Animal agriculture is choking the Earth and making us sick. We must act now | James Cameron and Suzy Amis Cameron

Film-maker James Cameron and environmentalist Suzy Amis Cameron writes that to preserve Americas majestic national parks, clean air and water for future generations leaders must be pressed to address foods environmental impact

Our collective minds are stuck on this idea that talking about foods environmental impact risks taking something very intimate away from us. In fact its just the opposite. Reconsidering how we eat offers us hope, and empowers us with choice over what our future planet will look like. And we can ask our local leaders from city mayors to school district boards to hospital management to help, by widening our food options.

On Monday and Tuesday, the city of Chicago is hosting a summit for the Global Covenant of Mayors for Climate and Energy to discuss climate solutions cities can undertake. Strategies to address and lower foods impact should be front and center.

Animal agriculture is choking the Earth, and the longer we turn a blind eye, the more we limit our ability to nourish ourselves, protect waterways and habitats, and pursue other uses of our precious natural resources. Raising livestock for meat, eggs and milk generates 14.5% of global greenhouse gas emissions, the second highest source of emissions and greater than all transportation combined. It also uses about 70% of agricultural land, and is one of theleading causes of deforestation, biodiversity loss, and water pollution.

On top of this, eating too much meat and dairy is making us sick, greatlyincreasing our risk of heart disease, type 2 diabetes, several major cancers (including breast, liver and prostate) and obesity. Diets optimal for human health vary, according to David Katz, of the Yale University Prevention Research Center, but all of them are made up mostly of whole, wholesome plant foods.

So what gives? Why cant we see the forest for the bacon? The truth can be hard to swallow: that we simply need less meat and dairy and more plant-based options in our food system if were to reach our climate goals.

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The Avatar movie set had plant-based menus. Photograph: 20th Century Fox/Everett/Rex Features

This can start with individual action. Five years ago, our family felt hopeless about climate change, and helpless to make meaningful change. But when we connected the dots on animal agricultures impact on the environment, coupled with the truth about nutrition, we took heart because it gave us something we could actually do.

To create change at the scale needed, this will take more than individual choice we need to get climate leaders on board about the impact of food. Cities and counties have used their buying power to transition fleets from diesel to electric, and we need to do the same with how we purchase food. We have done this in our own community, moving the lunch program of Muse School, in Calabasas, California, and the Avatar movie set to plant-based menus. Scaling up initiatives like these can make a big difference: if the US reduced meat consumption by 50%, its the equivalent of taking 26 million cars off the road. We think thats damn hopeful.

Decision-makers on all levels can make it easier for us to eat better, by expanding access to food options that are good for our health, affordable, and climate-friendly. Nationwide, cities and school districts have adopted food purchasing policies that include environment, health and fair labor standards. The city of Chicago is a recent adopter of this Good Food Purchasing Program, and so the solutions-focus of the summit is the perfect place to discuss how food can move us toward climate goals. In the same breath that we discuss fossil fuels, we should be talking animal ag, or were missing a big part of the problem and a big part of the solution.

Yes, food is inherently personal. Its the cornerstone of holidays, it fuels high school athletes and long workdays, and it nourishes nursing mothers and growing children. And yes, Americans love meat and cheese. But more than that, we love our majestic national parks, family beach vacations and clean air and water for our children and grandchildren.

As individuals, we can make choices on how to better nourish our families, and as citizens, we can encourage local leaders to make choices that will allow us to enjoy our land and natural resources now and in the future.

James Cameron is a film-maker and deep-sea explorer. Suzy Amis Cameron is a founder of Muse School and Plant Power Task Force.

Read more: https://www.theguardian.com/commentisfree/2017/dec/04/animal-agriculture-choking-earth-making-sick-climate-food-environmental-impact-james-cameron-suzy-amis-cameron

The sound of mega orgasms: the female composers taking music into intimate places

A soundtrack to an erotic feminist film, the crunch of crisps in your own mouth, a composition for strap-on and electric guitar meet the women who are making music and telling stories on their own terms

In the early 1990s, the accordionist and musical improviser Pauline Oliveros wrote the soundtrack for a feminist porn film called The Sluts and Goddesses Video Workshop. The film is presented and co-directed by Annie Sprinkle, a sex worker turned academic whose lecture covers everything from deep breathing and vaginal bling to STD prevention and mega orgasms. Along the way, we get a spectacular sonic counterpart of drones, glitches, bleeps, twangs and pulsations.

Conventional porn music this is not: no sultry saxophones, no oily bass guitars. Instead, Oliveros made sounds that are fun, tactile and inquisitive. If Sprinkles mission was to confront industry standards of what erotic looks like, freeing viewers to define their own tastes, Oliveros reminded us that the power to decide what music means should ultimately belong to the listener.

This autumn, in the wake of the allegations against Harvey Weinstein and others, a couple of things became urgently clear. We must listen more carefully to womens voices, and we must change the power structures that govern much of public and private life, including the arts.

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A screengrab from The Sluts and Goddesses Video Workshop (1992) by Annie Sprinkle and Maria Beatty Photograph: Vimeo

Pauline was empowering her listeners, says the writer Ione, the late Oliveross partner and regular collaborator. Sluts and Goddesses was not pornography, not if you mean the word in any pejorative or sleazy sense. It was about sexual freedom, showing that sexuality is a natural and wonderful thing for women. The sounds Pauline made were deeply sensual because they related to the body. Her music was always about the Earth, the body, being human, the cosmos.

The film gets a rare public screening this week at the London contemporary music festival, in a section termed (brace yourself) New Intimacy. Contemporary music has a long and tetchy history of labels, schools and isms, almost all coined by programmers or academics rather than artists themselves. New Intimacy seems a cheeky throwback to the contentiously named New Complexity and New Simplicity movements of the 1980s.

Empowering
Empowering listeners Pauline Oliveros. Photograph: Vinciane Verguethen

There is a particular irony to the new bit, given several of the works at LCMF are three or four decades old. But what about the intimacy? Modernism was about removing the body from art, says festival director Igor Toronyi-Lalic. About removing personal identity and prioritising science, abstraction and objectivity. With postmodernism, the body is reinserted into feminist art, queer theory. That is whats at the heart of the New Intimacy movement.

The series includes a work by Kajsa Magnarsson for strap-on and electric guitar; a piece by Claudia Molitor to be performed by audience members within their own mouths as they chew sweets, popcorn and crisps; and the 1965 film Fuses, in which Carolee Schneemann documents the most intimate moments of her relationship with composer James Tenney. Also in the mix is the pristine and ultra-sparse Second String Quartet by Wandelweiser composer Jrg Frey music so stripped back and delicate it can start to feel febrile, like the tender stuff left exposed after some kind of sonic disrobing. Aesthetically, its probably the diametric opposite to the sparkly dildos and nipple tassels of the film, but maybe the point is how these works share a potential to empower and turn the attention back on audiences.

Claudia Molitor has been exploring the haptic in music for nearly two decades, and welcomes the wide scope of New Intimacy. Its a provocation, right? Most of the time, women arent supposed to express ourselves in certain ways because its considered unbecoming, so maybe its good to put something out there that is unbecoming. If it makes people uncomfortable, thats all right. A lot of women spend quite a lot of their lives feeling uncomfortable. Anyway, its hardly new. Mozart said it with Cosi Fan Tutte: women have the same desires as men.

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Eva-Maria Westbroek in the opera Anna Nicole by Mark-Anthony Turnage in 2014. Photograph: Tristram Kenton for the Guardian

Composer and performance artist Jennifer Walshe likewise uses her work to deal with gender and identity. Her confrontational 2003 music theatre piece, XXX Live Nude Girls, featured Barbie dolls in all manner of sexual positions and scenarios of abuse. If you want to privilege the female gaze, she says, you have to privilege it at every level of production, right down to technical crews. Think of an opera like Anna Nicole. This was a work by Mark-Anthony Turnage, about the Playboy star Anna Nicole Smith. The librettist is a man, the composer is a man, the director was a man. Why arent women allowed to write their own stories?

Walshe also questions the potential in New Intimacy for exploitation or plain voyeurism. Sometimes I feel that women are forced into a position where they are only permitted to have a voice by articulating their most intimate details, she says. Memoirs by musicians like Viv Albertine, Kim Gordon, Carrie Brownstein, Kristin Hersh all of which are books I love get very deep into the personal in a way many memoirs by male musicians dont.

Is there the expectation that in telling their stories, they have to get into these details? That their stories are only worth being heard if they are explicit? Or, as women, is part of dealing with life being forced to deal with gender or sexuality in a way many of their male collaborators dont have to, which means its only natural to talk about it?

One lesson from Weinstein is that his alleged victims didnt speak out because the industry granted him a power that robbed them of their agency. We need to trust ourselves, wrote Mona Chalabi in the Guardian. The sickening allegations have reminded me just how important it is that we trust our instincts.

This also applies to the danger of glorifying artists. For centuries, we built up personality cults around composers made gods out of men like Mozart, Beethoven, Wagner, Britten and Stockhausen. These genius narratives might have let us believe we were accessing the divine when listening to Tristan und Isolde or Mittwoch aus Licht and so feel somehow aggrandised by proxy but if composers were supposed to be superhumanly talented, their means of production remained unattainable to the rest of us, and their behaviour potentially unaccountable. It was a recipe for alienation, for too much licence, for abuse.

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Red Note Ensemble perform 13 Vices by Jennifer Walshe and Brian Irvine at the New Music Biennial in Hull. Photograph: James Mulkeen

Pauline was very much not into all that, Ione says. All that genius crap. Just look at the collaborative, collegial, supportive way she worked with Annie and the group of women who made Sluts and Goddesses. Look at the way she improvised with anybody.

It seems contemporary music is moving increasingly in that direction. Gone are the towering iconoclasts of the 20th century. Instead, programmers from Huddersfield contemporary music festival to Glasgows Counterflows to LCMF are looking to provide nimbler, more personal experiences.

Its about getting us to relate to ourselves better, says Molitor, whose piece 10 Mouth Installationsincludes an instruction sheet suggesting the best order in which to eat the sweets, popcorn and crisps (Hula-Hoops to be precise). Its about not going for a big public statement where one person declares something and the audience laps it up. Its more of a negotiation: Im an individual, youre an individual, so lets all acknowledge our bodies and our presences in this space.

If contemporary classical music seemed a branch of the avant-garde too erudite for everyday gender politics, too esoteric to deal with the erotic, think again. With its flexible forms, exploratory sound worlds and playful intellectual provocations, this music is proving to have a special potential to redress the way we relate to status, to each other, to ourselves not only for those making music, but also for those listening.

Read more: https://www.theguardian.com/music/2017/dec/06/sound-of-mega-orgasms-female-composers-london-contemporary-music-festival-new-intimacy

It tears every part of your life away: the truth about male infertility

Men are facing a fertility crisis, so why is most practical and emotional support offered to couples struggling to conceive aimed at women?

James and Davina DSouza met and fell in love in their early 20s. They got married five years later, and three years afterwards had saved enough to buy a family home in a quiet cul-de-sac in London. Then, when Davina was 29 and James 33, they started trying for a baby.

I knew that the moment we bought a home, wed start a family, Davina tells me in their living room, beside shelves crammed with framed photos of nieces, nephews, cousins and siblings. My parents live down the road, and if I needed help to raise a child, my mum would be here.

We thought about all of that stuff, James adds. The job, the future, the house, the home: we make things happen.

But after a year of trying, nothing had happened. Davina went to their GP, who referred her for the kind of invasive tests that have become the norm for women who experience problems conceiving: she had an internal, transvaginal scan to check her womb for fibroids, and an HSG test, where dye was pushed into her fallopian tubes to see if they were blocked. Everything looked normal.

