We're losing the war on heart disease

Last week, my wife's life was at risk because we did not understand that women in heart distress do not necessarily experience the symptoms one might expect; indeed, they might have no chest pain at all.

My wife, a law librarian at Roger Williams University, is now home from Rhode Island Hospital (RIH) after a scary and unpleasant five nights. She will be OK.

But two weeks ago, she was misdiagnosed by her primary care provider. We too thought she was suffering only a stomach inflammation. In fact, she was experiencing a cardiac event.

Pixabay CC0

A week later, when primary care failed to yield an explanation and the pain became intolerable, we went to the ER.

My hat's off to the staff at RIH. In the ER, they respectfully heard out our recitation of symptoms and amateur self-diagnoses, erroneous as it turned out, and nonetheless rapidly and tenaciously checked out the heart. In the blood work, they discovered enzymes indicative of heart-muscle damage at 500 times normal levels. Our primary care provider had not tested for that.

You're going to hear a lot about women's heart health in the coming weeks, because February 3 is National Wear Red Day, a project of the American Heart Association (AHA) that kicks off American Heart Month. But I've known about Wear Read Day, and I've even worn red. I've known that symptoms of women's heart trouble are elusive. Still, I did not recognize the cause of my wife's distress. So this message can't be delivered early or often enough.

The day my wife came home, the January/February AARP Bulletin landed on our doorstep with the cover story, "America's War Against Heart Disease." A subhead reads, "75 years after it started, we’re losing the battle against our number 1 killer."

This isn't just news for seniors. Sari Harrar reported, "Death rates from heart disease rose 8.5 percent for adults ages 45 to 64 between 2010 and 2020." My wife is under 50.

The AHA says that women with any of these symptoms should "call 911 and get to a hospital right away":

1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
3. Shortness of breath with or without chest discomfort.
4. Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
5. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women may experience other symptoms that are typically less associated with heart attack, such as shortness of breath, nausea/vomiting and back or jaw pain.

Our home pharmacy since my wife came home.
RJ Peltz-Steele CC BY-NC-SA 4.0

Harrar reported particularly on the risk-compounding factor of gender.

For decades, women were underrepresented in clinical trials and their heart attack symptoms dismissed in emergency rooms as stomach pain or even emotional problems. The [AHA] published its first treatment guidelines for women in 1999, but it's taken longer for science to discover that the anatomy and electrical pathways of the female heart are unique, which may help explain why a woman's heart attack symptoms can be different from a man's.

Yet women's heart health is still understudied, according to a 2022 review of research in the journal Circulation Research, and women's heart attack warning signs are too often overlooked....

... [H]ealth professionals seem to have the same difficulty identifying heart disease in women: The same study found that when women suffering heart attacks arrive at an emergency room, they experience longer wait times ....  Another study found that women tend to wait longer before calling 911 when they're having a heart attack—up to 37 minutes longer.

This is not so simple as a problem of bias in perspective. All of my wife's doctors in primary care and at RIH were women. But the primary care providers failed to check out the heart, and the ER doc picked up on the possibility immediately.

Farrar's reporting showed that socioeconomics, race, and ethnicity further compound the problem of under-diagnosed or misdiagnosed heart disease. There might be real genetic differences based in race, but they cannot explain a 21% higher mortality rate for African-American adults over white adults, nor the increase in that gap over time, and a higher incidence of heart disease in Hispanic women and men over white women and men.

There are many viable explanations for disparities in outcome by race and ethnicity, importantly including consequences of wealth disparity, such as access to healthy food. But costs and fear of costs no doubt lead the pack of problems.

My family is fortunate to have access to healthcare. Insurance is available to us through both of our employers, which pay a portion of the premiums. Co-pays and deductibles for us are expensive, but manageable. 

The Rhode Island Hospital complex.
Kenneth C. Zirkel via Wikimedia Commons CC BY-SA 4.0

We don't yet have explanations of benefits for this bout of healthcare. But for an anecdotal point of comparison, a two-night hospitalization last year, with no surgical procedures, billed about $13,000 to our insurance. We were responsible for about $1,500. That's not going to stop us from going to the ER, but it will cause many people to pause. And lower-premium plans available through the Affordable Care Act can have much higher deductibles than ours.

A New York Times investigation featured on The Daily podcast this week opened with the story of a woman who stalled her emergency care for fear of costs. After at last seeking help and being hospitalized, she was responsible for a $1,900 tab. But that was too much for her fixed income. She struggled to meet even the demand of a payment plan while still buying food.

Alas, the Daily story was not even about costs. Rather, the investigation revealed that that patient's experience represented a prevalent norm at "nonprofit" hospitals that, by law, are not supposed to charge anything to people who can't afford it.

Some numbers about the Washington hospital highlighted in that story: Annual revenue: $27 billion. Tax break for "nonprofit" status: $1 billion. CEO's annual salary: $10 million.

The patient in the story was given a payment plan, but never an option not to pay. She prioritized the payments over her groceries because she felt indebted to the hospital for having saved her life. She imagined her money going to the staff who took care of her.

We are fortunate also because we live in the small state of Rhode Island and are only a short drive away from hospitals in Providence. Rural healthcare in America is another matter. In the Louisiana town where my wife grew up, and we still have family, the closest hospital is 70 miles away, and it's no tribute to cutting-edge technology.

