Figuring Out Who You Are

Hand with book“Please don’t call me Doctor Jones,” said an extremely distinguished PhD speaker I met recently; “I’m just a teacher named Joe. I’ve been Joe all my life.” His name is changed to protect the innocent.

Having one name all your life is almost as interesting to some of us… of a certain age… as meeting a prominent multiple-degree lecturer who calls himself “just a teacher.”

Not someone of many degrees, I am nevertheless someone of many names. Maiden name, married name, resumption of maiden name after divorce, brief and ill-fated second marriage (yep, changed my name again,) eventual marriage to my Final Husband, whose name I took on moving across the U.S. nearly a quarter of a century ago. Because I’ve been writing since college (Fran Moreland) I often joke – though this is not a source of pride, only comic relief – that my literary resume reads like an anthology. Each name still bears its own notoriety, as well as its own burdens.

A fascinating look at what names and name changes have meant to women over the centuries is offered by my talented writer/scientist friend Jo Anne Simson in a recent article published in Persimmon Tree magazine titled “What’s in a Name.”

Names, Simson writes, have been used against women in subtle – and sometimes not so subtle – ways to subjugate, control and deny their sense of personhood. Probably the most damning of these practices for women in America was the assigning to slaves the surname of their masters, which “ruptured a connection to a past culture from which they had been torn most unwillingly. Moreover, the name change signified an identity conversion from personhood to property… ‘Leave your past behind. You are now property, not a person.’”

This writer’s post graduate experience ended with an MFA in short fiction, University of San Francisco Class of 2000, which conferred a degree but no title. I have, however, managed to keep my final literary name since 1992.

At about the same time I took on the final marital/literary name above, my first grandchild was born, bringing the other defining ID: Gran. The favorites survive.

 

 

Choosing a better death

Could dying be better?

By now most people acknowledge that there are “good” deaths: peaceful, with minimal pain, at home surrounded by loved ones – and “bad”: pain-filled and prolonged, often for months or years and more often than not in a hospital or other institutional setting. The movement toward “good” death – legalized medical aid in dying – has been growing for decades in the U.S., but has been gaining momentum and attention in recent months.

Liner.2Robert Liner MD, a retired obstetrician/gynecologist, gave an informative update on the movement at a recent University of California San Francisco grand rounds. Liner is one of four patient plaintiffs in a California lawsuit which would make that state the sixth to legalize physician aid in dying, and a longtime supporter of leading end-of-life organization Compassion & Choices. The suit is also joined by three physician plaintiffs.

Liner, whose cancer is in remission, said he would personally prefer to avoid death altogether. “But along with birth, dying is a universal experience. It’s what we all do.” And equally universal, he noted, is the wish to make that experience a little more compassionate, a little closer to what most of us would choose.

Liner outlined the current status of California SB-128, the End of Life Options Act, now working its way through the senate. While granting terminally ill, mentally competent adults the right to ask their physicians for life-ending medication, the bill would also establish safeguards such as requiring assessments by multiple physicians and repeat requests for the medication made at least 15 days apart. A similar law in Oregon has proven valuable in many aspects over the 18 years in which it has now been in place, Liner said. Death W Dignity newspaper

He cited a study published in the New England Journal of Medicine at the end of the Oregon law’s first decade which found that since passage of the law Oregon has seen improved training for physicians in end-of-life care, an increase in individuals’ completing advance directives, improved pain management and rates of referral to hospice and an increase in number of people dying at home.

Putting the better-death movement in historical context, Liner referenced a significant case several decades ago that sometimes goes unnoticed. In 1991, he explained, New York physician Timothy Quill published an article in the New England Journal of Medicine describing how he had prescribed barbiturates to a dying patient when her leukemia reached a point at which she no longer wanted to live. A grand jury subsequently declined to prosecute. Quill later became one of the plaintiffs in a case that wound up reaching the U.S. Supreme Court. And in 1997 the Court let stand a New York law prohibiting what was then called physician-assisted suicide, ruling that there is no federal constitutional right to die – effectively turning the issue back to the states.

Five states – Oregon, Washington, Vermont, Montana and New Mexico now allow physician aid in dying, Liner explained. California’s efforts to become the sixth include a campaign launched last year by Compassion & Choices and the lawsuit filed early this year.