It was only then that anyone suggested testing James. He had his semen analysed, and was told that only 1% of his sperm were formed normally. Still, it only takes one, the consultant said. She told them not to worry and to carry on trying. Two years after Davina came off the pill, James was tested again. This time, he had no normally formed sperm at all.

My first thought was, Oh, its my fault, James says, quietly. He stares at the coffee table through his thick-framed glasses. I felt helpless. No one was talking about this stuff. Youd go online and there was no male conversation. Id Google problems having a baby or fertility issues, and the websites that came up were all pink. Id post in a forum and women would respond on behalf of their husbands. There was nothing for men.

Though he may have felt it, James is not alone. Across the western world, men are facing a fertility crisis. A landmark study by the Hebrew University of Jerusalem, published in July, showed that among men from Europe, North America and Australia, sperm counts have declined by almost 60% in less than 40 years. Fertility specialists have described it as the most robust study of its kind (the researchers came to their conclusions after reviewing 185 previous studies involving 43,000 men from across the globe) and the findings are stark. Such a significant decline in male reproductive health over a relatively short period in such a specific population suggests theres something in the way we live now that means its much harder for men to become fathers than a generation ago.

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Until recently, the focus of both fertility experts and research scientists has been overwhelmingly on womens bodies, while male reproductive health has been almost ignored. For decades, the average age of both fathers and mothers has been increasing, but its women who have felt the pressure of balancing the need to invest in their careers with the so-called timebomb of their own declining fertility. They have been encouraged to put family first and to change their lifestyles if they want to become mothers, at the same time as male fertility appears to have fallen off a cliff.

Davina says the consultant gynaecologist who was treating her and James had no hesitation about next steps. She said, Jamess sperm results are in, and we think you should go for IVF. That was it. The NHS didnt have any other options for us. Indeed, the NHS couldnt even fund any IVF in their area at that time, so they had to scrape the money together to go private. They spent more than 12,000 on two rounds of IVF, and were finally offered a third round on the NHS this year. But after nearly seven years of trying for a baby, they are still childless.

IVF takes a huge physical, hormonal and emotional toll on a woman, James tells me. Sometimes I felt totally powerless, ineffective. I questioned my masculinity, my sense of myself as a man, through those rounds of IVF. During consultations, James felt the conversations were always directed at Davina. I felt like I had to say, Im here. Id deliberately ask a question to make my presence felt.

On their first round of IVF, someone at the clinic recommended James take a vitamin supplement. It was the first time lifestyle factors had been mentioned. That was when I realised, maybe there is something I can do, he says between slurps of his own blend of bulletproof coffee (made with grass-fed butter, coconut oil and egg yolk). James, head of sixth form at a local school, is a fan of self-help books. Hes been on a high-fat, low-carbohydrate ketogenic diet for months and says its done him good: hes slim and spry, but says he wasnt always this way. Hes wearing a digital fitness tracker. But as someone who rarely drinks, has never smoked and doesnt ride a bike, there were few lifestyle changes he could make, beyond taking colder showers and wearing looser underwear. Still, his sperm quality has improved.

At the moment, the couples fertility problems are unexplained. They decided against adoption when social workers said theyd have to use contraception during the process, because it wouldnt be fair on an adopted child to move into a home with a new baby, and they arent prepared to stop trying just yet.

Weve talked about when were going to call it a day, James says.

Davina glances at him with wet eyes. It makes me sad to think well be putting a cap on it.

But it regularly comes up, he says. We did actually say at the end of this year well stop. Ive been asking, Why do we want to have children? Weve decided it isnt going to define us.

There is treatment for male infertility, but its certainly not in the fertility clinic, says Sheryl Homa, scientific director of Andrology Solutions, the only clinic licensed by the Human Fertilisation & Embryology Authority to focus purely on male reproductive health in the UK. Men are channelled from their GP with a semen analysis and sent straight to a gynaecologist in an IVF clinic. But gynaecologists are interested in the female reproductive tract.

A former clinical embryologist, Homa once led IVF laboratories in both the private and public sectors. I was quite horrified by the lack of investigation and appropriate management of male infertility, she says, so I decided to start my own clinic specifically to focus on male fertility diagnosis and investigation. Male reproductive health is being assessed through semen analysis, which she argues has a very poor correlation with fertility. Instead of having their detailed medical history taken and a full physical examination, men are being given a cup and asked to produce a sample.

Homa says the leading cause of male infertility (around 40%) is varicocele (a clump of varicose veins in the testes). It can be determined from a physical exam, and can certainly be ruled out by an ultrasound scan. All women get ultrasound scans; why arent men getting them?

Varicoceles can be repaired by fairly simple surgery under local or general anaesthetic, leading to a significant improvement in a couples chances of successful natural or assisted conception. But many are going undiagnosed. The NHS is carrying out far too many IVF treatments when they could be saving money by doing proper investigations in men.

Homa says there is also some evidence linking silent infections those with no symptoms, such as chlamydia in men with delayed conception and an increased risk of miscarriage. But if a man is judged by his semen sample alone, there would be no way of addressing these hidden concerns.

Apart from saving the NHS money, there are important medical reasons why men should be thoroughly examined, Homa argues. Semen parameters are a marker of underlying systemic illness: they might have diabetes, they might have kidney disease, they might have cardiac problems. It could be something much more serious thats contributing to the problem.

As for the possible reasons for falling sperm counts across the west, Homa mentions all the chemicals and pesticides that we are exposed to in our environment, as well as smoking, rising levels of obesity and increasingly sedentary lifestyles. But at the moment, ideas such as these including hormones in the water and BPA in plastics that might mimic the effect of oestrogen inside the body are just theories that make intuitive sense. In the absence of widespread research over time, no one can pinpoint exactly which factor or combination of factors is making the difference.

In the 10 years her clinic has been operating, Homa has seen demand for her services steadily rise. She says she gets the fallout from men whove been sent by their GP for multiple rounds of fertility treatments that fail, when IVF should be the last resort. But at the moment, National Institute for Health and Care Excellence (Nice) guidelines give GPs no option but to refer men with fertility problems to IVF clinics. If theres a female problem, the GP will refer them to a gynaecology clinic. If theres a male problem, they need to be referring to a consultant urologist who deals with male infertility. But its just not happening.

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Gareth Down and his wife, Natalie, went through 10 rounds of IVF before their son, Reece, was born. Photograph: Harry Borden for the Guardian

In some ways, Gareth Down and his wife, Natalie, were lucky: they knew from the start that their problems conceiving were probably down to Gareth, because he had had surgery to remove benign lumps on his testes as a teenager, and always feared they might interfere with his chances of becoming a father. But after 10 cycles of IVF that cost them tens of thousands of pounds, and several miscarriages, lucky doesnt feel like the right word.

I always wanted kids, says Gareth, 31. My mum was a childminder, and I was brought up looking after kids, so from as young as I can remember, weve had a house full of them. He and Natalie started trying for a baby six months before their wedding in 2010, and went to the GP a year later, when nothing had happened. Gareth was referred to a urologist, who confirmed that the surgery hed had as a teen had affected his sperm production, and that he had azoospermia: a zero sperm count.

The Downs were determined to have children, but trying almost broke them. It invades every part of your life, Gareth says. On a personal level, you have to confront the fact that you might not have a family. It affects you financially, as you try and save to fund the treatment. We had family fallouts because we couldnt see newborn nieces and nephews we just couldnt be around babies. We changed jobs because time off with certain employers was difficult. I had quite a customer-facing job at one point, and when they were telling me about their problems, I was thinking, You aint got problems. He pauses. I dont think there was any part of who we were that we held on to by the end. It tears just about every part of your life away.

Gareth has just put his 16-month-old son, Reece, to bed while Natalie is still at work. Reece was conceived with donor sperm, on their 10th round of IVF, when Natalie had had enough of the heartache of fertility treatment and was convinced they should give up. After going through so much to have him, their first feeling when Reece was finally born was not joy, but disbelief. It was surreal, says Gareth. I dont think either of us could accept it was real and going to last. Wed had so many ups and downs that we couldnt believe nothing bad was going to happen. We kept checking the cot to see if he was still there. It was weeks before we realised he was not going to be taken away from us.

It was during their final attempt to have a baby that Gareth set up his closed, men-only Facebook group, Mens Fertility Support. Over the years, Natalie had found a lot of comfort online, from forums and support pages to Facebook groups, and was surrounded by an international community of women going through the same experience. Gareth had tried to contribute in the same places, but never stuck around long. There were no other men there to relate to what you were saying, or make you feel you could say what you meant and that it wouldnt be taken the wrong way by an audience that vastly outnumbered you.

The 300 or so members of his group are a diverse mix of men, mostly from the UK. Some are just beginning to have problems with conception, others went through it decades ago; some never had a happy ending and are there to share their experiences that a life beyond trying to have a family is possible. Many members say its the only place they can be totally honest: the belief that the ability to father children is a marker of masculinity has left many unwilling to talk about their issues anywhere else.

We do get women wanting to join, Gareth tells me with a smile, but we want a degree of privacy. Its about having freedom to talk, to say, yes, those [IVF] hormones really do screw her up and its really tough. You need to be able to vent somewhere without causing offence to anyone you know.

Everyone Gareth and Natalie told about their problems conceiving assumed the issue must be hers. Every step of the way it was, Poor Nat whats going on with her? But he hopes that men are starting to seek help. If it was any other part of your body that wasnt working properly, youd seek advice. Slowly, those barriers are beginning to come down a bit.

He wonders whether the new figures on declining sperm counts could have been coloured by this growth in awareness: fertility treatments are more in demand than ever, so more men are having their fertility investigated. Are we just testing more, looking into things more? he asks. If you had fertility problems 40 years ago, you wouldnt have wanted to confront it or had anywhere to go with it.

Dr Xiao-Ping Zhai, the fertility specialist behind the Zhai Clinic, agrees. We never really tested men in the past, and if you use the word decline, you have to have something to compare it to. In the past, people probably had problems, didnt want to say they had problems, and didnt have children. Even though the Hebrew University of Jerusalem study is the best piece of research weve had so far, she points out, the data from 40 years ago is still very thin.

Trained both in western and traditional Chinese medicine, Zhai has a unique perspective on fertility treatment and, since she opened her Harley Street clinic more than 20 years ago, claims shes had a great deal of success in helping couples conceive even though many patients come to her out of desperation rather than faith in traditional medicine. Its mainly women who call to make the appointments. Eighty per cent of the time, the partner doesnt even want to come along. They dont think they have a problem.

Rather than look at sperm counts, Zhai takes a full health MOT of all her patients, using diagnostics from Chinese medicine to find out which part of the body needs to be addressed: You find that a lot of people have something that cant be discovered on a scan or through mechanical investigation what wed call a functional problem. Zhai offers a range of treatments according to the patients specific constitution, including acupuncture, herbal supplements and advice on lifestyle changes and diet. None of this is cheap: an initial consultation costs 250, and a four-week course of bespoke herbal supplements can cost up to 350.

But IVF treatment on Harley Street costs even more, and Zhai says many of her patients arrive in the consulting room having already spent lots of money. Its to do with the culture here: in the UK, if a man has a problem, then the woman needs IVF. IVF clinics can offer only what they specialise in.

In 2014, Zhai launched a national campaign to end the stigma attached to male infertility and improve the treatment choices offered to men. She called for a full parliamentary debate on male fertility issues, and on health secretary Jeremy Hunt to work with doctors to improve practice and treatment pathways for men within the NHS. But there has been no debate and no change in NHS strategy. There are too few options for infertile patients, Zhai says. It will take a long, long time to overcome this culture.