On The Takeaway from WNYC this week, Harold Miller, president of the Center for Healthcare Quality and Payment Reform, explained why more than 600, or nearly 30% of rural hospitals nationwide are at risk of closing, and 141 have closed since 2010.

A federal aid package to save rural healthcare might be well intentioned but is misguided, Miller said, because to be eligible, a hospital must shut down its inpatient services. But there are no resources to transport patients to larger urban hospitals hours away. The urban hospitals don't have the capacity for that influx anyway. The resulting healthcare system we are now creating would have failed catastrophically had it been in place during the pandemic, when inpatient capacity was stretched to the limit. And that's to say nothing of separating patients from their families by long distances.

It's critical that every person, man and woman, be enlisted in the war on heart disease. Everyone especially should be on guard for the risk to women that might not be easily identified by symptoms. We're going to have to rely on ourselves and one another all the more with a healthcare system that is inconsistently resourced and increasingly ill equipped for the fight.

Ukraine Bar Association soldiers on

Lawyers have never stopped work in Ukraine, and the bar has been a catalyst in the development of democracy there, I learned today at a presentation of the Federalist Society.

Gvozdiy via Zoom from Kyiv today.

Via Zoom from Kyiv, Dr. Valentyn Gvozdiy, vice president of the Ukraine Bar Association, joined the Federalist Society International and National Security Practice Group to talk about the evolution of the profession in Ukraine and the role of lawyers in the present war. Dr. George Bogden interviewed Gvozdiy.

The talk came on the heels of news of the firing of a slate of top Ukrainian government officials in a corruption scandal. Gvozdiy addressed that developing story, too, in response to questions.

After the independence of Ukraine from the Soviet Union in 1991, the legislature adopted a "Law on the Bar," in 1992, Gvozdiy recounted. The enactment liberated the bar from "complete state control," but instituted only "quasi self-governance."

Ukraine had long looked to join the European community of nations, and work began promptly after independence to move the country in that direction. A key plank in the platform of European standards, Gvozdiy explained, is the existence of an independent bar. A 1995 resolution in the Council of Europe provided an incentive, recommending the organization of Ukrainian lawyers. The recommendation later became a precondition of the landmark Ukraine-EU association agreement in 2014.

Formal progress was long stalled by the very conflict that animates the present war. The fledgling Ukrainian state was weak, and political leaders were susceptible to corruption by easterly interests. Like popular opinion and the commercial sector, the developing bar leaned westward. By the time Donetsk Oblast-born Viktor Yanukovych claimed the presidency in 2010, to the dismay of the United States, the Russian-leaning leader was walking a tightrope that could not hold. Katya Gorchinskaya explained for Eurasianet:

The catalyst for the Yanukovych administration’s downfall was Ukraine’s stop-and-start efforts to sign an association agreement with the European Union. By late 2013, a majority of the population backed a draft agreement. But the pact to draw Ukraine closer to the EU placed Yanukovych in a tough situation. The treaty would open the way for substantial EU economic assistance and other perks, such as visa-free travel to Europe for Ukrainian citizens. But it would also mandate compliance with transparency and accountability provisions that gave Yanukovych and his associates reason to pause. In addition, Russia, the Ukrainian president’s main foreign patron, was steadfastly against seeing Ukraine take even the tiniest step toward Europe.

Amid the push and pull, Parliament coughed up landmark legislation in 2012 that established the Ukraine Bar Association as fully self-governing. Two years later, the Maidan Revolution deposed Yanukovych, Ukraine and the EU concluded the association agreement, and Russia invaded Crimea.

"'An obstacle is often a stepping stone,'" Gvozdiy said of Yanukovych, invoking a maxim usually attributed to U.S. Revolutionary War Colonel William Prescott. "The former president is not only not popular in Ukraine, he is the worst person we can imagine in our recent political history."

The recent ouster of top Ukrainian officials amid a corruption scandal has unsettled supporters of Ukraine with fear that the Zelensky Administration looks unstable. The news broke at a sensitive time, as the Biden Administration is navigating German reluctance to provide advanced tanks to Ukraine and skepticism over military investment in Ukraine from House Republicans. Meanwhile, Joanna Kakissis explained for NPR, Putin will seize on the news to bolster his characterization of Ukraine as a western puppet and threat to Russian security, incompetent in purported independence without Russian intervention.

In fact, the ouster is a good sign for Ukraine and should bolster western support, Gvozdiy said. Zelensky is signaling to Ukrainians and the world that contemporary Ukraine has "complete intolerance to the corruption."

Formerly, politicians robbed public coffers, and any court order to halt corruption was unenforceable, he said. The ouster now demonstrates Ukraine's remarkable progress in only a few years.

Yet in the present war, the bar is among democratic institutions fighting for survival, Gvozdiy said. The bar "would wither and absolutely disappear under Russian law."

Ukrainian advocates have "never stopped practicing law during the war," Gvozdiy said. Their work has included the defense of prisoners of war, if often to the chagrin of Ukrainians. (Other members of the legal community, such as prosecutors and judges, are busy too, for example, collecting evidence of war crimes. They are law-educated, but, unlike advocates, not members of the bar, as Ukraine follows a bar model in the European civil law tradition.)

Upholding the rule of law is the lawyer's constitutional obligation, Gvozdiy said. "We're not defending their crimes," he said of the POWs. "We defend their human rights."

