefits self-esteem, self-efficacy, resilience and academic-cognitive performance.

Lawrence Rosen, a pediatrician and founder of the Whole Child Center, agrees. “It’s never too early to get kids outside,” he says. “We always want evidence of safety when prescribing things for babies and young children, but there are also things we just know, and this is one of them.”

There’s also the sleep factor with babies and young children, who are notorious for depriving parents of the same, he says.

“Being outside in the fresh air, running around and exploring promotes good sleep,” Rosen says.

Hodges has found this to be true with Mason.

Collin O’Mara, president and chief executive of the Virginiabased National Wildlife Federa-

tion, says the same applies to his children, ages 2 and 7. “Their sleep definitely improves after outdoors time,” he says.

O’Mara and his wife have made outdoors time a priority for their family from the start, he says.

“We want to encourage a lifelong love of nature because it has so many auxiliary benefits,” he says. “It helps children develop critical thinking and gives them hands-on learning, all of which [can] lead to improved ability with math and science when they enter school.”

In an era where so much of children’s lives are scheduled and scripted, O’Mara values the creativity his children develop in nature.

“Take a kid to a playground and they’ll get bored after a little while,” he says. “But take them to the woods and they will play for hours and never tire of it. A rock, for instance, can take on multiple roles over several hours.”

Rosen says that by taking children into the great outdoors,

“We want to encourage a lifelong love of nature because it has so many auxiliary benefits.”

Collin O’Mara, president and chief executive of the National Wildlife Federation

parents are modeling healthy habits. “From birth, kids pick up on their parents’ physical activity levels and mind-set,” he says. “If you get your kids out early, they will follow suit.”

For many new parents, the idea of getting their babies and young children outside might hold appeal, but can feel intimidating.

On a practical level, Rosen says parents with access to parks and forests should consider sun protection, checking for ticks and proper clothing for the temperature.

Hodges has learned from experience how to make hiking with babies an easier experience.

“It’s easy to think you need to bring everything when you have a baby,” she says. “But think about the distance and adjust your gear accordingly.”

A short hike, for instance, might require that you bring little more than a diaper and a few wipes in a Ziploc bag.

“One important tip is to always carry a plastic bag,” Hodges says.

This will help keep dirty diapers and the like separated from everything else.

Finding a community like Hike it Baby is also a good way to go.

“Then if you do forget something, you have somebody there to back you up,” Hodges says. “Also, if you have older kids, they can help keep the younger kids hiking on and like the role of ‘leader’ to toddlers.”

Think small when you first begin venturing out.

“Don’t try to get epic when you first start hiking with a baby,” Hodges says. “Go for things around your neighborhood.

While you might have been an avid hiker pre-baby, things are different, especially in the beginning with a new baby or toddler.”

But take heart, keep at it and before you know it, your child will be leading the way when it comes to the outdoors.

Says O’Mara: “Given a choice between going fishing and watching the latest Disney movie, our kids will choose fishing every time. They’re waiting to get outdoors as soon as they’re up.” n

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KLMNO WEEKLY

BOOKS

How U.S. health care fails women N ONFICTION

l

REVIEWED BY

A LICIA M UNDY

A

EVERYTHING BELOW THE WAIST Why Health Care Needs a Feminist Revolution

By Jennifer Block St. Martin’s.

324 pp. $27.99

s I was writing this review, Alabama had passed a draconian law that bans abortion except in cases where a woman’s health is at serious risk. The Food and Drug Administration had approved a new prescription drug injection to increase women’s sex drive and end what some ads called the “tragedy” of low libido. And OB/ GYNs around the country were offering “vaginal rejuvenation” through laser procedures that narrow the vaginal opening to create “a more youthful, pre-pregnancy state” — a technique that has prompted an FDA warning on safety.

If there was any doubt of an audience for Jennifer Block’s advocacy book, those recent events should lay that notion to rest. In “Everything Below the Waist: Why Health Care Needs a Feminist Revolution,” Block reveals the travails of women trapped by a medical profession that poorly serves their needs.