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The doctor who rang with Gary Parsons sperm count results simply said it was game over. Photograph: Harry Borden for the Guardian

Gary and Kim Parsons went to their GP two years after Kim stopped taking the pill, when there was still no sign of pregnancy. She went through all the regular tests blood tests and then more invasive examinations and everything came back A-OK, says Gary, 36, from his home in Burnham-on-Sea. Then it was my turn. Like James, Gary had no physical examination and was asked only to produce a sample to check his sperm count. That came back as a big fat zero. There was nothing to count.

When the doctor rang to deliver the results, he said it was game over. Gary blinks in disbelief when he tells me this. I really didnt need any encouragement to feel more down about things, so that was an unfortunate turn of phrase. Gary thinks this may have been because it was a conversation between men. That extreme, direct way of communicating might have been the only way he thought he could get me to understand that this is not something where I could drink a kale smoothie and everything would be OK.

Still, thats what Gary tried, at first. Or, rather, he turned to vitamin supplements and a high-protein diet in the hope they could help. Im a vegetarian, so for a second I thought, Oh no, Im one of these anaemic, lentil-based stereotypes. But, ultimately, he knew this probably wouldnt help because his count wasnt low it was zero. There was nothing to improve. Thats the thing Ive found hardest. Most problems Ive had in my life Ive overcome with either bloody-mindedness or effort, and thats not this, he says, shaking his head. Thats not this.

Garys infertility remains unexplained. The next step is for him to have a testicular sperm extraction procedure, to find out if hes producing sperm that are being blocked, which could potentially be extracted for use in assisted conception. Three years after they started trying for a baby, this will be the first time he will be examined beyond blood tests and semen samples.

Without Gareth Downs Facebook group, it would have been hard to find someone to talk to. Gary is a counsellor, and when he looked at who was registered with the British Infertility Counselling Association, the professional body for fertility counsellors in the UK, he found that the 46 registered practitioners were all women. Emotional support provision for men is glaring in its absence, he says. Its just a case of, On your bike, son. Get on with it.

The way that men are treated as the secondary partner in infertility treatment could have worrying consequences, he says. All the paperwork goes through the female. Everything is done through my wife. In meetings, its been very rare that Ive even been able to get any eye contact from a consultant so far. It occurred to me that, should my wife leave me, I would have no mechanism for resolving this, or getting any questions answered, and that would have an impact in terms of maybe meeting someone new, or even knowing if Im able to be a parent one day.

Edinburgh University professor Richard Sharpe, an expert in sperm count and male fertility, believes the University of Jerusalem studys findings should be taken very seriously. If something is having that big an effect something in our environment, diet, lifestyle, and we dont know what it is what else might it be doing to us? We think of sperm counts as a fairly crude barometer of overall male health. Its a warning shot across our bows.

Sharpe has been specialising in male infertility for 25 years, but even he can offer only general hypotheses about what could have made sperm counts fall by 60% in little over a generation. He thinks diet and lifestyle are much more likely to be contributory factors than environmental chemicals such as pesticides, plastics and hormones in the water, because the evidence that they could induce such striking effects at low levels of exposure is unconvincing. But our understanding of the normal process of sperm production is very poor, completely superficial, he says. Its a much more complex process to understand than the menstrual cycle, and we havent done enough research.

There is a chance that women might ultimately be behind the sudden drop in sperm count, Sharpe believes. His work has looked at the link between rates of maternal smoking and the use of painkillers during pregnancy, and the reduced sperm counts of sons in adulthood. A baby boys testes are formed during the first trimester, when many women dont know theyre pregnant, and the period immediately after their formation is critical for the production of testosterone. What we are seeing now could be the expression of a generational problem: the fact that, since the 1970s, women are more likely than ever to smoke and take over-the-counter painkillers.

But, again, the evidence isnt strong enough. There are four studies that all show a significant association between maternal smoking and reduction in sperm counts in male offspring, so its plausible, he says, but it cant explain the 60% fall, because not so many women smoke and smoke heavily. A longitudinal study, over 20 years, would be needed to demonstrate the effects of maternal lifestyle on male fertility, but long-term research projects are inherently difficult to get funding for, unless public bodies think the issue is critically important. Male fertility is not considered a high-priority issue, partly because theres this perception that its a problem solved by assisted reproduction. Thats not treatment of the underlying issue behind male infertility. Its simply ignoring it.

We may be sleepwalking into a future where we become increasingly dependent on assisted reproduction, Sharpe argues, without fully understanding the long-term consequences of the technologies were relying upon. Researchers have already demonstrated in animals that its possible to make sperm out of other kinds of cell. People are going to do this in humans not in the UK, initially, but they will somewhere in the world. Those techniques are going to be applied in the fertility clinic, but we dont have the knowledge to do it in a truly informed way, to know that its all safe, that there are no consequences.

Whatever the reasons for our underinvestment in male fertility lack of funding and research, male pride or the overemphasis on women in fertility treatment it has huge implications for both men and women. Were flying blind to a large extent, and so far weve been ridiculously lucky, Sharpe says. Its a perfect storm, at every level.

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Read more: https://www.theguardian.com/lifeandstyle/2017/nov/18/tears-every-part-life-truth-male-infertility-ivf

Nkechi Anele from Saskwatch: ‘I’ve hated my hair for most of my life’

In our series Beauty and the books the lead singer of Saskwatch talks about how coconut oil helped change her feelings about natural hair and the Art of War

Nkechi Anele, the lead singer for Saskwatch, also hosts Roots n All for Triple J and is the co-founder of The Pin. Anele has been reading an ancient war manual to help her with awkward social situations, and shares her secret weapon against sunburn.

Whats thrilling

Im really loving The Art of War. Its a 2,000-year-old military manual that came out of China and is written in code. It talks about tactics on the battlefield but its more philosophical so it can be applied to everyday life how to conduct yourself and how to master changes and challenges. Its all about talking about being on the offence, not on the defence. It can be applied to a lot of things, such as conversations or dealing with awkward social situations or turning awkward situations into your favour.

Its really good to apply to personal instances of your life like the way you see things and the way you see yourself in everyday life. Its all about taking care of yourself and making sure youre in the best possible position in your life.

I still havent got over the coconut oil phase. Its been a life changer for me. In the last year Ive followed the natural hair movement of black women and decided to stop having my hair in braids, or feeling like I had to have my hair in braids to feel beautiful. Its been a really big journey and coconut oil has been my hair saviour. Its an all-in-one moisturiser but it also helps curly hair grow; it protects curly hair from the sun. Coconut oil has been part of my transformation into loving my natural hair.

Turning to natural hair happened in two parts. I had my hair braided and it was braided really badly. I was at my friends house and shes one of those friends who tells the truth. She said, Your hair looks horrible. I have to take it out. I cant stand it. And she took it out.

Ive had my hair natural a few times in my life but not really loved it. Theres been semi-traumatic experiences such as strangers grabbing my hair and touching my hair in public. This has been an evolution because every day I wake up and think, Today is going to be the day that I hate my hair, and I dont hate my hair. Thats been a really unique thing for me to experience because Ive hated my hair for most of my life.

Hair is a very significant thing for women of colour, especially African women. My friend explained that hair to African women is like weight to white women. Its very important to maintain and it also establishes how you see yourself and how you feel about yourself in society. It becomes a philosophy: if youre not taking care of your hair, youre not taking care of yourself. The internet and social networking have meant we have a place where people are making black beauty content that isnt trying to say Hey, heres a black option. Its saying, This is what black people do. Now theres so many more resources on how to take care of your hair and so many hacks on how to manage it. Our hair is so intense; so curly and so knotty and so strong. I know so many people who are African and have broken combs with their hair. Its always a battlefield. The natural hair movement has been another step forward for black women in being proud of what theyre born with. Im happy I came to it in my 20s, but I wish I had come to it earlier.

Whats nostalgia-inducing

Recently I met Pia Miranda and it reminded me how much I loved Looking for Alibrandi when I first read it. From ages 12 to 17, I think I read the book twice a year. That book for me was the first time experiencing someone who was seen as Australian but not really the idea of Australian. There was this kick-ass chick full of attitude and full of spunk, had these crazy love crushes and was super intelligent, and was the underdog. When I saw [Miranda], it brought back so many memories of how much I loved that book and I really want to reread it.

Im a moisturising fiend. Im quite obsessed with Aesop at the moment. Ive been using Damascan rose facial treatment ($75) which is like rose oil. The first time I was introduced to Aesop, it was a present my mum gave me the first time I went overseas. Aesop has this smell that reminds me of Australia when I go away. When Im away and using Aesop, I can still smell the gumtrees of home. I live near a park and you can smell the flowers as the seasons change and it reminds me of that.

What I keep going back to

Raymond Carvers What We Talk About When We Talk About Love is something I reread again and again, mainly because sometimes you think, What the hell did I just read? The stories are so short and nothing happens but everything happens in them. I have to read them over and over again because, depending on your mood, the stories can be interpreted in so many different ways and have such an impact. Youre reading his short stories and waiting for the punch to happen, for the moment when it all clicks and all makes sense to you.

Its a classic but Ive only been introduced in the past two years. I still find myself when looking for something to read choosing a random story and thinking, Oh god, this is so epic.

I bite my lips when Im nervous or when if Im working on something [so] paw paw is my saviour. Its like coconut oil in that I use it for different things but I feel like its the only thing when your lips are dry beyond repair that will work.

Another thing I use again and again is vitamin E cream. I get sunburnt on one part of my face. Ten years ago my friend put me on to vitamin E cream and its the best thing. Whenever you burn yourself or you want your skin to look really lovely, its just the thing. I rarely wear foundation; I use moisturiser as my foundation. If Im going out and I want to look fresh or dewy thats what I put on my skin. Its the be all and end all for me.

Read more: https://www.theguardian.com/lifeandstyle/2017/nov/14/nkechi-anele-ive-hated-my-hair-for-most-of-my-life

Introducing Halo Top: the ‘healthy’ ice-cream taking over America

Marketed as the low-calorie, high-protein and low-sugar alternative to ice-cream it is now outselling tubs from Ben & Jerrys and Hagen-Dazs

Everyone you love is gone. There is only ice-cream is the darkly humorous sign off used in a recent ad for fast-growing American ice-cream brand Halo Top.

The Black Mirror-style commercial, which ran in US cinemas before films including the horror flick It, features an elderly woman being force-fed ice-cream by a robot in some dystopian future.

It was directed by Mike Diva, who has built a YouTube following with his advertising parodies, and who typifies the offbeat digital marketing aimed at millennials that has helped turn Halo Top into serious competition for bestselling brands such as Magnum, Ben & Jerrys and Hagen-Dazs.

The somewhat noir US TV ad for Halo Top ice-cream.

The Los Angeles-based company was founded at the start of the decade by Justin Woolverton, a former lawyer who suffered hypoglycemic episodes when he indulged his sweet tooth. So he bought a $20 ice-cream maker on Amazon and began trying to create healthier alternatives. It was just something that I was making in my kitchen because I didnt like sugar, he told one interviewer about his Eureka moment.

While most ice-creams are a sugar and fat-laden treat, Halo Top bills itself as a low-calorie, high-protein and low-sugar alternative to mainstream brands, with flavours such as mochi green tea and rainbow swirls. Its recipe uses sugar substitute Stevia, which means a scoop of its Vanilla Ice contains 60 calories versus 250 in a similar sized dollop of Hagen-Dazs.