One program attendee asked what American lawyers can do to help. Relayed by Bogden, the questioner expressed frustration that we don't have on-the-ground skills with obvious application, like other professionals have. 

I often have shared this frustration. We can't charge to the rescue like healthcare workers, nor mission like clergy. Even for pro bono projects at ABA conferences in the United States, I've picked up litter and organized dogs for vaccination, but I've never been asked to use my skills as a lawyer.

Gvozdiy's response was revealing, but not gratifying. Ukrainian lawyers need not just financial support, he said, but mental health support.

"We need professionals who can help us in a professional way to understand better how we need to behave and work and combine war with the practice of law," he explained. "We need training ... which will teach us how to react and how to reflect, how to communicate, how to live in peace with yourself and with all this pressure as a professional."

I'm not sure we're well stocked in the United States with experts in practicing law in a war zone. But when the conflict finally comes to an end in Ukraine, I know where we can find some.

Google censors opinion condemning private censors

On December 31, Google blocked access to a Savory Tort post from 2019 on free speech and censorship in New Zealand.

I received this message from Google on New Year's Eve:

As you may know, our Community Guidelines (https://blogger.com/go/contentpolicy) describe the boundaries for what we allow--and don't allow--on Blogger. Your post titled "NZ prosecutions for sharing Christchurch vid would suppress news, free speech, but worse is empowerment of private censors" [my boldface] was flagged to us for review. This post was put behind a warning for readers because it contains sensitive content; the post is visible at http://www.thesavorytort.com/2019/03/nz-prosecutions-for-vid-sharing-would.html. Your blog readers must acknowledge the warning before being able to read the post/blog.

Why was your blog post put behind a warning for readers?

Your content has been evaluated according to our Adult Content policy. Please visit our Community Guidelines page linked in this email to learn more [link below]. We apply warning messages to posts that contain sensitive content. If you are interested in having the status reviewed, please update the content to adhere to Blogger's Community Guidelines. Once the content is updated, you may republish it at [URL omitted]. This will trigger a review of the post.

For more information, please review the following resources:
Terms of Service: https://www.blogger.com/go/terms
Blogger Community Guidelines: https://blogger.com/go/contentpolicy 

Sincerely,
The Blogger Team

Setting aside for a moment the irony of private censorship of a post about private censorship,* I wanted to understand what triggered the block. As the headline indicates, I fretted in the post about New Zealand criminal law being turned against online re-publishers of the horrifying video of mass shooting at a Christchurch mosque in 2019. I wrote that the lack of newsworthiness exception in New Zealand law would be problematic in U.S. First Amendment law, and the prosecution could not withstand analysis under Brandenburg v. Ohio (1969). And I wrote some about how the modern internet has posed a challenge to the dated First Amendment doctrine.

Willow Brugh via Wikimedia Commons and Flickr CC BY-SA 2.0

At first, I thought maybe I linked to the objectionable video itself; I had not. I did mention by "dot com" name a problematic website from earlier internet days that was infamous in freedom-of-information circles for hosting gruesome content. But I didn't hyperlink it, and the site no longer exists at that address anyway.

The message from Google referred to the "Adult Content policy."  Here's what the policy disallows:

We do allow adult content on Blogger, including images or videos that contain nudity or sexual activity. If your blog contains adult content, please mark it as 'adult' in your Blogger settings. We may also mark blogs with adult content where the owners have not. All blogs marked as 'adult' will be placed behind an 'adult content' warning interstitial. If your blog has a warning interstitial, please do not attempt to circumvent or disable the interstitial - it is for everyone’s protection.

There are some exceptions to our adult content policy:

• Do not use Blogger as a way to make money on adult content. For example, don't create blogs that contain ads for or links to commercial porn sites.
• We do not allow illegal sexual content, including image, video or textual content that depicts or encourages rape, incest, bestiality, or necrophilia.
• Do not post or distribute private nude, sexually explicit, or non-explicit intimate and sexual images or videos without the subject’s consent. If someone has posted a private nude, sexually explicit, or non-explicit intimate and sexual image or video of you, please report it to us here [hyperlink omitted].

There's nothing remotely sexual about the 2019 post. Nor is there any depiction or description of violence, other than a reference to the mere occurrence of the tragedy, which was well reported in news media with plenty more detail.

Links to The Savory Tort were once banned from Facebook, too, for more than a year. When I inquired, Facebook sent me a form message saying that The Savory Tort violated Facebook terms of service for content. I sent further inquiries, made appeals, etc., but Facebook never clarified how the terms were violated. Indeed, Facebook never responded with other than form messages confirming the ban. For all the hoopla about a "Facebook supreme court" and thoughtful, human review of content, those avenues apparently are not open to the little people such as me.

Ultimately, a former student and labor attorney complained about the ban to Facebook, after he was denied permission to share a link to my blog. He kindly let me know. Subsequently, consequently?, and suddenly, links could be posted. The ban vanished as mysteriously as it had appeared. Not a word from Facebook, then or since.

The Facebook ban came about upon a complaint from someone who didn't like something I wrote, I suspected. That happens. For example, I wrote once about a family law case in the Massachusetts Supreme Judicial Court, and I was threatened with legal action by the disappointed party. 

It's easy for someone to complain to Facebook or Google Blogger about online content. The complaint is not necessarily reviewed by a real person, or it is and the person is incompetent or indifferent. It's easier to block or take down content than arbitrate a dispute. That's why trolls and publishers have been able to abuse the notice-and-takedown system that has debilitated fair use of intellectual property.

