Tag Archives: The World in Words
(Updated) I originally wrote this post around the 65th anniversary of the Hiroshima and Nagasaki bombs. The recent earthquake in Japan seems to echo those incidents in certain ways: a calamitous event, followed by massive destruction and huge loss of life; entire communties wiped out; high levels of radiation in the atmosphere; unpredictability; fear.
Some foreign media organizations have made the comparisons (for example, here and here). Also implicitly making the connection was Prime Minister Naoto Kan, who has called the quake and its aftermath Japan’s worst crisis since World War Two. A further sign of the historical significance of the moment, and of the country’s plight: Japanese Emperor Akihito made the first television address of his reign.
That said, there are significant differences between the 1945 bombings and the earthquake. The most obvious is that the 1945 events were military attacks (though the vast majority of victims were civilians). The destruction of two cities and the radiation released was fully intended by Japan’s wartime enemy, the United States. Also, radiation levels today are nowhere near as high as in the aftermath of the bombings. Nor, so far, is the loss of life, as shockingly high as it is.
I checked in with a couple of Japanese friends (one is a Hiroshima-based journalist; the other, a professor who has interviewed many A-bomb victims.) Their reponses were similar: for whatever reason, the Japanese media and public are not making a strong connection between Japan’s current crisis and the A-bombs. One connection, though, has made, as reported in the New York Times: the earthquake and tsunami have rekindled memories of conventional World War Two air raids among elderly survivors of those bombing campaigns.
In the podcast I put together for the 65th anniversary of the dropping of the Atomic bombs, there are two takes on self-censorship. A child survivor of Hiroshima explains why she kept quiet about her experiences for so long, through the pain and guilt of survival. She was seven when the the bomb fell, killing her parents and siblings but inexplicably sparing her. Late in life, Sueko Hada tells her story, in the presence of her daughter and granddaughters. They’ve heard some of it before, but she includes many new details this time. I snapped this picture of the family on the day I interviewed Mrs Hada in 2005. My report originally aired on The World as part of a series on the mental health of Atomic Bomb survivors, known in Japan as hibakusha.
Before I met Mrs Hada, I don’t think I fully understood why people with painful pasts remain silent, essentially censoring their own histories. But if you grew up in post-war Japan, surrounded by people who believed that radiation sickness was contagious and hereditary, you too might keep quiet about your past.
The legacy of Hiroshima and Nagasaki is hard to gauge. Japanese children still visit the Hiroshima Peace Memorial Museum (above). But these days, Tokyo Disneyland is a far more popular destination for school groups.
For many Americans, the use of the bomb remains a hugely sensitive issue. Views both pro and con seem entrenched, dialogue virtually impossible. The debate — such as it is — hasn’t progressed much since the 1995 controversy over The Smithsonian’s Enola Gay exhibition. But there has been new research about some of the earliest news reporting of the bombs. That began in 2005, when several dispatches written by Chicago Daily News reporter George Weller were published first time by the Tokyo newspaper Mainichi Shimbun. That was followed by publication in English of those and other reports in First into Nagasaki, a book put together by Weller’s son, Anthony.
Weller blamed U.S. military censorship for the previous non-publication of his reports. But Japanese freelance reporter Atsuko Shigesawa disputes that in a new book. (Japanese links here and here.) At the Library of Congress, she came across a statement from Gilbert Harrison, who was a sergeant in the US Army Air Forces and went to Nagasaki with Weller. Harrison went on to become editor of the New Republic. In his statement, he describes how he delivered Weller’s reports to a Chicago Daily News employee in Tokyo. As far as he knows, he says, the reports were filed there and then and were not subject to military vetting. He says he “doesn’t know why” the New York Times and the Arizona Republic reported in 2005 that “our reports were censored and not printed for 60 years.”
Atsuko Shigesawa believes that the true acts of censorship in reporting on the A-bombs were self-imposed, sometimes by reporters, sometimes by their editors. In Weller’s case, she believes his editors at the Chicago Daily News killed many of his stories. And when it came to other reporters filing stories from Hiroshima and Nagasaki, Shigesawa found that newspapers routinely cut the segments dealing with radiation sickness and other after-effects of the bombs on the human body. (The photo above was taken at a hospital in Tokyo. The original caption reads: “The patient’s skin is burned in a pattern corresponding to the dark portions of a kimono worn at the time of the explosion.”) In addition to these editorial cuts, at least one correspondent chose not to report on his hospital visits, believing that they were part of a plot to hoodwink him. William Lawrence of the New York Times wrote that American reporters were being subjected to “a Japanese propaganda campaign calculated to shame Americans for using such a devastating weapon of war”. He continued: “I am convinced that, horrible as the bomb undoubtedly is, the Japanese are exaggerating its effects in an effort to win sympathy for themselves in an attempt to make the American people forget the long record of cold-blooded Japanese bestiality.” For those reasons, Lawrence did not write about his hospital visits and the cases of radiation sickness he witnessed until 1972, in his memoir.