Scales of justiceLiner distributed copies of the April edition of San Francisco Medicine, the journal of the San Francisco Medical Society, in which he and two of the other physicians involved in the lawsuit explain their support for legalized aid in dying. “Collectively, we represent almost a century of medical practice, teaching and research…(and) probably most relevant is our extensive experience caring for dying patients,” write lawsuit plaintiffs Liner, Donald Abrams, MD and Marcus Conant, MD in San Francisco Medicine.

The lawsuit is backed by national disability rights advocacy group Disability Rights Legal Center, Liner explained, and cites a number of reasons why aid in dying should now be legalized. While some arguments – such as privacy and liberty interests – are complex, one seems fairly straightforward: California penal code section #401, which makes it a crime to aid or encourage someone to commit suicide (a very different situation from a dying person’s wish to shorten his suffering), was written more than a century ago. Before dying shifted from being commonly a home event overseen by the familiar family physician to hospitals or other institutions where the large majority of Americans now spend their final days and weeks. Before medical technology made it possible to prolong life, often far past any “life” many would choose.

Liner, and millions of other Americans, believe choice in dying should rest with those who are dying themselves.

 

 

Want to put your brain to good use?

child Head

(Part Two of Data Today – Better Tomorrow)

Could this be you? Creating a better tomorrow through brain research??

It turns out one does not have to be a pro football linebacker to have a brain worth studying. One does not even need to have a brain like Albert Einstein’s, Steven Hawking’s or any of those scientists/exceptionalists/geniuses whose brains would seem worth figuring out.

One only needs to be 18 or over and willing to be studied, and then to go sign up on the Brain Health Registry. This entitles you to sit back and wait for your brain to help discover a cure for Alzheimer’s or ADHD or depression, or perhaps help find better ways to treat traumatic brain injury. Not bad, for just having a brain and investing a little time (no money.)

This writer got off to a sluggish start as a Brain Health Registry member. Signed up early on because it sounds like such a great endeavor, but then I ran into a few off-putting instructions like “This will take about 20 minutes. It is best done in a quiet room where there will be no distractions or interruptions.” Twenty minutes, quiet rooms and absence of distractions are three things hard to come by around my house.

Eventually, however, the requisite conditions were found, and I was off to create a better tomorrow – well, in partnership with a few thousand other participants and some very smart neuroscientists – by finding out stuff about the human brain. And this is one fascinating journey. The neuroscientists find it fascinating because they really are going to figure stuff out. But for participants, the fascination is in the process.

Participants enter a little basic, very general data about medical/family history etc. Then the fun begins. We have two sets of ‘Cognition’ tests aimed at assessing our memory, attention and other cognitive characteristics. “These tests give us a sense of how your brain is currently functioning,” the screen says. This participant can only wonder what the Brain Health assessment people think about how her brain is functioning. The ‘Cognition’ tests are computer games on steroids. For a while you try to remember and replicate the pattern of dots, and then you go to the card games. The card games require Yes or No answers about what the cards are doing, press D for Yes and K for No. My brain kept trying to tell me what the cards were doing, while my fingers tried to remember that K was not for Yes.

It is, all in all, a lot more fun that the computer games the rest of the world is playing.

In another three to six months, the BHR people will be reminding me to go back and do it again, or do something else, to see how the brain is getting along. Perhaps they will flag my entry and advise me to check myself into an institution. But more likely they will just combine my data with the data of a zillion more or less anonymous others – and find a cure for Alzheimer’s! Or depression! Or improvements in treatment of traumatic brain injuries! All with the help of my weary, aging brain. Plus, when the survey was completed I got an email from UCSF professor Michael Weiner, MD telling me I am a medical hero. “You’re helping to make brain research faster, better and less expensive – and ultimately that gets us closer to a cure for Alzheimer’s, Parkinson’s, and other brain disorders that strike tens of millions of Americans every year.” Who could resist?

You may want to go straight over to the Brain Health Registry and join the fun.

Data Today, Better Tomorrow, yay!

Women's Health Initiative

Some of us are suckers for studies: clinical trials, focus groups, surveys – whatever promises to shed a little light on the human condition, or possibly make that condition a little better.

This writer is a hopeless volunteer.

I have had my knees examined by MRIs, perhaps studying why I still have the originals despite a long history of abuse. I have had blood drawn for a study of celiac disease by someone who came to the house as part of the deal but unfortunately was not trained to find veins without causing excruciating pain. I have filled out lengthy surveys about addictive behavior – which may include addiction to study-participation (though that was not among the category choices.)