Here, Google said that the post "was flagged to us for review" (my italics) and "has been evaluated." The choice of words, muddling passive voice notwithstanding, suggests that a third party triggered the review. How anyone, even a bot, at Google then could have found adult content, or anything in violation of the content terms, is a mystery to me. I can conclude only that the block was imposed automatically upon the complaint, with no review at all.

I would seek further explanation or ask for a human review, but that, it seems, is not an option. Google offers me the opportunity to have the block reviewed only after I "update the content to adhere to Blogger's Community Guidelines." I see no violation of the guidelines now, so I don't know what to update.

Now let's come back around to that irony, which might not be coincidental.  (Irony and coincidence are not necessarily the same thing, whatever Alanis Morissette would have you believe.)  The dangers of private online censorship was the theme of my post in 2019. The block on my post occurred in December 2022 only weeks after Elon Musk began to censor his critics on Twitter. Musk is still at it, by the way, seemingly having acceded this week to Indian government demands that Twitter censor critics of Prime Minister Narendra Modi. 

At the same time in December that Musk was making headlines with Twitter censorship, the Supreme Court scheduled (for Feb. 21) the oral argument in Gonzalez v. Google LLC (track at SCOTUSblog). The case asks whether internet service providers such as Google enjoy section 230 immunity from liability in the provision of targeted content, such as search results, apart from the conduct of traditional editorial functions, akin to newspaper editors choosing letters to the editor. David McGarry explained for Reason two weeks ago, "The plaintiff is Reynaldo Gonzalez, whose daughter was murdered in a 2015 terrorist attack. [He] argues that YouTube, a Google subsidiary, should face liability because its algorithms recommended terrorist content posted on the platform that Gonzalez says aided the Islamic State."

That's a potential liability exposure that might incline Google to censor first and review later.

Perhaps someone triggered the automatic censorship of a great many online articles about private censorship, hoping to make the very point that private censorship is dangerous. If that's what happened here, I would offer a grudging salute. But I would like to see the point actually made, not just fruitlessly attempted.

At the end of the day, I'm not so broken up about the block, as opposed to a ban like Facebook's, which frustrated me no end, as I could not share content at all with family and friends. A reader who encounters a sensitive content warning wall might be only more interested to know what lies beyond. And my target audience isn't children anyway. 

I figure there's a reasonably good chance that this post will wind up behind a warning wall for having referred to a warning wall. So be it. Anyone interested enough to be investigating a four-year old story of censorship probably will get the ironist's point, and mine.

* My journalism ethics professor at Washington and Lee University in the early 1990s, the late great Lou Hodges, railed against the word "censorship" to describe private action, so would have regarded the term "private censorship" as outrageously oxymoronic. Professor Hodges was steeped in classical learning and recognized that the word "censor" comes from the Ancient Roman word referring to a public magistrate whose responsibilities, on behalf of the state, included counting people and property—thus, "census"—and the enforcement of public morals through what we now call "censorship." To honor Professor Hodges, I long insisted on the same distinction. But in recent years, I have given in to the modern trend to employ the term regardless of the private or public nature of the actor. Professor Hodges could not then have anticipated that we would soon have an "Internet" that looks very much like a public commons, thus reviving the seemingly antiquated First Amendment problem of the company town. The term "censorship" seems to me apt for a world in which transnational corporations such as Google and Meta might as well be governments from the perspective of ordinary people.

Lawyers be a-ballin'?

Canadian lawyers protest legal aid de-funding in 2014
(Sally T. Buck via Flickr CC BY-NC-ND 2.0).
My wife was a legal services attorney after law school.
Her salary could not have paid both law school debt
and even a modest mortgage.

A student loan specialist giving advice on The Takeaway this morning said, "Don't live like a lawyer when you're a student, and you won't live like a student when you're a lawyer."

Betsy Mayotte, founder and president of The Institute of Student Loan Advisors, was repeating an aphorism, she said, as a caution against students borrowing more than they need for higher education. Don't count on any program for loan forgiveness, she warned; rather, assume that you'll have to pay back every dime.*

That's sound, conservative economic advice, especially for an America stretched thin on credit card debt and short on long-term savings. But for anything, I could not work out how the aphorism embodied the message.

What does it mean to "live like a lawyer"?

Mayotte had just cautioned students that they should take the time, however boring the task sounds, to read the whole of their promissory notes. The notes well explain what borrowers are in for, she advised, and "no one told me that" will not later be an excuse to default on debt.

Also good advice. But doesn't living like a lawyer mean being supremely attentive to the fine print and acting conservatively in anticipation of adverse circumstances?

In her informative and insightful book, How to Be Sort of Happy in Law School, Professor Kathryne M. Young related research that successful lawyers are more often natural pessimists, marking a contrast with the successful optimists who have the lead in the other professions, clergy and medicine. That's because a lawyer's job is to prepare for the worst, while clergy and doctors are busy instead coaxing their clients toward a joyful salvation of one kind or another.

Did the aphorism mean to be an optimist when a student, so you don't have to be a student when you're a pessimist?  What does that even mean?

You, dear reader, are no doubt quicker on the draw than I, so you've probably worked it out. It dawned on me an hour or so later:

Don't live like a baller when you're poor, or you'll be poor when you're supposed to be ballin'.