Reports in the US media have begun to question whether Halo Top is really as healthy as the marketing makes out, with some dieticians raising concerns about the use of artificial sweeteners.

Halo Top is now stocked in supermarkets across America, with the company shifting nearly $50m (38m) worth of ice-cream in the US last year. Its sales accelerated in 2016 after GQ writer Shane Snow lived on Halo Top ice-cream for 10 days and the resulting article went viral.

The brands rise has been propelled by social media: it has 590,000 followers on Instagram and more than 700,000 on Facebook.

The social media buzz helped Halo Top chalk up another milestone in the summer when industry data showed its pint pots were outselling Unilevers Ben & Jerrys and Nestls Hagen-Dazs in US grocery stores for the first time. Halo Tops parent company, LA-based Eden Creamery, is seizing the day with one recent report suggesting it is exploring a sale that could value the company at up to $2bn.

Read more: https://www.theguardian.com/lifeandstyle/2017/oct/20/introducing-halo-top-the-healthy-ice-cream-taking-over-america

Good enough for Beyonc: chocolate ganache, paella and stir-fry vegan recipes

Forget dodgy dal and chickpea salads and be inspired by World Vegan Day with our pick of delicious, colourful and healthy meals

Whether its down to health and environmental concerns or merely following in Beyoncs footsteps, veganism is on the rise around the world. Those who eschew all animal products (including leather, honey, eggs and dairy) are increasing in numbers in the UK, the US and in Australia.

Now, in the aftermath of World Vegan Day, we asked three well-known Australian vegan chefs for their favourite and most delicious vegan recipes.

Raw and Peaces chocolate ganache tarts

Basic shortbread crust
3 cups cashews (dry)
cup coconut oil, liquid
cup coconut flour

Chocolate ganache
2 cups cashews, soaked
3/4 cup cacao powder
cup coconut oil
cup agave
1 cup water
1 tbsp vanilla
1 tbsp psyllium

To make the shortbread, grind cashew nuts to a fine flour consistency in a high-speed blender. Pour into a mixing bowl. Add coconut oil and mix through with your hands. This will get sticky. Then add coconut flour slowly and knead into dough. Excess shortbread can be stored in a freezer bag in the freezer. You may need to add a little more coconut oil when working with it again.

Line some small tart cases with plastic wrap. Press shortbread mix into these not too thick using your finger to neaten off the edges. Set in freezer.

To prepare the chocolate ganache, place all the ingredients in a high-speed blender and blend. Then pour into tart cases and return to freezer to set. Allow to soften in the fridge before serving.

The Naked Vegans stir no-fry with coconut cauliflower rice

Stir
This veggie stir-fry with coconut cauliflower rice is easy to prepare when youre short on time. Photograph: Ben Dearnley/Murdoch Books

Serves 4

A great working-week dinner option, this dish is colourful, filling and tasty, and really easy to prepare when youre short on time. Just chop, whiz up some stuff and throw it all together.

Lime and tamari marinade
125 ml ( cup) cold-pressed extra virgin olive oil
2 tsp cold-pressed sesame oil
Juice of 1 lime
4 tbsp tamari
2 tbsp finely chopped fresh ginger

Veggie mix
125 g (2 cups) broccoli florets
1 red capsicum (pepper), seeded and finely sliced
90g (1 cup) julienned carrot
115g (1 cup) bean sprouts
30g (/ cup) shredded bok choy (pak choy)
40g ( cup) shredded savoy cabbage
red onion, finely sliced
1 garlic clove, crushed

Coconut cauliflower rice
500g (4 cups) cauliflower florets
45g ( cup) finely desiccated coconut
tsp Himalayan pink salt or Celtic sea salt

The
The Naked Vegan by Maz Valcorza (Murdoch Books, $39.99)

To serve
4 tbsp black or white sesame seeds
3 tbsp coriander (cilantro) leaves

Blend the marinade ingredients in a high-speed blender until well combined. Pour into a large mixing bowl.

Add all the veggie mix ingredients to the bowl. Toss together, then allow to marinate while you make the cauliflower rice.

Carefully pulse the cauliflower coconut rice ingredients in a food processor until the cauliflower resembles the texture of rice. Do not over-process, or the cauliflower will turn into a puree.

To serve, divide the coconut cauliflower rice among four bowls and top with the veggie mix. Sprinkle with the sesame seeds, garnish with coriander and serve.

Recipe from The Naked Vegan by Max Valcorza (Murdoch Books, $39.99)

Smith & Daughters paella

Smith
A well-travelled Spanish paella recipe takes a vegan twist. Photograph: Bonnie Savage/Hardie Grant Books

Sure, youve had paella before, but this happens to be the fifth-generation (maybe more) recipe of the grandmother of chef Shannon Martinez from Melbourne restaurant Smith & Daughters. If the Spanish immigrants knew their descendants would use this well-loved and travelled recipe to make vegan paella, they may have had second thoughts. But non-vegans can add anything to this paella prawns, sausage, squid, seasonal vegetables. Just cook separately and add to the paella at the end.

Serves 4-6

1.25 litres (5 cups) vegetable stock
1 large pinch of saffron threads
60ml ( cup) olive oil
1 medium onion, chopped
green capsicum (bell pepper), diced
red capsicum (bell pepper), diced
1 tsp fine salt
2 tomatoes, tinned or fresh, diced (only use fresh if tomatoes are in season)
3 garlic cloves, crushed
2 tsp sweet paprika
1 tsp smoked paprika
400g bomba or medium-grain rice
185g podded broad (fava) beans or substitute peas
Cooked seasonal vegetables, such as asparagus and peas in spring or pumpkin (squash) and olives in winter

Garnish
Lemons, cut into wedges
Extra-virgin olive oil
Sea salt flakes
Flat-leaf parsley, roughly chopped

Place the stock in a medium-sized saucepan and bring to the boil. Remove from the heat and drop in the saffron. Set aside to infuse for at least 5 minutes. You will see the stock turn bright yellow.

Heat the oil in a 30cm or slightly larger paella pan or ovenproof casserole dish over low heat. Add the onion, capsicum and salt and cook, stirring occasionally, for about 15 minutes, until the vegetables are very soft and almost jammy. Add the tomato and garlic and cook for a further 15 minutes or until the sauce becomes thick.

Add the paprikas and stir to combine, then add the rice and broad beans and coat with the sauce. Cook for 12 minutes, or until the rice begins to turn translucent.

Smith
Smith & Daughters: A Cookbook (that happens to be vegan) by Shannon Martinez & Mo Wyse (Hardie Grant Books, $48) Photograph: Hardie Grant Books

Preheat the oven to 150C.

Pour the stock over the rice and turn up the heat to high. Stir to make sure the rice is evenly spread across the pan, then simmer for exactly 5 minutes. Do not stir.

Transfer the paella to the oven and cook for 1215 minutes until the liquid has been absorbed. Remove from the oven and stir through the cooked seasonal vegetables. Cover the pan with a clean tea towel and set aside for 5 minutes.

Place lemon wedges sporadically but evenly throughout the paella, drizzle with extra-virgin olive oil and sprinkle with sea salt flakes and chopped parsley.

Recipe from Smith & Daughters: A Cookbook (that happens to be vegan) by Shannon Martinez & Mo Wyse (Hardie Grant Books, $48)

Read more: https://www.theguardian.com/lifeandstyle/2017/nov/03/good-enough-for-beyonce-chocolate-ganache-paella-and-stir-fry-vegan-recipes

Goodbye and good riddance to livestock farming | George Monbiot

As the artificial meat industry grows, the last argument for farming animals has now collapsed, writes Guardian columnist George Monbiot

What will future generations, looking back on our age, see as its monstrosities? We think of slavery, the subjugation of women, judicial torture, the murder of heretics, imperial conquest and genocide, the first world war and the rise of fascism, and ask ourselves how people could have failed to see the horror of what they did. What madness of our times will revolt our descendants?

There are plenty to choose from. But one of them, I believe, will be the mass incarceration of animals, to enable us to eat their flesh or eggs or drink their milk. While we call ourselves animal lovers, and lavish kindness on our dogs and cats, we inflict brutal deprivations on billions of animals that are just as capable of suffering. The hypocrisy is so rank that future generations will marvel at how we could have failed to see it.

The shift will occur with the advent of cheap artificial meat. Technological change has often helped to catalyse ethical change. The $300m deal China signed last month to buy lab-grown meat marks the beginning of the end of livestock farming. But it wont happen quickly: the great suffering is likely to continue for many years.

The answer, we are told by celebrity chefs and food writers, is to keep livestock outdoors: eat free-range beef or lamb, not battery pork. But all this does is to swap one disaster mass cruelty for another: mass destruction. Almost all forms of animal farming cause environmental damage, but none more so than keeping them outdoors. The reason is inefficiency. Grazing is not just slightly inefficient, it is stupendously wasteful. Roughly twice as much of the worlds surface is used for grazing as for growing crops, yet animals fed entirely on pasture produce just one gram out of the 81g of protein consumed per personper day.

A paper in Science of the Total Environment reports that livestock production is the single largest driver of habitat loss. Grazing livestock are a fully automated system for ecological destruction: you need only release them on to the land and they do the rest, browsing out tree seedlings, simplifying complex ecosystems. Their keepers augment this assault by slaughtering large predators.

Flock
Sheep supply around 1% of our diet in terms of calories. Yet they occupy around 4m hectares of the uplands. Photograph: Murdo MacLeod for the Guardian

In the UK, for example, sheep supply around 1% of our diet in terms of calories. Yet they occupy around 4m hectares of the uplands. This is more or less equivalent to all the land under crops in this country, and more than twice the area of the built environment (1.7m hectares). The rich mosaic of rainforest and other habitats that once covered our hills has been erased, the wildlife reduced to a handful of hardy species. The damage caused is out of all proportion to the meat produced.

Replacing the meat in our diets with soya spectacularly reduces the land area required per kilo of protein: by 70% in the case of chicken, 89% in the case of pork and 97% in the case of beef. One study suggests that if we were all to switch to a plant-based diet, 15mhectares of land in Britain currently used for farming could be returned to nature. Alternatively, this country could feed 200 million people. An end to animal farming would be the salvation of the worlds wildlife, our natural wonders and magnificent habitats.

Understandably, those who keep animals have pushed back against such facts, using an ingenious argument. Livestock grazing, they claim, can suck carbon out of the atmosphere and store it in the soil, reducing or even reversing global warming. In a TED talk watched by 4 million people, the rancher Allan Savory claims that his holistic grazing could absorb enough carbon to return the worlds atmosphere to pre-industrial levels. His inability, when I interviewed him, to substantiate his claims has done nothing to dent their popularity.

Similar statements have been made by Graham Harvey, the agricultural story editor of the BBC Radio 4 serial The Archers he claims that the prairies in the US could absorb all the carbon thats gone into the atmosphere for the whole planet since we industrialised and amplified by the Campaign to Protect Rural England. Farmers organisations all over the world now noisily promote this view.

A report this week by the Food Climate Research Network, called Grazed and Confused, seeks to resolve the question: can keeping livestock outdoors cause a net reduction in greenhouse gases? The authors spent two years investigating the issue. They cite 300 sources. Their answer is unequivocal. No.

It is true, they find, that some grazing systems are better than others. Under some circumstances, plants growing on pastures will accumulate carbon under the ground, through the expansion of their root systems and the laying down of leaf litter. But the claims of people such as Savory and Harvey are dangerously misleading. The evidence supporting additional carbon storage through the special systems these livestock crusaders propose (variously described as holistic, regenerative, mob, or adaptive grazing) is weak and contradictory, and suggests that if theres an effect at all, it is small.