Currently, I am proudest of being an original part of the Women’s Health Initiative, which launched in 1993 with more than 160,000 postmenopausal women including this writer. In 1993 this was a Very Big Deal: studies had been made for all sorts of things with all sorts of participants, but finally there was a study of WOMEN. It sought to discover links between cancer (imagine! Studying women and cancer!) medical protocols, diet and other factors. Being a congenital wimp, and knowing I wouldn’t change my diet or stick to other proscribed regimens, I just signed up for the control group… but still. Even we control groupies are useful.

Over the years, WHI has developed a huge amount of useful data, probably the most beneficial being the finding that (imagine! Studying women!) hormone replacement therapy was not the be-all and end-all we had originally thought, but actually not such a good idea. (Read all about it.)

WHI has published over a thousand articles, approved well over 300 ancillary studies, and twice conducted extension studies. Findings have been about links between age, daily activities, diet etc and things like body fat, omega oils, heart disease, endometrial cancer – there is a list of useful discoveries resulting from this one large and ever-growing study project that boggles the mind.

Some – though surely not all – of this data is collected through regular survey forms received every year by WHI participants in addition to the annual birthday cards that by now this writer accepts as a “Congratulations! Are you’re still alive?” greeting. They seek data about lifestyles and life changes along with the traditional general health issues – and sometimes make one wonder what the next findings may be. My personal favorite question was, “When you enter a room full of people, do you often imagine they are talking about you?”

Paranoia after mastectomy? Who knows.

It is fascinating to be on the questioning end of tomorrow’s answers. Next blog: The Brain Health Registry. Assuming my closely-watched brain is still functioning.

ISIS: What’s In A Name?

Islamic State flag

Remember when Isis was just a Greek goddess? The goddess of – among other things – health and wisdom?

Not many people today would know the goddess, but there are few who don’t know ISIS. According to a new CNN/ORC poll, people in the U.S. consider ISIS a greater threat than Iran, Russia, North Korea, China – or probably even the economic woes of the earlier Isis’ native land.

In an effort to increase understanding of the situation, Celia Menczel of San Francisco’s Commonwealth Club Middle Eastern Affairs group recently assembled a panel of experts to discuss the issue in both human and political terms. Moderated by Media Analyst Dina Ibrahim, the program was titled The Islamic State. Panelists included Honorary Consul General of Turkey Bonnie Joy Kaslan; Kurdish human rights activist Karaman Mamand; University of California, Davis Professor Karima Bennoune, author of the irresistibly titled Your Fatwa Does Not Apply Here; and Jordanian academic Maher Kalaj.

Panelists were invited to give a brief overview of their perspectives. This unfortunately was an impossible assignment; though several panelists made valiant attempts, it turns out that expert views and insights on the Islamic State simply cannot be condensed into ten minutes – if, indeed, a day. The issue is too vast, too complex, too fraught and too weighted with centuries of conflict.

But on one issue there was emphatic agreement: ISIS is not a state.

Kaslan led off her summary with that declaration, and concluded by stressing the importance of this distinction: ISIS, ISIL, SIC, IS, Da’ish is many things, but not a state. Among the many things it is? A terrorist organization; an amorphous group of men who commit unspeakable acts of violence and brutality; a sprawling movement that condones and conducts beheadings, kidnappings, mass executions of religious groups, absolute subjugation of women.

A state, most would argue, involves more than territorial control – which ISIS surely has, in constantly shifting areas – and more than the declaration of power. A state exhibits some degree of care and concern for its people – and the rest of humankind.

Many diverse elements of the troubling terrorist movement were illuminated by members of the distinguished panel, but this was perhaps the key:

Whatever ISIS is, it’s not Islamic to the vast majority of believers in Islam…… and hopefully it will never become a state.

Life: a sexually transmitted, fatal condition

sunset

Life is a sexually transmitted condition that is invariably fatal.

That well-phrased truth – often attributed to British author Neil Gaiman – led off a talk not long ago at San Francisco’s Commonwealth Club by Atul Gawande, physician and author of, most recently, Being Mortal. Gawande’s message was all about being mortal, and facing that inevitable death in advance. In other words, if we mortals could please just admit our mortality – and talk about what we’d like our final days/weeks/months to look like – much good would result.

This writer has been on that soapbox for several decades.