While advocating for women, Block also argues that the women’s movement has not delivered the magnitude of change in female care that’s needed. Fifty years after the start of the feminist revolution, American women are still second-class citizens when it comes to health care. In one of her opening vignettes, a 46-year-old woman undergoes a minimally invasive hysterectomy at a major medical center. Two days later she complains of severe pains, and her heart rate jumps. Her doctor’s response is to send her home with a prescription for anti-anxiety pills.

Two days after that, the woman is rushed into emergency surgery, and doctors find that her intestine had been damaged during the hysterectomy. She leaves the hospital with a colostomy bag. “You may already be familiar with this story,” Block writes. “Woman needs medical care. Woman is ignored.

Woman has to fight.”

Block notes that “there are no

REUTERS/MICHAEL SPOONEYBARGER

People protest Alabama’s new abortion law at the state capitol in Montgomery in May.

sacred cows in this book,” and that includes America’s fertility industry, where women endure openended treatments for a diagnosis of “unexplained infertility.” That leads to budget-busting artificial insemination, embryo freezing, repeated injections and surgery.

Block tracks down a doctor in Pennsylvania, Danielle Miller, who produces better outcomes by taking the time to find the underlying reasons that women can’t get pregnant. The difficulty could be linked to hormonal imbalances or endometriosis — a diagnosis, says Miller, that is “not difficult.

It’s just complicated.” And, for the doctor, less lucrative.

Block, a former editor of Ms. magazine, was also editor of the revised “Our Bodies, Ourselves,” the original women’s health-care bible. Her 2007 book, “Pushed: The Painful Truth About Childbirth and Modern Maternity Care,” delivered a scathing critique of “medicalized” childbirth in the United States.

In blunt language, Block ad-

dresses the consequences of the movement to criminalize abortion and limit women’s access to clinics. “Ninety percent of counties in the United States have zero abortion clinics,” she writes. “Mississippi and six other states have just one for the whole state.” The result: “Underground abortion is a thing again.”

One of the most interesting people in the book is Carol Downer, a mother of six and co-founder of the Federation of Feminist Women’s Health Care Centers.

Downer was an influential activist in the 1970s and leader of the original women’s self-help movement. She and others “hopped up on tables with a mirror, flashlight, and speculum to show other women how to view their own cervices,” Block writes.

Block uses Downer’s saga to show how divisions within the women’s movement played a role in women’s loss of control over their health care. In 1971, Downer was ostracized at the National Organization for Women conference

and told not to get too graphic at the meeting promoting self-exams. After abortion became legal two years later, self-helpers such as Downer were seen as “retro.”

Mainstream feminists were focused on expanding the role of women in health care: They should become doctors, not just play doctor with a plastic speculum.

Feminist health activists now “regret this turning point,” Block writes. Today, about 60 percent of OB/GYNs in the United States are females. But about a third of women in the country will have hysterectomies before they are 60, nearly a third of pregnant women have C-sections, and maternal mortality rates are increasing.

The book’s upsetting anecdotes, startling statistics and terrific interviews will leave you outraged or simply sad. n Alicia Mundy is the author of “Crystal Mesh: How Addiction to Money Turned Medical Device Makers and Doctors Into Street Dealers,” due out in October.

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KLMNO WEEKLY

FIVE MYTHS

The Great Depression BY

R OBERT F . B RUNER

Ninety years ago this fall, the stock market experienced the Great Crash. Shortly thereafter, America’s economy slumped into the Great Depression. Though misconceptions about them abound, these events have had a huge influence on decision­makers ever since. If, as Mark Twain supposedly said, “History does not repeat itself, but it often rhymes,” then right now might be a good time to correct some myths about the Great Depression.

MYTH NO. 1 ‘Roaring Twenties’ excesses caused the Depression.

Indeed, the Roaring Twenties were a time of consumerist excess among a certain moneyed class — think of the lavish parties in “The Great Gatsby.”