The best that can be done is to remove between 20% and 60% of the greenhouse gas emissions grazing livestock produce. Even this might be an overestimate: a paper published this week in the journal Carbon Balance and Management suggests that the amount of methane (a potent greenhouse gas) farm animals produce has been understated. In either case, carbon storage in pastures cannot compensate for the animals own climate impacts, let alone those of industrial civilisation. I would like to see the TED team post a warning on Savorys video, before even more people are misled.

As the final argument crumbles, we are left facing an uncomfortable fact: animal farming looks as incompatible with a sustained future for humans and other species as mining coal.

That vast expanse of pastureland, from which we obtain so little at such great environmental cost, would be better used for rewilding: the mass restoration of nature. Not only would this help to reverse the catastrophic decline in habitats and the diversity and abundance of wildlife, but the returning forests, wetlands and savannahs are likely to absorb far more carbon than even the most sophisticated forms of grazing.

The end of animal farming might be hard to swallow. But we are a resilient and adaptable species. We have undergone a series of astonishing changes: the adoption of sedentarism, of agriculture, of cities, of industry.

Now it is time for a new revolution, almost as profound as those other great shifts: the switch to a plant-based diet. The technology is depending on how close an approximation to meat you demand (Quorn seems almost indistinguishable from chicken or mince to me) either here or just around the corner. The ethical switch is happening already: even today, there are half a million vegans in the land of roast beef. Its time to abandon the excuses, the fake facts and false comforts. It is time to see our moral choices as our descendants will.

George Monbiot is a Guardian columnist

Read more: https://www.theguardian.com/commentisfree/2017/oct/04/livestock-farming-artificial-meat-industry-animals

Read this and you may never eat chicken again

Most meat animals are raised with the assistance of daily doses of antibiotics. By 2050, antibiotic resistance will cause a staggering 10 million deaths a year

Every year I spend some time in a tiny apartment in Paris, seven stories above the mayors offices for the 11th arrondissement. The Place de la Bastille the spot where the French revolution sparked political change that transformed the world is a 10-minute walk down a narrow street that threads between student nightclubs and Chinese fabric wholesalers.

Twice a week, hundreds of Parisians crowd down it, heading to the march de la Bastille, stretched out along the center island of the Boulevard Richard Lenoir.

Blocks before you reach the market, you can hear it: a low hum of argument and chatter, punctuated by dollies thumping over the curbstones and vendors shouting deals. But even before you hear it, you can smell it: the funk of bruised cabbage leaves underfoot, the sharp sweetness of fruit sliced open for samples, the iodine tang of seaweed propping up rafts of scallops in broad rose-colored shells.

Threaded through them is one aroma that I wait for. Burnished and herbal, salty and slightly burned, it has so much heft that it feels physical, like an arm slid around your shoulders to urge you to move a little faster. It leads to a tented booth in the middle of the market and a line of customers that wraps around the tent poles and trails down the market alley, tangling with the crowd in front of the flower seller.

In the middle of the booth is a closet-size metal cabinet, propped up on iron wheels and bricks. Inside the cabinet, flattened chickens are speared on rotisserie bars that have been turning since before dawn. Every few minutes, one of the workers detaches a bar, slides off its dripping bronze contents, slips the chickens into flat foil-lined bags, and hands them to the customers who have persisted to the head of the line.

I can barely wait to get my chicken home.

Chickens
Chickens roam in an outdoor enclosure of a chicken farm in Vielle-Soubiran, south-western France. Photograph: Iroz Gaizka/AFP/Getty Images


The skin of a poulet crapaudine named because its spatchcocked outline resembles a crapaud, a toad shatters like mica; the flesh underneath, basted for hours by the birds dripping on to it from above, is pillowy but springy, imbued to the bone with pepper and thyme.

The first time I ate it, I was stunned into happy silence, too intoxicated by the experience to process why it felt so new. The second time, I was delighted again and then, afterward, sulky and sad.

I had eaten chicken all my life: in my grandmothers kitchen in Brooklyn, in my parents house in Houston, in a college dining hall, friends apartments, restaurants and fast food places, trendy bars in cities and old-school joints on back roads in the south. I thought I roasted a chicken pretty well myself. But none of them were ever like this, mineral and lush and direct.

I thought of the chickens Id grown up eating. They tasted like whatever the cook added to them: canned soup in my grandmothers fricassee, her party dish; soy sauce and sesame in the stir fries my college housemate brought from her aunts restaurant; lemon juice when my mother worried about my fathers blood pressure and banned salt from the house.

This French chicken tasted like muscle and blood and exercise and the outdoors. It tasted like something that it was too easy to pretend it was not: like an animal, like a living thing. We have made it easy not to think about what chickens were before we find them on our plates or pluck them from supermarket cold cases.

I live, most of the time, less than an hours drive from Gainesville, Georgia, the self-described poultry capital of the world, where the modern chicken industry was born. Georgia raises 1.4bn broilers a year, making it the single biggest contributor to the almost 9bn birds raised each year in the United States; if it were an independent country, it would rank in chicken production somewhere near China and Brazil.

Yet you could drive around for hours without ever knowing you were in the heart of chicken country unless you happened to get behind a truck heaped with crates of birds on their way from the remote solid-walled barns they are raised in to the gated slaughter plants where they are turned into meat. That first French market chicken opened my eyes to how invisible chickens had been for me, and after that, my job began to show me what that invisibility had masked.

My house is less than two miles from the front gate of the Centers for Disease Control and Prevention, the federal agency that sends disease detectives racing to outbreaks all over the world. For more than a decade, one of my obsessions as a journalist has been following them on their investigations and in long late-night conversations in the United States and Asia and Africa, with physicians and veterinarians and epidemiologists, I learned that the chickens that had surprised me and the epidemics that fascinated me were more closely linked than I had ever realized.

I discovered that the reason American chicken tastes so different from those I ate everywhere else was that in the United States, we breed for everything but flavor: for abundance, for consistency, for speed. Many things made that transformation possible.

But as I came to understand, the single biggest influence was that, consistently over decades, we have been feeding chickens, and almost every other meat animal, routine doses of antibiotics on almost every day of their lives.

Caged
Caged battery hens in a chicken farm in Catania, Sicily. Photograph: Fabrizio Villa/AFP/Getty Images

Antibiotics do not create blandness, but they created the conditions that allowed chicken to be bland, allowing us to turn a skittish, active backyard bird into a fast-growing, slow-moving, docile block of protein, as muscle-bound and top-heavy as a bodybuilder in a kids cartoon. At this moment, most meat animals, across most of the planet, are raised with the assistance of doses of antibiotics on most days of their lives: 63,151 tons of antibiotics per year, about 126m pounds.

Farmers began using the drugs because antibiotics allowed animals to convert feed to tasty muscle more efficiently; when that result made it irresistible to pack more livestock into barns, antibiotics protected animals against the likelihood of disease. Those discoveries, which began with chickens, created what we choose to call industrialized agriculture, a poultry historian living in Georgia proudly wrote in 1971.

Chicken prices fell so low that it became the meat that Americans eat more than any other and the meat most likely to transmit food-borne illness, and also antibiotic resistance, the greatest slow-brewing health crisis of our time.

For most people, antibiotic resistance is a hidden epidemic unless they have the misfortune to contract an infection themselves or have a family member or friend unlucky enough to become infected.

Drug-resistant infections have no celebrity spokespeople, negligible political support and few patients organizations advocating for them. If we think of resistant infections, we imagine them as something rare, occurring to people unlike us, whoever we are: people who are in nursing homes at the end of their lives, or dealing with the drain of chronic illness, or in intensive-care units after terrible trauma. But resistant infections are a vast and common problem that occur in every part of daily life: to children in daycare, athletes playing sports, teens going for piercings, people getting healthy in the gym.

And though common, resistant bacteria are a grave threat and getting worse.

They are responsible for at least 700,000 deaths around the world each year: 23,000 in the United States, 25,000 in Europe, more than 63,000 babies in India. Beyond those deaths, bacteria that are resistant to antibiotics cause millions of illnesses 2m annually just in the United States and cost billions in healthcare spending, lost wages and lost national productivity.

It is predicted that by 2050, antibiotic resistance will cost the world $100tn and will cause a staggering 10m deaths per year.

Disease organisms have been developing defenses against the antibiotics meant to kill them for as long as antibiotics have existed. Penicillin arrived in the 1940s, and resistance to it swept the world in the 1950s.

Tetracycline arrived in 1948, and resistance was nibbling at its effectiveness before the 1950s ended. Erythromycin was discovered in 1952, and erythromycin resistance arrived in 1955. Methicillin, a lab-synthesized relative of penicillin, was developed in 1960 specifically to counter penicillin resistance, yet within a year, staph bacteria developed defenses against it as well, earning the bug the name MRSA, methicillin-resistant Staphylococcus aureus.

After MRSA, there were the ESBLs, extended-spectrum beta-lactamases, which defeated not only penicillin and its relatives but also a large family of antibiotics called cephalosporins. And after cephalosporins were undermined, new antibiotics were achieved and lost in turn.

Each time pharmaceutical chemistry produced a new class of antibiotics, with a new molecular shape and a new mode of action, bacteria adapted. In fact, as the decades passed, they seemed to adapt faster than before. Their persistence threatened to inaugurate a post-antibiotic era, in which surgery could be too dangerous to attempt and ordinary health problems scrapes, tooth extractions, broken limbs could pose a deadly risk.

For a long time, it was assumed that the extraordinary unspooling of antibiotic resistance around the world was due only to misuse of the drugs in medicine: to parents begging for the drugs even though their children had viral illnesses that antibiotics could not help; physicians prescribing antibiotics without checking to see whether the drug they chose was a good match; people stopping their prescriptions halfway through the prescribed course because they felt better, or saving some pills for friends without health insurance, or buying antibiotics over the counter, in the many countries where they are available that way and dosing themselves.

But from the earliest days of the antibiotic era, the drugs have had another, parallel use: in animals that are grown to become food.

Eighty percent of the antibiotics sold in the United States and more than half of those sold around the world are used in animals, not in humans. Animals destined to be meat routinely receive antibiotics in their feed and water, and most of those drugs are not given to treat diseases, which is how we use them in people.

Instead, antibiotics are given to make food animals put on weight more quickly than they would otherwise, or to protect food animals from illnesses that the crowded conditions of livestock production make them vulnerable to. And nearly two-thirds of the antibiotics that are used for those purposes are compounds that are also used against human illness which means that when resistance against the farm use of those drugs arises, it undermines the drugs usefulness in human medicine as well.

Caged
Caged chickens in San Diego, California. California voters passed a new animal welfare law in 2008 to require that the states egg-laying hens be given room to move. Photograph: Christian Science Monitor/Getty Images

Resistance is a defensive adaptation, an evolutionary strategy that allows bacteria to protect themselves against antibiotics power to kill them. It is created by subtle genetic changes that allow organisms to counter antibiotics attacks on them, altering their cell walls to keep drug molecules from attaching or penetrating, or forming tiny pumps that eject the drugs after they have entered the cell.

What slows the emergence of resistance is using an antibiotic conservatively: at the right dose, for the right length of time, for an organism that will be vulnerable to the drug, and not for any other reason. Most antibiotic use in agriculture violates those rules.

Resistant bacteria are the result.


Antibiotic resistance is like climate change: it is an overwhelming threat, created over decades by millions of individual decisions and reinforced by the actions of industries.