Gawande and his interviewer, University of California San Francisco professor Alice Chen MD, spoke of the need for shared decision-making, shifting away from the paternalistic ‘doctor knows best: here’s what we’re going to do for you’ attitude to the physician giving information and involving the patient in making choices. But their decision-making would still put the doctor first and patient second. This writer respectfully disagrees.

Atul Gawande

Atul Gawande

In response to a question from the audience, Gawande agreed that “a patient with unbearable suffering should be given the option to hasten death.” But he followed this perfectly rational statement with an irrational comment: “every hastened death is a failure of the medical system.”

Give us a break.

The medical system needs, at some point, to confront this reality: Life… is invariably fatal. The medical system cannot forestall anyone’s death forever. The medical system cannot protect, absolutely, against unbearable suffering. Compassionate physicians across the U.S. are recognizing this fact, and increasingly backing the legalization of aid in dying for the mentally competent terminally ill.

Gawande, Chen and countless others are proponents of palliative care, an excellent, relatively new segment of care in this country. They would have us believe that palliative care is the be-all and end-all of end-of-life care, and they oppose the option of legal aid in dying. Palliative care, an option many choose, is a fine addition to healthcare. It can keep pain to a minimum and often insure comfort; as a last resort, palliative sedation can render the patient essentially unconscious for whatever hours or days remain until death comes.

But it is a cruel myth that palliative care, or even the best hospice care, can guarantee anyone will slip peacefully from good life to gentle death. Pain, indignity, discomfort and distress are part of the process; some of us don’t want much of that.

Legal aid in dying, the option to choose at what point to let invariable fatality happen, is the only guarantee. It’s an option that we should all have.

Sailing as Metaphor

Sailing under Bay Bridge 4.11.15Life. Play it safe – or risk everything? Avoid conflict or seize the day?

At the end of a long-anticipated visit from across the country, this writer’s family – west coast grandmother, east coast son and daughter-in-law, granddaughters 11 and 13 – was invited to go sailing on San Francisco Bay with a close friend who owns (and carefully operates) a 36-foot sailboat. After showing us around – it sleeps seven, with almost all the comforts of home – our captain delivered a safety lecture, explaining things like where the life jackets are, and the way the boom can swing quite suddenly and one is advised to stay out of its way. He went into some detail about what to do if he fell overboard: a safety device attached to the stern contains rope and flotation collar, so all that’s required is to keep circling until the man overboard can grab the line. He then issued life jackets to the girls and offered them (this boat has life jackets for about a dozen) to the grownups. I declined, knowing full well that I would last about five minutes max in the chilly waters of the Bay; go figure.

Skip & Georg 4.11.15For the next several hours we had a glorious sail, under the Bay Bridge, around the back of Alcatraz, nearing Angel Island, swinging parallel to the Golden Gate and heading back to meander homeward along the city’s edge. Picnicking in the sunshine and taking advantage of spectacular photo ops. I had one scary moment on the turnaround; it’s been a long time since I last sailed. Almost home we were stopped by the bay patrol and told not to sail back below the bridge for 10 minutes or so. Once we were cleared they explained to boats waiting on either side that Vice President Biden had been driving across the bridge. All in all it was a glorious day. In looking back, though, it’s hard to miss the basic messages:

1) Let the kids explore the universe, but keep the life jackets on.

2) White caps and turbulence make things interesting, and are seldom fatal.

3) The vessel with more power is supposed to get out of the way.

4) You can circle around someone who’s sinking, but he has to grab the lifeline himself.

5) On the other hand, when the sinker is you, be grateful for those circling around.

6) When you think the world’s going to keel over, there is ballast that brings it back to steady.

7) Sometimes the vessel with more power claims the right-of-way. Chill.

8) Wear sunscreen, and bring extra layers.

9) Don’t miss the scenery while you’re looking at your camera phone.

10) Life’s a breeze.

 

Sailboat behind Alcatraz

 

 

Bernie Sanders, presidential candidate?

Bernie Sanders 3.30.15

Bernie Sanders, the feisty Vermont senator introduced as “Independent in every sense of the word” isn’t likely to change if he runs for President. And if he does run – a suggestion that brought the evening’s loudest applause during a recent appearance at the Commonwealth Club of California – it should not be dull.