We don’t — and probably never will — have the full story of what influenced those initial reports of Hiroshima and Nagasaki. But there’s enough to suggest that self-censorship played a prominent role.
For another take on the meaning of Hiroshima and memory, check out Rahna Reiko Rizzuto’s memoir Hiroshima in the Morning. It was a 2010 finalist in the autobiography category of the National Book Critics’ Circle Award.
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Like millions of others, I grew up with the BBC. Today I work for a BBC co-production. I’m not a BBC employee, but I’m close to this story. And, um, that’s not me in the picture. I use a smaller microphone.
The cuts: five BBC language services will close (Serbian, Albanian, Macedonian, Portuguese for Africa and English for the Caribbean). Seven more language services, including Mandarin Chinese and Hindi, will be cut back from radio to internet only. A further six services will stop transmitting on short wave.
It means an estimated 30 million fewer BBC listeners worldwide. Will people migrate to the web and to English language news, or will the BBC – and its news values – become less influential?
There was a huge amount of coverage of this story. Most people were critical of the cuts with the British government — rather than the BBC — receiving the blame (here and here for example). But in Britain there is a BBC-despising minority which offered its own spin.
For the pod, I picked some of the best pieces of the BBC’s own coverage: interviews with the director of BBC global news Peter Horrocks, former World Service director John Tusa, and British foreign minister William Hague. Hague heads the Foreign Office, which has presided over the BBC World Service.
I also interviewed Debbie Ransome, head of the axed Caribbean Service. The Caribbean Service could be seen as some broadcast throwback to the days when the World Service was known as the BBC Empire Service. But Ransome says the service is unique in that it is regional, and so rises above the interests of any single country. She says the other broadcast media in the region either take political sides, or play a lot of music and not much else.
So which global radio services will move in to replace the BBC? The pod’s last interview is with journalism professor George Brock. He says that services run by the Chinese and Russian governments are likely to benefit, especially in Africa and Asia. And they don’t have the same news values as the BBC. Where the Beeb is remarkably successful at maintaining its editorial independence, Brock says the Russian and Chinese operations are mainly mouthpieces of their respective governments.
In this podcast, we have a story from California-based freelancer Corey Takahashi on a new exhibit in Silicon Valley that traces the history of computers and their languages. When Corey and I talked about how to approach this story, we decided that language was the key. Computer programming languages are world-famous among computer programmers, but almost completely unknown to the rest of us. I mean, have you heard of Fortran? Have these languages developed the same way as other languages, acquiring grammatical rules, then breaking them? Is there such a thing as beautiful code, worthy of our gaze in a museum?
Also, new research suggests that hard-to-read typographical fonts may help us remember the ideas they spell out. Jonah Lehrer spoke to the BBC about this. He writes a blog for Wired on neuroscience. Last September he wrote a post about using his kindle. He found the kindle-reading to be incredibly comfortable and easy — maybe too easy. More recently he noted that new research appears to confim that hunch. It suggests that we are less likely retain information if it is written in a clear, easy-to-read typeface like Clearview:
Part 3 of the pod concerns the architectural grammar of the United Nations Security Council. The design layout of the Council’s chamber and adjourning rooms is considered so important that replicas have been constructed during refurbishment.
Our man in New York Alex Gallafent does a fantastic job of turning a tour of the temporary chambers into an audio history of how architecture and design have shaped the history of UN Security Council.
The first pod story of 2011 comes from Mali, where a group of people are trying to use storytelling to preserve the Tamasheq language. The language is spoken by a dwindling number of the nomadic Tuareg people.
That’s followed by a conversation about the merits of the King James Bible, which turns 400 in 2011. In secular Britain, those merits aren’t strictly religious. In fact, people like former UK poet laureate Andrew Motion view the King James Bible as a literary giant, second only perhaps to Shakespeare. He argues that we are fast forgetting how it has shaped English-language poetry, fiction and rhetoric.
Then, the main event: the R word. Or perhaps the R-rated word: rationing. For manyAmericans, the idea of rationing is, well, unAmerican. In Britain though, rationing is part of the national psyche: it got the country through two world wars, and its collectivist values are at the core of Britain’s government-run health service. Now though, the emergence of expensive, new end-of-life drugs are challenging Brits’ belief in rationing.
During World War II and for nine years after, the British government rationed most food items: meat, flour, eggs, sugar. The government also strictly controlled the supply of gasoline, soap, stockings—even the number of buttons on jackets.