It is also like climate change in that the industrialized west and the emerging economies of the global south are at odds. One quadrant of the globe already enjoyed the cheap protein of factory farming and now regrets it; the other would like not to forgo its chance. And it is additionally like climate change because any action taken in hopes of ameliorating the problem feels inadequate, like buying a fluorescent lightbulb while watching a polar bear drown.

But that it seems difficult does not mean it is not possible. The willingness to relinquish antibiotics of farmers in the Netherlands, as well as Perdue Farms and other companies in the United States, proves that industrial-scale production can be achieved without growth promoters or preventive antibiotic use. The stability of Masadour and Lou and White Oak Pastures shows that medium-sized and small farms can secure a place in a remixed meat economy.

Whole Foods pivot to slower-growing chicken birds that share some of the genetics preserved by Frank Reese illustrates that removing antibiotics and choosing birds that do not need them returns biodiversity to poultry production. All of those achievements are signposts, pointing to where chicken, and cattle and hogs and farmed fish after them, need to go: to a mode of production where antibiotics are used as infrequently as possible to care for sick animals, but not to fatten or protect them.

That is the way antibiotics are now used in human medicine, and it is the only way that the utility of antibiotics and the risk of resistance can be adequately balanced.

Excerpted from Big Chicken by Maryn McKenna published by National Geographic on 12 September 2017. Available wherever books are sold.

Plucked! The Truth About Chicken by Maryn McKenna is published in the UK by Little, Brown and is now available in eBook @14.99, and is published in Trade Format @14.99 on 1 February 2018.

Read more: https://www.theguardian.com/lifeandstyle/2017/oct/13/can-never-eat-chicken-again-antibiotic-resistance

The 21st-century Hollywood: how Silicon Valley became the worlds trend capital

Forget Los Angeles. If you want to get rich and famous fast, in anything from food to fashion, San Francisco is the place to be. But will handing that kind of power to a new global elite come at a price?

The strangest thing about Bulletproof Coffee isnt stirring a pellet of grass-fed butter and a dollop of coconut oil into your morning cup and calling it breakfast, weird though that is to swallow. No, what makes Bulletproof really unusual is the trajectory the trend has followed. The craze started with the Silicon Valley entrepreneur Dave Asprey, who turned the alleged weight-shedding, brainpower-enhancing benefits of caffeine turbocharged with fat into a mini-empire. He took the idea to Santa Monica, where he opened a cafe. David Beckham started dropping in.

From there, it spread to fashion. Vogue has called it the new green juice; at the recent fashion shows, it was on the way to replacing espresso and egg-white omelette as the standard front-row breakfast. Dan Brown, whose novels surely give him zeitgeist bragging rights, has been telling interviewers how 4am writing sessions for his latest book, Origin, were fuelled by Bulletproof. Aspreys ready-made, cold-pressed Bulletproof products are about to go on sale in Whole Foods Market stores, at which point the journey from Silicon Valley quirk to bona fide hipster lifestyle trend will be complete.

Bulletproof
Bulletproof Coffee turbocharged. Photograph: Richard Lautens/Toronto Star via Getty Images

The direction of travel of trends outwards from Silicon Valley was visible when Duncan Selbie, the chief executive of Public Health England, warned of the perils of sitting at your desk all day and called for employers to introduce walking meetings to reduce stress and back pain among the workforce. The pioneer of the walking meeting was Steve Jobs and the habit is so deeply ingrained in Silicon Valley culture that the Frank Gehry-designed Facebook headquarters features four hectares of wifi-enabled wildflower meadows, with milkshake stands dotted along paths. On Prince Street in New Yorks Soho, the newest boutique to open alongside Marc Jacobs and Ralph Lauren is evidence of the first true fashion trend to originate in Silicon Valley. Allbirds, the woollen sneakers that are already de rigueur at Googleplex, are spreading to a creative class of people architects, interior designers, entertainers in music and acting, as the San Francisco-based cofounder Joey Zwillinger told the New York Observer.

Free sushi, massage chairs, toilet seats that heat up employees at top companies here live like celebrities, says Ravi Belani, director of the Alchemist, a startup accelerator and lecturer in entrepreneurship at Stanford University. Two hundred miles from the Sierra Nevada, where gold-rush fortunes were made overnight in the 19th century, and 500 miles from the Los Angeles hills where stars were born in the 20th century, Silicon Valley has become the 21st-century Hollywood. If you want to get rich and famous fast, this is where you need to be. Its not like this place is full of beautiful people, says Bebe Chueh, the cofounder of the law firm Atrium, which specialises in helping startups, but you can accelerate your career here. You dont need to wade for years through a company structure. You can make it all happen when you are 22. Anjula Acharia, who, as a celebrity manager and a partner in Trinity Ventures, bestrides the worlds of Hollywood and tech, says that, in the tech sphere, people are still wearing anoraks. They do still look sort of geeky. This is definitely not New York or London in terms of style. But they have become the global elite. People see that, and they want to be part of that world.

Twenty years ago, when we started lastminute.com, tech was totally weird and geeky, remembers the cross-bench peer and Twitter board member Martha Lane Fox. At that point, people were still wondering if the internet was really going to be a thing. As a relatively young woman wanting to be involved in it, I struck people as bizarre. And, although there are still not nearly enough women, that perception has changed. There has been a huge cultural shift.

Cool,
Cool, (in a sense) an Allbirds woollen shoe. Photograph: Allbirds/Scott Darling

Revenge of the nerds is how Troy Carter the former manager of Lady Gaga and now a Silicon Valley venture capitalist describes this change. Last year, Carter told Time magazine about leaving a barbecue in Silicon Valley with a feeling that the power was shifting. The new stardust glinting from the glass offices of Silicon Valley has not gone unnoticed by the fashion world. Virgil Abloh, the founder of Off-White, a Kanye West collaborator and probably the hottest name in the fashion industry right now, attended Septembers iPhone X launch in the company of his friend Jony Ive, the chief design officer of Apple, and Angela Ahrendts, senior vice-president of retail at Apple, who was wearing a pink lace Burberry trench (Ahrendts was CEO of Burberry until 2014).

In the same month, the San Francisco-born, New York-based fashion designer Alexander Wang who, until recently, liked to hold up Ralph Laurens empire as his aspiration began to talk about wanting to be more like Amazon. Obviously, the big opportunity is digital. I feel that today there is still not a single lifestyle brand that operates like a tech company, he said. Imagine a creative director today for a brand like Amazon. What would that look like? Karl Lagerfeld has built Chanel into a pop-cultural powerhouse on the back of his instinct for the modern and has made gorgeous, aspirational set design a fashion-week calling card a Paris street by night, the gardens of Versailles. Last October, he built a datacentre for his show, with the colours of tweed suits picked out in tangles of Ethernet cables.

Silicon Valleys ascent to glamour can be crudely measured in the intermarriage with models (Snapchats Evan Spiegel to Victorias Secrets Miranda Kerr, in May), ostentatious parties (Sean Parkers fantasy-themed redwood forest wedding, reported to have cost $10m) and glossy magazine covers (Spiegel was called the first Silicon Valley sex symbol by GQ after landing the cover of Italian Vogue Uomo two years ago). Not to mention the films (The Social Network, 2010), the booming roll-call of bold-faced name investors (Jay-Z in Uber, Ashton Kutcher in Airbnb) and, er, interplanetary ambitions (Elon Musk is only dropping by on his way to Mars). At the core of all this, says Lane Fox, is the new reality that tech is at the centre of who we are and that is true for celebrities as well. Managing social media is a huge part of being a model or a pop star now, so, in a way, they are stars of tech.

Snapchats
Snapchats Evan Spiegel with Miranda Kerr. Photograph: Stefanie Keenan/Getty Images for Baby2Baby

The financial crisis played its part in Silicon Valleys Hollywood makeover. After 2008, a lot of the Ivy League grads who would have gone to Wall Street to make money started to come to Silicon Valley instead. There was a new sexiness about being an entrepreneur, says Belani. There have been negative imports that have come with that: a kind of bro culture, or fraternity culture, that arrived with that intake, he adds. Chueh has seen a physical and cultural migration since she moved to San Francisco in 2011. Gradually, the ecosystem has moved from Cupertino, where the culture was kind of hardcore geeky, to San Francisco, where it is more about web applications and tech-enabled ideas than it is about hardware and semiconductors. Chichi members clubs have sprung up in the city: the Battery in 2015, the Modernist this year. The size of Silicon Valley egos have been mapped, through the last decade, in the pages of the architecture journals that have tracked an arms race of starchitect-designed offices. The Airbnb headquarters features a replica of the war room from Dr Strangelove. The new Apple Park spaceship has grandeur on a scale to rival the pharaohs pyramids.

Silicon Valley has shaped a new culture in which work looks like play (ping-pong tables in reception, bean bags in W1A), but in which being off duty is frowned upon, even at weekends. This is rooted in the brutal reality that, when you run a website, its always on, says Lane Fox. Its not like a shop. You dont get to close it. Combined with the sense of mission that is the Silicon Valley creation myth, this has bred a workaholic culture, which has become a badge of honour. The idea here is that work and play are one, says Chueh. Work isnt something you go to from nine to five to get a paycheck. Its an extension of your passion.

The working hours take their toll, and while early startup culture was fuelled by pizzas laid on for team all-nighters, Silicon Valley has gradually absorbed the wellness fixation of its native California. Bowls of free M&Ms have been replaced by meditation pods. At Apple Park, fruit from the 9,000 drought-resistant trees will be harvested for use in the canteen, which will serve 14,000 lunches a day. In parallel with the keto-diet and Bulletproof enthusiasts, Silicon Valley is a driving force behind a boom in veganism, powered by enthusiasm for the new frontier of healthy, sustainable faux-meat products. Its cool now to be vegan, says Belani.

In contrast to the enthusiasm for radical diets and alternative work spaces, fashion in Silicon Valley is noticeably low key. Time spent on sartorial decisions is time that could be better spent working. Form follows function. You have to look at the weather to understand the dress code here, says Chueh. It can be cold in the early morning and hot in the afternoon, so its all about layers: a T-shirt and a hoodie. On the other hand, there are no real seasons. So, unlike in, say, Boston, your wardrobe is pretty much the same all year round.

I dress totally differently when I am in Silicon Valley as opposed to Hollywood, says Acharia-Bath. For instance, no one wears heels here, so, if you do, it becomes, like, a thing.

The flat-shoe, jeans and backpack uniform, technically unisex, but with a masculine, grey-marl slant, holds up a mirror to a very male world. This is still an industry so dominated by men, especially at the top level, says Lane Fox. Which should be enough to give us pause as this culture grows in influence, setting the agenda in ever more arenas. And just as the maverick, anarchic mindset that can be exciting and progressive in startup culture becomes something more dangerous as the big beasts of tech control and shape every aspect of our lives, from the news we read on Facebook to the private thoughts that are open secrets thanks to Googles search history, Silicon Valleys radical attitude to nutrition has the potential to act as a gateway drug to more extreme versions of biohacking. Ambrosia is a San Francisco startup that offers transfusions of young peoples blood, for 6,200 a session, to a client list with a median age of 60. Better sleep and an improvement in some early indicators for cancer and Alzheimers are among the benefits Ambrosia claims from early research (although the scientific community has been cautious about the results to date).

Yes, this sounds ridiculous. But then, there was a time not so long ago when you might have been sceptical about the prediction that, by 2015, the average British child would spend less time outdoors than a high-security prisoner (less than an hour on average, whereas a lifer should get 60 minutes, under UN guidelines). Or that one in three British preschool children would own their own iPad. But what came out of Cupertino changed all that. Silicon Valley is the new Hollywood in many ways, but with one crucial difference: this time, its not just make-believe.