But the period wasn’t primarily defined by this kind of indulgence or market speculation. Milton Friedman and Anna Jacobson Schwartz’s comprehensive 1963 study, “A Monetary History of the United States, 1867-1960,” shows that the 1920s experienced low price inflation and stable economic growth. Scholar Harold Bierman Jr.’s research on the 1929 crash found that overvalued stocks were isolated to a few sectors and were of relatively short duration. A 2003 study by the Federal Reserve Bank of Minneapolis concluded that in 1929, many stocks were undervalued.

In any case, only a small percentage of the population owned securities at the time. And a culture of excess and careless speculation hardly characterized the entire nation.

MYTH NO. 2 The Great Crash caused the Great Depression.

Writing for TheStreet.com in July, Steve Fiorillo called the October 1929 stock market crash “the most obvious occurrence that portended doom and started the depression.”

Modern historians view the

crash not as the cause but as an amplifier of macroeconomic forces. The uncertainty it generated helped deepen the Depression, Friedman and Schwartz acknowledge in “The Great Contraction, 1929-1933,” but it was “a symptom of the underlying forces.” The downturn that characterized the Depression — a global phenomenon — was brought about by an almost perfect storm of factors, including Germany, France and Britain returning to the gold standard that they’d abandoned during World War I, which proved unsustainable. In part to boost European economies, the Federal Reserve kept interest rates low.

But when it increased rates in 1928 and again abruptly in 1929, lending decreased, as did resulting economic activity.

MYTH NO. 3 Herbert Hoover did nothing to fight the Depression.

Just after the crash, though, Hoover cut taxes by about $160 million in an effort to stimulate the economy, increased public-works spending, and secured agreements among business and labor leaders to maintain wages and avoid work stoppages. Despite these efforts, by late 1931, America’s economic slump had accelerated, so Hoover increased federal spending and loans to states, liberalized the Fed’s credit expansion, created the Reconstruction Finance Corporation to lend to and invest in companies and jobs, established

ASSOCIATED PRESS

Men on their way to build roads as part of the Civilian Conservation Corps, a public work relief program during the Great Depression.

special banks to support farmers and homeowners, and declared an international debt moratorium to stabilize currencies and restore trade. He might have intervened more robustly and earlier, and he may have lacked the political skills needed to build public confidence in his policies. But the charge of inaction doesn’t hold.

MYTH NO. 4 The New Deal cured the Great Depression.

It’s true that President Franklin D. Roosevelt deserves credit for ending the death spiral of public confidence and economic conditions. But recovery to pre-Depression conditions would be years away.

Yes, useful reforms in banking and finance, electric power, labor relations, and Social Security were pillars of the New Deal. Yet it’s a stretch to say that the New Deal’s progressive reforms ended the Depression: Federal Reserve monetary policy, suspension of the gold standard by governments around the world, the easing of global trade and the industrial expansion during World War II arguably had more impact on

recovery, according to studies

by Christina Romer, Barry Eichengreen, Robert J. Gordon, Robert Higgs and many others.

MYTH NO. 5 The Great Depression ended in 1939.

That year may be a convenient focal point because it marks a new historical episode, the onset of World War II. Yet it is hard to say the Depression really ended then, because important metrics of prosperity continued to lag. In 1939, the unemployment rate stood above 15 percent; it wouldn’t fall below 5 percent until 1941. Personalconsumption expenditures — a measure of how much Americans spend on goods and services — similarly didn’t return to 1929’s level until 1941. n Bruner is university professor at the University of Virginia, dean emeritus of the Darden School of Business and a senior fellow at the Miller Center of Public Affairs. He is a co-author of “The Panic of 1907: Lessons Learned From the Market’s Perfect Storm.”

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21+

This product has intoxicating effects and may be habit forming. Marijuana can impair concentration, coordination, and judgment. Do not operate a vehicle or machinery under the influence of this drug. There may be health risks associated with consumption of this product.

For use only by adults twenty-one and older. Keep out of the reach of children.