The problem is that "lawyer" doesn't mean rich to me. 

I'm a lawyer. Not rich. My wife's a lawyer. Also not rich. I checked.

The vast majority of my former students work in public service jobs, if they're in JD-required positions at all. And even the few in private practice: not rich. Okay, I can think of one. But I think he was rich already.

Don't get me wrong. We're not struggling. Two JDs put our household income in the 90-something percentiles, according to the DQYDJ calculator, with me in the 90s as an individual and my wife, who has a master's degree, as well as her law degree, in the 70s. 

But income is only one measure of wealth, and, I daresay, not the most important. We both went into serious debt to get those JDs. Our home is mortgaged. We had not paid off our graduate education by the time our only child went to university. And we could not afford to get her through four years without her going into debt, too. 

Neither of us started off loaded. We still buy our clothes at Goodwill and Savers. Habits die hard. I just threw away my wife's socks with holes in them while she was out of the house. She won't do it. But I think she deserves better.

When I left law practice in 1996, I was making $50k, which is about $95k adjusted for inflation. I left that for my first job in academics, where I made $35k—$15k less than the IT guy. "Supply and demand," the dean said.

Now I make more. But after advancing in academics for 25 years, I still make less than the average lawyer in the mid-Atlantic, where I practiced, and just a little more than the nationwide average starting salary for a first-year associate.

The takeaway is that I don't associate being a lawyer with being rich. And it's alarming if people are going to law school with that expectation, or if that's how the public sees lawyers. "Kill all the lawyers" was the suggestion of a butcher.

I just finished some physical therapy for an injured shoulder. The bill for that, to my insurer, was $355 per hour. I saw a podiatry specialist recently. That was billed at $122 for what I think was scheduled as a 15-minute appointment, though it took less than 10.  We'll call it $488 per hour.  I like both those providers, but neither is a superstar gracing the cover of Physicians Weekly.

A very gross number, but the average U.S. lawyer's billable hour now runs about $300. The lawyer has more investment in education than the physical therapist, if a bit less than the doctor. The lawyer is a bargain. Clergy is a better bargain, but that's their thing.

Why isn't the saying, "Don't live like a doctor when you're a student, and you won't live like a student when you're a doctor"?

Well, of course, not everyone in healthcare is rich, either.  My wife had an ER visit and hospital stay, no procedures, last summer that was billed at about $13,000 for two days. At the same time, one of my nieces and one of my brothers work as nurses in hospitals; neither of them is making bank. Where's the money going?

I don't know what the right graduate school investment is to get rich. I didn't make it. Maybe whatever gets you to be a healthcare CEO. Be the owner of the hospital, not a provider in it.

Law and medicine can open the door to opportunity, to improve your lot if you're not living comfortably. I'm not knocking that. But no one should go into educational debt without a plan at least to do better than status quo. And plans should be based on realistic expectations.

The aphorism doesn't fit. Worse, it's dangerously misleading. We've got a problem in America with access to education and upward socioeconomic mobility. Simplifying the narrative to suggest that a professional degree will necessarily afford return on investment is not part of the solution.

* I've been reading about the challenges against the Biden student loan forgiveness order. You can follow the legal story at Reason. I'd love to see the plan go through; my daughter would benefit. I'm sorry to say, though, I think the challengers are right: the President exceeded his authority. The unfortunate political outcome, I predict, is that the Administration will be blamed for breaking a promise, and the Supreme Court will be blamed for enforcing the law, both thereby suffering unwarranted further damage to already embattled credibility. Meanwhile, Congress, which in fact held the key to untie the President's hands, but can't ween itself off addiction to money, and especially Democrats, who passed on a real opportunity to make a difference for access to education and socioeconomic opportunity, will escape accountability.

With regard to the title of this post, you can read more about the circumfix a-/-ing at Wiktionary. Read more about "the habitual be" at Slate.

I've been away from the blog for a while owing to an exhausting, if variably rewarding and challenging December and January. I'm back in the saddle now and look forward to catching up on some matters I'm eager to share. Thank you for your patience, and stay tuned!

Politics complicates football: Sympathy for ... Iran

As advertised, last week in Kraków, Poland, I had the great privilege to talk law, development, and the FIFA World Cup, with the group stage under way in Qatar.

Students and faculty of the American Law Scientific Circle (KNPA) and American Law Program at Jagiellonian University (Koło Naukowe Prawa Amerykańskiego TBSP UJ and Szkoła Prawa Amerykańskiego UJ), in collaboration with the Columbus Law School at the Catholic University of America, generously hosted me.  The talk kicked off a KNPA lecture series on "Law and Sustainability." My especial thanks to KNPA President Zuzanna Maszniew and her leadership team.

Photo © Zuzanna Maszniew, used with permission.

I was no John Oliver, to be sure, but I hope I stimulated thinking about the Gordian Knot of sport and politics and its implications for the Middle East and North Africa's place at the table.

Today, November 29, the United States will round out its play in the group stage in Qatar with a match against Iran, simultaneously with a high stakes stand-off between England and Wales. It's a big day, football fans.

Meanwhile, coming home to the States this week, I've been disappointed that Americans are not more in tune with the fascinating stories of geopolitics that are unfolding under the sporting tents of the Qatar World Cup. I admit, what's happening now in China dangles meritorious distraction. But with the USMNT facing Iran today, I want to mention one of the stories from Qatar that has gripped me.