Read more: https://www.theguardian.com/lifeandstyle/2017/oct/23/the-21st-century-hollywood-how-silicon-valley-became-the-worlds-trend-capital

Reality shrivels. This is your life now: 88 days trapped in bed to save a pregnancy

The long read: Months before she was due to give birth, disaster struck for Katherine Heiny. Doctors ordered her to lie on her side in bed and not move and gave her a 1% chance of carrying her baby to term

When I was five years old, my parents decided they could no longer watch the nightly news. Or rather, they could no longer watch it if I was in earshot. The coverage of the attack at the Munich Olympics had caused me to have such an intense fear of being killed by gorillas that I couldnt sleep. No matter how many times my parents explained the difference between terrorist guerrillas and primate gorillas and that there were no gorillas in Michigan anyway I remained sleepless with worry late into the night for weeks. My parents eventually gave up and subscribed to the afternoon paper as well as the morning one.

The problem is not just that I am a champion worrier. Its that I court worry I seek it out, I invite it into my home, never remembering how hard it is too dislodge it from its comfortable chair by the fire. I watch true-crime documentaries when Im alone. I Google photos of black widow spider bites. I know the statistics about paracetamol overdoses. I have memorised the beaches with dangerous riptides. I have installed a carbon monoxide detector in every house I have ever lived in. And when I got pregnant with my first child, I bought What to Expect When Youre Expecting and the chapter titled What Can Go Wrong was the one I read first.

Retained placenta; umbilical cord prolapse; foetal arrhythmia; toxoplasmosis; preeclampsia; placental abruption; gestational diabetes; cytomegalovirus: I read about all of them, and learned the warning signs. Perhaps to other women, these complications remain obscure, shadowy threats during pregnancy, but to me they were hard, clear, immediate dangers. When my obstetrician told me that mine was a perfectly normal pregnancy, the very first thing I said was: Are you sure?

And yet I was surprised when disaster struck. The things you worry about arent supposed to happen thats what worry does. Its a preventative. And my disaster happened quickly, without fanfare or drama. One second, I was a nice, normal, happy pregnant married woman of 32, walking across my bedroom to my desk while my husband made lunch downstairs. And then the warm fluid gushed out of me, soaking my clothing and leaving a little wet spot on the pale green carpet.

I yanked down my jeans and pants, expecting blood, but there was only wetness. I knew it was very likely that my waters had broken, but I was barely 26 weeks pregnant. It didnt seem possible. I stepped out of my clothes and went to the top of the stairs to call my husband. He stood on the landing with his hands all sticky from making hamburgers, and I told him what had happened. We discussed it for a surprisingly long time. Was it really so bad? How much fluid? Maybe a cup? Was there blood? Was the baby still kicking? Should I call my doctor? Yes, we decided.

I wrapped a towel around my waist and called my obstetrician. He was a man in his late 50s with a perpetual hangdog expression, and for this reason, my husband and I called him Doggie B. I loved Doggie B. Nothing ever surprised him, nothing ever alarmed him. I could not picture him giving me bad news, and because I could not imagine it, I felt it wouldnt happen.

I want you to meet me at the hospital, Doggie B said. Go to the maternity ward. And I want you at Georgetown Hospital where they have the neonatal unit.

I put on fresh pants and jeans and my husband and I drove to the hospital. It was 29 January 2000, and an ice storm was just beginning. Something happened to me on the way to the hospital: my mind split in two. One half was convinced that that this trip was unnecessary, that, of course, my water hadnt broken, that I was just fine. The other half was just as sure my waters had broken and that I would almost certainly go into labour and give birth to a baby too young to live. The two halves of my mind rotated inside my head like the lights of a lighthouse, the worried part flashing and then disappearing, replaced by the calm one.


At the hospital, a doctor who looked just like Andie MacDowell performed a pelvic exam and took vaginal swabs. A nitrate test was done on one of the swabs for the presence of amniotic fluid. (Its presence would have meant membranes containing the baby had ruptured three months prematurely and would most likely cause me to go, disastrously, into labour.) The other swab was for sent off to the lab to check for the presence of arborisation, otherwise known as ferning, because amniotic fluid produces a delicate, leafy pattern under the microscope. Both tests were negative, although they were running a repeat just in case. I began to feel a little ridiculous.

The Andie MacDowell doctor told us that there was no evidence that I was leaking amniotic fluid, but that they were going to admit me, she said, on the strength of my story.

The strength of my story! I was appalled. Im a writer of course I told a strong story. Maybe I didnt need to be here, I told my husband, as nurses wheeled my gurney into a private room. Maybe I should just tell an equally strong story about how nothing was wrong and go home.

The doctor came back. I just saw the ferns, she said. You have definitely ruptured. Well try to delay labour as long as possible.

Three months? I asked.

Yes, thats the hope, she said.

I wouldnt have been so scared if it werent for the look on her face.

Dom
Illustration: Dom Mckenzie

Nurses came into my room and began to bustle around me while the doctor explained that my condition was called preterm premature rupture of membranes, or pPROM. The two most dangerous (and most common) complications of pPROM are extreme pre-term birth and chorioamnionitis, a bacterial infection of the foetal membranes. Both are devastating for the foetus. I reached for my husbands hand.

The nurses put me in Trendelenburg, meaning my hospital bed was tilted so that my head was 20 degrees lower than my feet. (I thought it was some long German word that meant head below feet on the side of a mountain.) A nurse wrapped a foetal monitor to my belly with a thick strap, explaining that it could be read from the nurses station, and they would know immediately if I began having contractions. Another nurse slid a pair of puffy compression leggings on to my legs. They inflated and deflated every other minute with a whooshing sound. It was like having Darth Vader breathing at my bedside. I was told to lie on my side in order not to put pressure on my vena cava, which would lower the babys oxygen supply. Yet another nurse poked a needle into my arm to start a line for intravenous antibiotics.

The doctor gave me a shot of steroids to help develop the babys lungs, in case the baby would shortly be needing those lungs to breathe. Arent steroids counter-indicated in pregnancy? I asked.

Yes, but its more dangerous to go without, she said.

Doggie B called the hospital to stay that he couldnt make it in because of the ice storm. In his absence, the doctor ordered the nurses to give me a shot of terbutaline, a medication that can delay preterm labour for up to 48 hours.

Please, I begged. I dont want any more shots. Im not in labour. This could be so bad for the baby.

From the moment I learned I was pregnant, I had divided the world into things that were OK for the baby, and things that were bad for the baby. The first group included rice, poached chicken and yoga, The second group included alcohol, secondhand smoke, deli meat, smoked seafood, raw eggs, soft cheese, pt, caffeine, unwashed vegetables, diet soda, eggnog, x-rays, aspirin, ibuprofen, antihistamines, nasal decongestants, cough syrup, librium, valium, sleeping pills, castor oil, vitamin A supplements, paint fumes, insect repellent, acupuncture, cats, hair dye, altitude, saunas, reptiles, tick bites, microwaves, electric blankets, rollercoasters, bikini waxes, stiletto heels, hot dogs and tap water. I trusted no one but myself and Doggie B to categorise items, and certainly not a doctor I had met 10 minutes before.

They gave me the terbutaline anyway. It made me dizzy and cold, though it makes most people hot. They piled more blankets on top of me. My hands shook uncontrollably.

The neonatologist came to talk to us. He had thick glasses and he talked in percentages. It was clear that he was not interested in offering comfort; he was there to convey information. He told us that for babies born at 26 weeks, the survival rate is 50%. Of the surviving half, one-third had major disabilities, and are likely to be dependent on caregivers for ever. It was common for them to have breathing problems, cardiac disorders, brain bleeds, cerebral palsy. Brain damage, deafness, blindness. Another third had more moderate disabilities: spastic muscles, significant hearing loss, impaired vision without blindness. The final third (the best we could hope for, apparently) had milder learning disabilities, anemia and digestive complications.

I watched him dispassionately, not really listening. He was so stereotypically nerdy that I couldnt get over it. Why was he telling us all this scary shit anyway? I wasnt going to go into labour. The baby wasnt going to be born yet. Why couldnt anyone understand that?


The first night was longer than I would have believed possible. Visiting hours ended and the nurses chased my husband out. He drove home on streets that crackled and shifted with ice. I was not allowed to stand, or even sit. I was served a dinner that I was too nervous to eat. And I learned about bedpans. Peeing into something the size and shape of a casserole dish while lying in bed with your head angled toward the floor is messy and awkward.

But that is not the worst thing about bedpans. The worst thing is the other people involved. Having to ask someone to bring you a bedpan, having to make conversation with that person while you use it, having to apologise because your aim is a little off and now theres a wet spot on the sheets, having to ask that person to wipe you, having to ask her to wipe you again because you still feel damp and sticky, having to thank the person, and you do really thank her, you are so grateful, its just that two hours ago you were an upright person with a little dignity, and now youre not.

The hospital lowered the lights in the hall, just like on a transatlantic flight. Nurses went by on squeaky shoes. I lay on my side and gripped the metal railing of my bed. The lighthouse in my mind revolved, and for one instant the room was flooded with cold, bright, white fear for the baby. Then it was gone. Certainty that the baby would not be born early stole over me, and I gathered that certainty close. I lay awake and watched the sleet falling outside my window. It occurred to me that I could not see the ground.

Doggie B came to see me the next day.

Can you believe this? I said to him. Me, your most paranoid patient!

He didnt bother to deny that I was his most paranoid patient. When he spoke, his voice was mild and unconcerned. He said that I would remain on bed rest, and unless infection forced us to act sooner, he would deliver the baby at 33 weeks, when the greatest risk was over.

I didnt want to have the baby at 33 weeks. I wanted to have the baby at 40 weeks, like everyone else. I knew the risks. But I had also been told the risks of preterm infection: a baby born with brain damage, cardiac defects, limb abnormalities, microcephaly, hydrocephalus, paralysis, bone lesions, eye lesions or possibly no live baby at all. I refused to weigh the risks; I would simply not go into labour, nor would I develop an infection. That was all there was to it.

I frowned at Doggie B. Why 33 weeks? Why not go to May 10? That was my due date.

He shrugged. OK, May 10.

He was a much better liar than the Andie MacDowell doctor.

After Doggie B left, the nerdy neonatology doctor came to my room again. He wanted me to go down to the neonatal intensive care unit (NICU). You need to see what a preemie looks like, he said, pushing his glasses up his nose. You need to prepare yourself.

The Andie MacDowell doctor was there, too. A three-pound baby takes some getting used to, she said. You dont want to see one for the first time in the delivery room.

To both of them, I turned a deaf ear and a sullen face. I was not going into labour. I was not going to go to the NICU and no one could make me. Conversation was cut short when another nurse came in and told me that my monitor had showed slight disturbances, and gave me another shot of terbutaline.

I cant believe terbutaline makes you cold, this nurse said as she took blankets from the blanket-warmer and I shivered beneath them. Out in the hall I heard her say to someone: That one is so contrary.

I could see remotely that all these doctors and nurses knew something I didnt. I found out much later that what they knew were the odds. Fifty per cent of women with pPROM go into labour within 48 hours, and 95% deliver within one week of rupture. Four of the remaining 5% deliver within two weeks. One percent of women with pPROM experience spontaneous resealment of the membranes and go on to carry the baby to term.

One per cent.


Do you knit or crochet? one of the nurses asked me early on. Lots of bed rest patients find that helps them pass the time. No, I read and I write, I answered, pretentiously. And untruthfully, because I have always watched a great deal of TV.