Although there was wartime rationing elsewhere, including in the United States, it generally applied to fewer items over fewer years and was quickly forgotten. In Britain, however, rationing became a part of the national identity.
Many older Britons speak of rationing as a great legacy of those wartime and post-war years, when people sacrificed their own interests for the greater good.
After World War II, the British government extended this societal approach to health care. It created the National Health Service, the NHS.
Today, 95 percent of Britons get their care through the government-run program. In order to provide care to everyone, the government says it must place limits on the care it provides. It must ration.
Limits to Care
“We have a limited budget for health care, voted by Parliament every year, and we have to live within our means,” said Michael Rawlins, chairman of a government agency called the National Institute for Health and Clinical Excellence (NICE).
NICE decides which drugs and other treatments can be prescribed by NHS doctors.
NICE was created in 1999 to clarify the reasons why certain drugs are approved and others are rejected. “In the old days it used to be done in secret, behind closed doors, in smoke-filled rooms,” Rawlins said. “Now it’s explicit. Everybody knows what the rules are.”
NICE’s rationing decisions start with a basic premise: The government should spend its limited resources on treatments that do the most good for the money. NICE calculates cost-effectiveness with a widely used measure called a quality-adjusted life year (QALY).
In essence, NICE asks these questions: How much does a drug or procedure cost? How much does the treatment extend the average patient’s life? And what is the quality of that life gained?
The calculations are complicated, but imagine that a cancer treatment costs $100,000 and that it extends the life of the average patient by four years. That means the cost of the treatment per year gained is $25,000.
Now imagine that for part of those four years the patient will be in pain and bedridden. NICE might figure the quality of that life at 50 percent of perfect health. Under NICE’s formula, that would make the drug half as cost-effective. In other words, the result would be $50,000 per quality-adjusted year gained.
NICE has set a maximum that it will spend on a treatment: about $47,000 per quality-adjusted year gained.
NICE tends to assume, without always performing calculations, that most common treatments are cost effective—including insulin for diabetes, cholesterol-lowering drugs for heart disease, and kidney transplants.
Instead, NICE analyzes only selected therapies, such as expensive new drugs that may extend life at the end of life. It has calculated that some of the more expensive drugs meant to slow the progression of Alzheimer’s Disease and some cancers fall below the cost-effectiveness threshold. In such cases, NICE says, the NHS shouldn’t pay for the drugs.
NICE chairman Michael Rawlins acknowledged that his agency’s decisions deprive some patients of drugs that may extend their lives by several months or more.
“We do recognize that the end of life is a very special time,” Rawlins said. “[It] allows people to attend weddings, see a grandchild born, seek forgivenesses.”
But he argued that if Britain spends a lot of money at the end of life, “we’re going to have to deprive other people of cost-effective care.” Rawlins said that might mean spending less money at the beginning of life—and might result in a higher infant mortality rate.
A Cancer Patient Fights Back
“Imagine how I feel when I hear people saying that if they give me the drugs I need to stay alive, babies are dying,” said David Cook, one of a growing number of British cancer patients speaking out against NICE and its rationing formula.
A senior government manager in his fifties, Cook was diagnosed with kidney cancer in 2004. Two years later his prognosis was bad.
Cook’s doctor said he would die within months unless he got a drug to slow the growth of his tumors. But the cost of the drug was high—too high for NICE in light of the advanced stage of Cook’s cancer—and the NHS refused to pay for it.
Cook fought back. He contended that NICE’s rationing formula calculates cost-effectiveness based on the average patient, but individual patients might do better on a given treatment, which would make the drug more cost effective than NICE suggests. Cook’s doctor believed that was true for him, so Cook pleaded his case before a panel of experts.
“I had to persuade a total of six people that were in the room” he said. “I had to talk for my life.” Cook won his appeal—he got the drug—but he resented that he had to fight for it, that he was treated as an exception.
Cook has other complaints about NICE.
He says the agency treats patients inequitably; it is more likely to reject drugs for rarer cancers like his because the treatments are more expensive than those, say, for breast cancer or lung cancer. “We’re being penalized for having…the ‘wrong’ type of cancer,” he said.
Cook contends that NICE overreaches by measuring the quality of a patient’s life. He said it should not be up to bureaucrats to decide that the life of a bedridden patient, for instance, is worth a quarter or a half that of someone in perfect health.
Cook further argues that NICE neglects an important fact—that by helping a patient live longer, a drug may improve not only that patient’s life but also the lives of loved ones. For his part, Cook remains active and working and has helped care for his wife, who has been diagnosed with breast cancer.
Stories like David Cook’s—about the government restricting access to life-saving drugs—have become common in the British media.