In Iran's opening match with England last week, Iranian footballers refused to sing their own national anthem (BBC).  Stony faced, the players apparently chose to stand in silent solidarity with rights protestors against the government at home (N.Y. Times). Subsequently, Iranian authorities arrested a former national-team footballer known for occasional anti-regime sentiments (Guardian). At Iran's second match, the lads toed the line.

The anthem stunt was extraordinarily courageous. The players had to have known the disgrace they brought on the regime would have consequences when they go home, if not sooner.

Iranian footballers in 2018.
Mahdi Zare/Fars News Agency via Wikimedia Commons CC BY 4.0

More, though, I was struck by the reminder that people and their governments are not the same thing.

I'm a reasonably bright person, as people go, and I've seen a lot of the world. I come from an immigrant family myself. I grew up with a dear Iranian friend. Her stepmother taught me how to make tahchin, and her dad eagerly gave me his own well worn copy of All the Shah's Men. I shouldn't need to be reminded that people are just people, much the same around the world, just trying to make the best of things and find some joy where we can; and that it's wrong to ascribe the Machiavellian motives of states, whether others or our own, to their citizens. The protests now in China say the same.

Yet, I admit, I had followed the USMNT into the World Cup with something of a Cold War mentality, maybe because of the era when I grew up. Yellow ribbons, burning effigies, and "Death to America" chants all bounce around my long-term memory. I was determined that we and our Group B compatriots from England and Wales should beat Iran to make some kind of political point. A Miracle on Ice or Rocky IV situation.

The Iranian men's demonstration unsettled my unconscious prejudice. As a result, a part of me has been pulling for Iran in their last matches, even while, still, I had to favor the England squad, which features some of my beloved Manchester City stars, and Wales, which invokes Lasso-esque Wrexham affections. And even while, of course, I support my home USMNT today, there will be a part of me that wants to see the Iranian side make a pride-worthy showing.

Anti-corruption law violates business-owner privacy, EU court holds with myopic appraisal of transparency

A key European Union transparency law that allows watchdogs to trace corporate ownership to combat corruption has been struck down by the EU high court for compromising personal privacy.

EU beneficial owner registry map from Transparency International, 2021. Read more.
CC BY-NC-ND 3.0

I'm not a hard skeptic on the personal privacy prerogative of the EU General Data Protection Regulation. To the contrary, I've written that there's a lot to like about the emerging global privacy norms embodied in the GDPR, and, contrary to conventional wisdom, American social expectations, if not yet federal law, are converging with Europe's.

That said, the EU Court of Justice yesterday announced a profoundly problematic decision at the junction of public access and personal privacy. The blanket disclosure requirements of a key anti-money-laundering law can't stand, the court held, because they don't calibrate the public need for access with the privacy of natural-person business owners with sufficient precision, that is, as a function of necessity and proportionality.

Troublingly, the court characterized transparency norms, which are grounded in treaty and law more firmly in the EU than in the United States, as specially relevant to the public sector and not fully implicated in the private sector, in the context of business regulation.

The potential implication of this proposition is that access to information is limited to a requester learning "what the government is up to," to the exclusion of government oversight of the private sector. That's a cramped and problematic construction of access law that has dogged journalists and NGOs using the U.S. Freedom of Information Act (FOIA) for decades. Read more in Martin Halstuk and Charles Davis's classic 2002 treatment. As I have written in my comparative research on access to information, access to and accountability of the private sector is a problem of our times. We must solve it if we're to save ourselves from the maw of corporatocracy.

In my opinion, the CJEU decision fundamentally misunderstands and overstates the legitimate scope of data protection regulation with the effect of enervating transparency as a vital oversight tool. The impact is ironic, considering that data protection regulation came about as a bulwark to protect the public from private power. The court turned that logic on its head by using personal privacy to shield commercial actors from public scrutiny.

Unfortunately (for this purpose), I have my hands full in Europe (coincidentally) right now, and I lack time to write more. Fortunately, Helen Darbishire and the team at Access Info Europe already have written a superb summary. Their lede:

In a ruling that has sent shockwaves through Europe’s anti-corruption and transparency community, the Court found that the Fifth Anti-Money Laundering Directive (AMLD5, 2018) is too loosely framed and provides for overly-wide public access to the [ownership] registers without a proper justification of the necessity and proportionality of the interference with the rights to privacy and personal data protection of the beneficial owners.

A saving grace, Access Info observed, is that the court did not rule out transparency per se; rather, requesters will have to fight for access case by case on the facts, upon a properly narrowed regulation. In U.S. constitutional terms, it's like saying the one-size-fits-all law was struck for vagueness, but the regulatory objective still can be achieved under a narrower rule that works as applied. All the same, journalists and non-profit watchdogs are not famously well financed to fight for access on a case-by-case basis.

The case is No. C‑37/20 & No. C‑601/20 in the Grand Chamber of the CJEU.

With FIFA World Cup under way in Qatar, law students study sport and soft power, law and development

I'll be talking law, development, and the World Cup today in Kraków, Poland.

Thanks to the American Law Scientific Circle (KNPA) and American Law Program at Jagiellonian University (Koło Naukowe Prawa Amerykańskiego TBSP UJ and Szkoła Prawa Amerykańskiego UJ), in collaboration with the Columbus Law School at the Catholic University of America, for hosting me. This talk kicks off a KNPA lecture series on "Law and Sustainability" and begins at 3 p.m. CET at Pałac Larischa 203, Bracka 12.