I couldnt write because I couldnt sit up. I also couldnt write because if I focused too much on my situation, the lighthouse in my mind would revolve and the worried, scared part of me would rush out, gibbering with alarm, baying, screaming, howling that the baby was going to be born too soon, the baby was coming now, the baby was going to die. How could I write with that going on?

I had a headache from being in Trendelenburg. I couldnt remember what it was like to look someone in the eye, so long had I now spent gazing up at everyone from thigh-level. When I ate, it was one wobbly, precarious forkful at time. After a while, I just gave up and if I couldnt eat it with my fingers, I didnt eat at all. I drank through a straw, until everything tasted the same: like the plastic of the straws.

I couldnt write, so instead I read. Constantly. Ceaselessly. I had to hold the book open in front of me sideways, like someone gripping a large steering wheel. My husband brought me books and I stacked them on my overbed table, and as I read each book, I held the next book in my free hand, with my finger marking the start of the first chapter so that as soon I finished one book, I could immediately start another. I must have read dozens of books while I was in hospital, and I can only remember one of them.

Only one book held my interest. I told my husband exactly where to find it on the bookshelf near my desk and he brought it to me: Steven Callahans Adrift, a memoir of the 76 days in 1982 during which Callahan had survived in an inflatable life raft after his sailboat sank. I had fallen in love with the book when it was first published, in 1986. It seems like a strange choice of reading for a teenage girl, especially one as studious and non-athletic and seasickness-prone as I was. But I have always been drawn to survival stories: they dovetail nicely with my chronic fear of disasters.

Callahan spent more than two months in a rubber raft in the middle of the Atlantic, spearing fish to eat raw, using solar stills to distil water, and making endless, desperate makeshift repairs to his patched and leaking vessel. I had read Adrift many times over the years, but now I read it again, and was inspired by his suffering and ingenuity in a new way. I was in a hospital bed where nurses brought me meals three times a day, and I slept in a bed on clean sheets and was in no danger of drowning. I could do this. I could.


You dont sleep in hospital. You cant sleep. Too many people coming and going. A nurse comes every four hours to check your vitals: temperature, pulse rate, blood pressure, babys heartbeat. Another nurse comes in every two hours to make sure you are doing your kick-counts. Meals come three times a day, plus a night-time snack for pregnant women, which means four times someone comes into your room to deliver a meal, and four more times someone comes back to collect the tray. A nurse comes every time you need to use the bedpan. An orderly comes every morning to take you for an ultrasound. Your obstetrician comes by every day to check on you, and you dont want to miss his visit, because he is the only one who tells you what you want to hear no, theres no sign of infection; yes, Im sure youll carry to term. The hospital chaplain stops by once a day. She was a mousy woman with a perpetually scared expression. Its not a good look on a hospital chaplain.

So thats more than 30 people coming to your room and interrupting your sleep. And then theres the physical part of it. If you are confined to bed, after you lie on your side for a few days, it begins to feel as if your hip sockets are lined with metal shavings, as if the sheets are covered with shattered glass. Before long, red, rough, scaly patches the size of saucers appear on your hips and your shoulders the beginnings of bedsores. The compression leggings chafe your thighs.

You forget how to sleep. The line between waking and sleeping used to be as clear and sharp as the line down the middle of a road, but after two weeks, that line has blurred and is almost invisible. You stagger back and forth across it like a shambling drunk, until there is no more sleeping and waking; there is just this dim, dull, soupy consciousness. Your reality shrivels down into one long, hazy, beige-tiled tunnel. You used to worry, but it has gone beyond that now. Worry used to be inside you, but now you are inside it. Worry is a dome that has descended over you and trapped you. This is your life now. This is your world.

Every day about 10am, an orderly arrived with a gurney and I carefully scooted on to it and then the orderly pushed the gurney through the hospital halls to the prenatal department.

Two weeks had gone by, and I hadnt gone into labour. This seemed to surprise everyone but me and Doggie B, who began, cautiously, to speak of resealment. The nerdy doctor came by and gave me a whole bunch of new statistics about what the babys chances were at 28 weeks, at 30 weeks. He didnt go beyond 30 weeks, though. They removed my IV. Everyone talked about something called BP as though they were speaking of the Rapture. (Bathroom Privileges.) The atmosphere in my room became positively springlike, despite the snow outside.

Doggie B said the first step would be for me to get up and take a shower. A shower! Nothing could have been more tempting. He gave me a date. Now it was something to look forward to. I had my husband bring in a bottle of my favourite shampoo and a bar of coconut soap. The day finally came. A nurse removed my circulation leggings. I sat up slowly and swung my feet to the floor. The nurse took my arm and helped me to stand. I stood there, swaying. Amniotic fluid poured out of me and splashed to the floor. The nurse let go of my arm in surprise. I lay back down and turned my face to the wall.

It took me a while to regain my strange equilibrium, especially considering that the doctors now suspected I had been leaking continuously since the first rupture. Rupture of the membranes is considered prolonged (and therefore dangerous) when more than 24 hours passes between the rupture and the onset of labour. My waters had broken more than 300 hours ago. The risk of sepsis was very high.

Katherine
Katherine Heiny. Photograph: Leila Barbaro

But still, two days maybe three and the stubbornly optimistic side of my personality fought its way to the forefront and re-planted its battle flag. The Andie McDowell doctor wrote in my chart: Patient needs to understand that resealment is highly unlikely at this time and that preterm birth is almost a certainty. Yeah, well, thats what she thought. This baby was not coming early. I simply wouldnt allow it.

Another week in bed went by. Every once in a while, they had me stand up, and every time I leaked amniotic fluid. But still I didnt go into labour. Nor did I have a fever or abdominal pain, the two greatest indicators of infection. Life as I now knew it went on.

After I had been on bed rest in the hospital for 25 days, there came a time when I stood up and no fluid gushed out of me to splatter on the floor. The nurse and I looked at each other in amazement. Go take a shower, quick! she said. Ill change the sheets on your bed.

It was not the slow, luxurious shower I had dreamed of, but I can tell you this: it was pretty fucking nice. They didnt allow me out of bed again that day, but I was finally taken out of Trendelenburg. I stood up the next day and again there was no leak. I took another shower.

When Doggie B came to see me next, I was sitting in a chair to greet him, radiant, both my pride and my belly enormous.

I had done it. I had resealed. I was in the 1%.


Doggie B wanted to send me home. I fought him. I had been in the hospital for almost a month at this point, and I was pretty much institutionalised. Go home? Without the foetal monitor? With no nurses to listen for the babys heartbeat every four hours? No daily ultrasound? Uh-uh. He was crazy if he thought I could handle that much responsibility. I told him that I needed to be in the hospital near the NICU. I pointed to my chart where it said Severe Risk Pregnancy in big scary letters. Doggie B stood firm. He discharged me and my husband drove me home.

Steven Callahan writes of seeing the first food after his rescue a cake of chipped coconut topped with a dot of red sugar and how he looked at it in wonder and thought: Red! That was exactly how I felt when I saw my house again. Green! Blue! Lilac! My hospital room had been unrelentingly beige.

I was still on almost total bed rest, allowed up for 15 minutes twice a day. A shower in the morning and dinner at night. Out of the hospital, the lighthouse in my mind revolved faster and faster, unchecked by the nurses reassurance. I counted constantly how often the baby kicked, and took my temperature five times a day. The amniotic sac had resealed, but the rupture had been extremely prolonged, greatly increasing the chances of an infection reaching the baby. Even feeling the babys movements could not quell my worry. Doggie Bs receptionist learned to put me straight through to him when I called.

Time ground slowly by. My husband brought me breakfast in the morning before he left for work. Our housekeeper brought me lunch. My husband brought me dinner and we ate at the card table he had set up in the corner of our bedroom. Then I crawled back into bed and worried until I fell asleep, woke up, and started another day. That was my routine, and I never varied from it. I dont mean I never varied from it significantly; I mean I never varied from it at all.

Thirty-one weeks. Thirty-two weeks. Thirty-three. Still I didnt go into labour. I lay in bed and stroked my abdomen with my fingertips. Thirty-four weeks. Thirty-five. March ended and April began. A blizzard of cherry blossoms replaced the snow outside my bedroom window. Thirty-six weeks. Thirty-seven weeks. I no longer watched TV or pretended to read books. I knew nothing but my belly and the endless waiting. Time had softened and stretched like taffy, pulling itself into long, gooey ribbons. Thirty-eight weeks. Thirty-nine. I was certain that the baby would be born on 21 April, the same day Steven Callahan was rescued. But 21 April came and went. And then one day I got up to take my morning shower and felt the slightest trickle of fluid run down my leg. My waters had broken for the last time.


Our son was born 12 hours later at Sibley Hospital in Washington DC. We named him Angus. And so my life changed again in another minute, another second. The two halves of my mind fused back together. I went from severe-risk pregnancy to healthy new mother. I was totally unprepared. For so long the goal had been to stay pregnant I had almost forgotten that a baby was the end result. I knew nothing about newborns, nothing about breastfeeding or burping or vaccinations. The nurses had to show me everything. One them said, in a careful voice: Ive heard about you, I think. I could tell that whatever she had heard was, at best, a mixed review. Didnt you rupture very early and do a lot of bed rest over at Georgetown?

I felt a stubborn thump of pride. Thirty days at Georgetown. Eighty-eight days altogether.

Wow, she said. I bet you never want to see a hospital again.

I didnt know how to tell her that almost the opposite was true. It wasnt just that I knew about hospitals now, and knew I could survive a long stay in one. I was a different person from the one who had been admitted all those weeks and months ago: a tried person, a changed person. Very few experiences transform your view of the world and yourself, but bed rest did that for me. I had beaten nearly unthinkable odds. All the things I have always meant to fix about myself but had never got around to my stubbornness, my hypochondria, my inflexible nature had turned out not to need fixing. Had, in fact, turned out to be survival skills.

Twenty-four hours went by, and I cried because I never wanted Angus to get any older. The impossible had happened: time had speeded up.

Six months later, I arranged to speak to Steven Callahan by phone. I told him how much his book had meant to me, how much he had inspired me. We discovered that we had both been obsessed with numbers, with calculating and re-calculating the days of our progress. I told him that my ordeal had altered me in some fundamental way, that sometimes I even missed the mind-bending, terrifying force of it. He agreed.

Sometimes I feel a loss, he said, in terms of the fact that few if any experiences I will ever have again can equal the intensity and importance of that one. You try to mine the precious elements of the experience, but they slip away from you, and thats another loss. You try to appreciate this enormous gift youve been given, but eventually you just get on with it.

The precious elements of my experience were fading, too. I took my bathroom privileges for granted now. I slept on my back again. I went for walks. I worried about traffic jams and deadlines and love handles, just like a normal person. I got on with it.

Angus is 17 now, taller than me, taller than my husband. He has the beginnings of a moustache and a voice as deep as James Earl Joness. He knows how to do laundry, and make spaghetti. He can take the Metro by himself, and he learned to drive this summer. Its possible he watches porn on the internet. (Its extremely possible.) I have new fears and worries, about teenagers. The bright, icy terror of the hospital is behind me, but it has taken a long time.

One day, when Angus was about three years old, I cleaned out a closet and unexpectedly found the plastic water pitcher that had been by my hospital bed. In an instant, the lighthouse in my head revolved, and everything went white and cold. I was certain that the baby was in danger so certain that I had to run to the bathroom and vomit. I dont know why this surprised me, or why I thought I would be different, immune to the after-effects of my ordeal. All survivors have scars.

Main illustration by Dom McKenzie

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Read more: https://www.theguardian.com/lifeandstyle/2017/oct/24/88-days-trapped-in-bed-to-save-a-pregnancy-bed-rest