Part of the reason is that many new cancer drugs have become available in the last few years, and some of these drugs are extremely expensive.
NICE’s rejection of such drugs has fueled a growing backlash against the agency. Patient groups and drug companies have called it heartless and indiscriminate.
NICE’s future now hangs in the balance.
In May 2010, Britain’s ruling Labour Party, which founded the agency, lost a general election. The new Conservative-led government has said it will establish a cancer fund, totaling more than $300 million a year, to pay for some cancer drugs turned down by NICE.
This comes at a time of economic crisis in Britain. The government is making large cuts in just about every other public service.
Health economist Alan Maynard of the University of York said it may seem compassionate to set up a cancer fund, but it undermines NICE at a time when the country needs to be reminded of the value of rationing.
These days in Britain, few speak favorably about an agency that was set up to ensure that the government could provide the best care to the most people.
Shriver is an American who lives in London. Her latest novel, So Much for That, is about the U.S. health care system and how, in her view, it failed a woman who was dying of cancer. Shriver said her novel would have turned out “drastically differently” if she’d been writing about the British health care system.
The novel follows a character who has mesothelioma, a rare but deadly disease that is usually caused by exposure to asbestos. The character is partially based on a close friend of Shriver’s who lived 15 months after being diagnosed with mesothelioma. Shriver says her friend’s treatment cost $2 million.
“If she had been in the UK, that character would have been given palliative care alone,” said Shriver. “They would have tried to keep her comfortable and out of pain, but they would have skipped the major surgery. They would have skipped all that excruciating chemotherapy.”
“I think that my character and indeed my friend would have been better off in the United Kingdom,” Shriver said.
A Model for Other Countries?
Britain’s medical rationing has been noticed around the world. A steady stream of health officials from countries like Brazil, China, and Poland have visited NICE to see if setting up a rationing agency along similar lines makes sense for them.
Some American health care experts wanted to establish an agency like NICE as part of reforming the U.S. health care system. But after Sarah Palin cited Britain as the inspiration for what she claimed was an Obama Administration plan for “death panels,” that idea was dropped.
In fact, in this year’s health care reform law, Congress specifically prohibited British-style rationing. Medicare, for example, cannot apply quality-of-life tests in determining the cost-effectiveness of treatments.
Lionel Shiver is not pleased with that outcome. She said Americans still don’t seem ready to focus on some key end-of-life questions. “At least in the UK we’re having the conversation. How much is a life worth? And what kind of quality of life is that?”
But as other countries look to Britain as a model, it’s far from clear that the model itself will survive.
And that begs the question: Can explicit health care rationing work anywhere if it’s in trouble in the very country that may be best equipped to take it on?
The online version of the Oxford English Dictionary has just had a makeover. One of the new features is a list of 1,000 sources for English words and expressions. These tend to be authors (Shakespeare, Dickens, Twain) or publications (Chambers’s Cyclopaedia, Geographical Journal, New York Times). This is a historical list; there is no room for, to name but one modern linguistic innovator, André 3000.
My favorite entries are for people or publications I haven’t heard of: Helkiah Crooke — what a name!– a 17th century physician and anatomist; Anne Baker, a 19th century philologist; the Dictionary of the Older Scottish Tongue.
With budgets tight at American schools and colleges, and with a growing interest in Chinese, what happens to a language like Italian?
Once a heritage language, Italian is now more of a lifestyle choice. At Eataly — a new food emporium in New York City — TV chef Lidia Bastianich offers cooking and language classes. A latte just tastes better when you can order it in the original language, or so the thinking goes. Meantime, Italian has been canceled at SUNY-Albany, and appears imperiled elsewhere, at colleges and grade schools. It’s only through the rearguard action of people like Margaret Cuomo of the Italian Language Foundation that the language is still studied in the United States.
Also in the pod this week: Latin America is livid with the Royal Spanish Academy. That’s nothing new — there’s always been tension over how Spanish should, if at all, be regulated. But now, the academy wants to reduce the alphabet from 29 to 27 letters. The victims are a couple of couples: ch and ll, both beloved in the Americas. These sounds — or spellings — aren’t disappearing. They just will no longer have their special place in the dictionary. Those dictionary publishers will no doubt put out new editions, which will help their bottom line: they must love the Royal Spanish Academy!
Venezuela’s Hugo Chávez must like the academy too: it’s given him something else to rail about. Now that ch is no longer recognized, he has proclaimed that he will henceforward be referred to Ávez. Sounds kind of cockney.
Helping us wade through the inter-Spanish linguistic warfare is Ilan Stavans, author of Spanglish, the Making of the New American Language. Listen to an interview with him on that subject here.