I'll share some of the subject matter later.  Too much football to watch!

Qatar World Cup opens Sunday; meanwhile, Netflix series stokes embers of FIFA corruption scandal

I visited CONMEBOL HQ in Asunción, Paraguay, in October.
The South American angle on the FIFA corruption scandal
was engagingly fictionalized in El Presidente in 2020.
(Photo by RJ Peltz-Steele CC BY-NC-SA 4.0.)

The sport world is abuzz over the Netflix documentary series, FIFA Uncovered, dropped November 9, just weeks before the FIFA World Cup opener in Qatar.

Many in Qatar are crying foul by filmmaker Miles Coleman for dredging up the ugliness of the FIFA corruption scandal, the focus of this docuseries, right now. But in an interview with renowned MENA scholar James Dorsey, Coleman, who created This Is Football for Amazon Prime in 2019, said he had no motive other than historical documentation. The timing of the release, Coleman said, is to bring football fans up to speed on the facts, so they can have informed conversations around the Qatar World Cup.

FIFA was rocked by scandal in 2015 when investigators led by the U.S. Department of Justice (DOJ) arrested top officials in Zurich and issued an avalanche of indictments. It was revealed then that corruption practically poisoned every part of world football governance, especially the bidding process for the world's top sporting event and its 2010 award to Russia for 2018 and Qatar for 2022.

Qatar narrowly edged out a bid from the United States in 2010, and disgraced FIFA President Sepp Blatter and his allies accused the United States of spite. Purportedly relieved of corrupt process, FIFA in 2018 awarded the 2026 World Cup to the joint bid of the United States, Canada, and Mexico.

When issues remain controverted, the docuseries presents all voices, Coleman told Dorsey. Indeed, the interviews are what makes the series worthwhile. Most of the story has been told already and well; I read and reviewed a number of books on the subject in the first pandemic summer. The docuseries, though, includes interviews with just about every key player, including Blatter himself, as well as Qatar bid chief H.E. Hassan Al Thawadi; "Qatar whistleblower" Phaedra Al-Majid, featured recently on Norwegian television; and Mary Lynn Blanks, romantic partner of corrupted American football official Chuck Blazer, who died in 2017.

Among the revelations, or at least confirmed suspicions, arising from the docuseries interviews is the fact, borne out by evidence besides his own testimony, that Blatter favored the United States rather than Qatar to host the 2022 World Cup. For all Blatter's failings, he was outmaneuvered by the colossal corruption machine that he helped to create. African Football Confederation President Issa Hayatou, a rival of Blatter's within FIFA, was key to securing the Qatari win. Hayatou was joined in his efforts by Jack Warner, president of the North, Central America and Caribbean Association, whose defection infuriated Blazer.

On Wednesday next week, November 23, at Jagiellonian University in Kraków, Poland, I will lead a discussion, "Law, Development, and the World Cup."  The program, in English, begins at 3 p.m. local time at Pałac Larischa 203, Bracka 12.

The World Cup opens Sunday night in Doha, Nov. 20, at 1100 US EST/1600 GMT, when Qatar hosts Ecuador in Group A. The United States MNT plays its Group B opener against Wales on Monday, Nov. 21, at 1400 US EST/1900 GMT. Poland plays its Group C opener against Mexico on Tuesday, Nov. 22, at 1100 US EST/1600 GMT/1700 CET.

Hat tip to Alessandro Balbo Forero, an alum of my Comparative Law class who wrote his final paper on football and Brexit, for alerting me to the drop of FIFA Uncovered. He's an Arsenal supporter, but nobody's perfect.

Here is the trailer for FIFA Uncovered:

And here is the Dorsey interview of Coleman:

In shadow of Ukraine war, webinar tells story of UN Genocide Convention, Polish-Jewish jurist Lemkin

The Jagiellonian Law Society and its President Elizabeth Zechenter, a visiting scholar at Emory, have put together another superb program prompted by the legal implications of the war in Ukraine.

"Lemkin, Genocide, and the Modern World" will run on Zoom in two parts, the first on December 1, 2022, at 12 noon U.S. EST, 1700 GMT, and the second in January, TBA. Free registration is required.

Here is a summary:

You are invited to a webinar on Raphael Lemkin, the UN Genocide Convention, and the likelihood of prosecution of the crime of genocide. Distinguished academics will discuss Lemkin and the Genocide Convention in light of the recent Russian aggression in Ukraine. Lemkin was Polish and Jewish and survived WWII. He had complex, divided loyalties and life experiences that influenced his work. He is often portrayed as a lone ranger, but he was effective in gaining support for his ideas, especially among women groups, who made the convention possible. Lemkin had a complex relationship with Stalin, which influenced his approach to the convention.

The Holocaust Encyclopedia has more on Raphael Lemkin.

Speakers include:

• Professor Donna Lee-Frieze, Deakin University, Melbourne, Australia, a genocide studies scholar specializing in memory and aftermath; 
• Professor Doug Irvin-Erickson, Carter School Director of the Genocide Prevention Program at George Mason University;
• Professor A. Dirk Moses, Australian historian teaching in political science at the City College of New York, CUNY;
• Professor Roman Kwiecien, Department of International Law at Jagiellonian University, arbitrator at the Permanent Court of Arbitration in the Hague) and the Court of Conciliation and Arbitration within the OSCE in Geneva;
• Professor Marcin Marcinko, Jagiellonian University Law School, chair of the National Commission for Dissemination of International Humanitarian Law at the Main Board of the Polish Red Cross, and co-organizer of the Polish School of International Humanitarian Law of Armed Conflict.

The Jagiellonian Law Society hopes also to feature contributions from Ukrainian scholars, arrangements pending.

The program is a result of the collaboration of the Jagiellonian Law Society with support from the International Human Rights and Women Interest Committees of the American Bar Association; the New York State Bar, New York City Bar, and New Jersey Bar; the Department of Russian and East European Studies at the University of Pennsylvania; and the School of Diplomacy and International Relations at Seton Hall University.

Again, registration is free.

As Jacoby talk commemorates Kristallnacht, Ukraine recurs in historical record of flights from oppression

An upcoming talk on Kristallnacht, a recent experience in the Paraguayan Chaco, and the ongoing war in Ukraine have me thinking lately about cultural and religious freedom.

In commemoration of Kristallnacht, award-winning Boston Globe columnist Jeff Jacoby will speak at the S. Joseph Solomon Synagogue of the Maimonides School in Brookline, Massachusetts, on Sunday at 7 p.m. The talk will be livestreamed.

Jacoby's father was the sole survivor of his family at Auschwitz. 

"He didn’t hate God for what he had lost and didn’t abandon the Judaism in which he had been reared," Jacoby wrote of his father. "On the contrary, he deepened it with observance, study, and prayer."

Last week I had the privilege of visiting Mennonite communities in the Chaco region of Paraguay. Mennonites arrived in Paraguay in three waves, circa 1875, 1930-32, and 1947. Each time, they sought refuge from regimes that wished to extinguish their religious freedom, if not their lives.

Restored "Koloniehaus" at Filadelfia, Paraguay
RJ Peltz-Steele CC BY-NC-SA 4.0

On a world map at the Fernheim Colony House in Filadelfia, I was struck in particular by one remarkable line tracing Mennonite migration. The journey ran eastward from Ukraine, then Austria-Hungary, to Siberia in 1908; then further east to China, turning south to Indonesia in 1927; then turning back westward across the Indian Ocean and isthmus of Suez, to Europe; and at last on to Paraguay to join the end of the second migration there in 1932.

Besides the astounding odyssey it represented, the line resonated with me both because of the current conflict in Ukraine and because my own grandfather's Jewish family fled what is today western Ukraine at about the same time.

Map at the Filadelfia Mennonite Museum,
similar to the one at the Colony House
RJ Peltz-Steele CC BY-NC-SA 4.0
with no claim to underlying work

As has been widely reported, one Russian strategy in the present war in Ukraine is the forced relocation of Ukrainians, especially children, to Russia, whether to be given passports and politically and culturally Russified, or, in the case of dissenters and combatants, to be condemned and disappeared in remote parts. The strategy is not new.  Just before the Russian invasion of Ukraine in February, I wrote about the forced relocation of Polish ethnic minorities, such as the Lemkos, from western Poland to Soviet Russia in 1947.

The parallels are not coincidental.  The Mennonites fled increasingly unstable Austria-Hungary for Russia before the outbreak of World War I. Then, scarcely a decade after the Russian Revolution, rising nationalism rendered even Siberia inhospitable, prompting the exodus of the late 1920s. After World War II, Mennonites remaining in an eastern Germany about to be gifted to the Soviet Union departed in another migratory wave, in 1947. They were not alone; justifiably afeard Christians of other sects departed as well.

Engrossed in the map in Paraguay, I muttered something unkind about Putin. Standing nearby, Fernheim archivist Gundolf Niebuhr said quietly, "History repeats itself."

Niebuhr and I talked about the complex relationship of the contemporary Mennonite Paraguayans with their Latino and indigenous neighbors.  They work closely together, literally, on farms, in schools, and in governance.

But the legacy of repeatedly fleeing oppression, Niebuhr told me, is that even in prosperous and peaceful times, people are dogged by a lurking anxiety over the inevitable impermanence of the idyll. To look around, the Mennonites and their partners have defined the unique cultural identity of the human Chaco. Yet are the Mennonites still only visitors? Will the day come when Asunción says, assimilate, or else? And it will be time to move on again.

Struggle and perseverance are enduring themes in Jewish identity. The former seems inescapable, as expressions of antisemitism abound. Hate simmers now in the Twitter scandals of Kyrie Irving and Kanye West.  Last week, mourners marked the fourth anniversary of the Pittsburgh synagogue attack. Yet the Jewish tradition teaches that anxiety is counter-productive. God will light the way, as always he has. That seems to have been the remarkable faith walk of Jeff Jacoby's father. Still, there are scarce few among us who do not struggle to eschew fears and doubts.

The Jewish people have a strong claim to unrivaled familiarity with persecution. But assimilation and expulsion of the other seems well ingrained in the human mode of operation, regardless of the nature of the otherness. An elder of my Christian church reminded me yesterday that being Christian is not supposed to be easy. The "Good News" might offer salvation, but leisure and luxury are not part of the methodology, at least not in this life.

I live without fear of being alienated in, or exiled from the only home I know. That is a blessing. All of us possessed of that blessing owe open hearts to anyone who loses it, whether in Pittsburgh, Paraguay, or Ukraine.