Within the first several minutes of his talk Sanders had ticked off a list of reasons he might indeed be tempted to enter the presidential fray: “Income inequality, planetary challenges, growing disillusionment with the establishment, massive greed, reckless and illegal behavior on the part of Wall Street resulting in millions of people losing their jobs and homes, a corporate establishment that cares only about its own interest…

“The American middle class,” Sanders says, “has been disappearing for the last 40 years. Forty-five million Americans live in poverty. Despite the Affordable Care Act, 35 million are still uninsured. The U.S. is the only major country that does not guarantee healthcare as a right.”

Sanders deplores what he sees as a movement toward oligarchy, with a handful of very rich holding the reins of power. Within that handful are the Koch brothers. Citing their 1980s Libertarian campaign goals, Sanders lists a few expectations of what oligarchic control would bring: abolition of Medicare, Medicaid and the postal service, abandonment of all government welfare, abolition of the minimum wage…

Sanders’ rapid-fire listing of grim possibilities ahead, shared in both his prepared remarks and in the Q&A moderated by San Francisco Supervisor David Campos, had more than an occasional campaign-speech sound. “It would be a very sad state of affairs if Hillary (Rodham Clinton) ran without serious opposition,” he said. Nor does he have much enthusiasm for likely Republican candidate Jeb Bush. “There clearly is something wrong with the political system if we’re not seeing dozens and dozens of vibrant young leaders whose dad wasn’t president or whose husband wasn’t president.”

Sanders & Campos 3.30.15His own platform would likely have the overturning of Citizens United and movement toward publicly funded election as a primary plank, a change Sanders sees as necessary to restoring democracy to our democratic system. Sharing the top would be fixing income inequality, an injustice he terms obscene and grotesque. “Between 2013 and 2015,” he said, “the 14 wealthiest people – Gates, Kochs, Buffett – saw their wealth increase by $157 billion. Not what they’re worth; increase. That $157 billion is more wealth than is owned by the bottom 40 percent of the American people. One family, the Walton family, owns more wealth than the bottom 40 percent.” Sanders on income inequality is Sanders in a rage against injustice.

The senator also has solutions: make public colleges free, weatherize houses, invest in solar, build a national rail system. Overturn Citizens United.

“The issue is not what happens in Congress,” he says; “it’s what happens in the grassroots. You’re going to have to start listening to the working class, not just billionaire corporations. Mobilize young people to say ‘stop spending billions on the military, spend on education.’

“This stuff is not easy,” the possible-candidate adds. “These guys who have got it all want more.” And Sanders is quick to say that he has few friends on Wall Street, in corporate America or in the military-industrial complex. “But I have seven beautiful grandchildren,” he adds, “and I’ll be damned if they’re not going to live in a country we can be proud of.”

Which sounds a little like he may run for President.

The Human Face of Human Trafficking

chained wrists

Suppose, just for a moment, you are a 13-year-old girl who has been trafficked in America, the land of the free.

You’ve been brought to the U.S. – kidnapped, sold by your impoverished family, picked up from the streets of some land where girls have no value – and prostituted. Or more likely here, you’re a very unlucky American child victimized by traffickers. As a result of this tragic history, you are pregnant. Or, you survived God knows what only to become a 20-something victim of human trafficking – which now leaves you pregnant.

You should be forced to carry this pregnancy to term? Excuse me?

This is the human face of the human trafficking bill currently being held up in the Senate. Texas Senator John Cornyn’s “Justice for Victims of Human Trafficking” bill would “boost support for and protection of victims of human trafficking” – unless they happen to get pregnant. Once they become pregnant, that support and protection disappears. Tucked away within the multi-page piece of legislation is a stipulation that abortion could not be paid for with these funds.

It’s the old Hyde Amendment thing – the bill passed late in the 20th century that sent women’s reproductive rights straight back into the 19th century with the stipulation that never a federal dollar would be paid to help them end unwanted pregnancies.

Some young trafficking victims might still seek help, since there are now exceptions in cases of rape or incest. But the fact that the victim herself would bear the responsibility for proving the circumstances of her pregnancy is an insult added to egregious injury.

Human faces get lost in congressional rancor. Senators accuse one another of subterfuge and betrayal. Republicans accuse Democrats of one thing, Democrats accuse Republicans of another. Very little gets done. And in it all, the human faces disappear: faces of mere children who never had a break, of women of every age who deserve a life.

If they had voices, those faces might say, “Remember me?”

Russia-Ukraine Conflict in One Fast Hour

Foreign Affairs 101:

Ukraine_Majority_Language_Map_2001

Ukraine Majority Language Map

If it’s possible to condense the incomprehensibly complex Russia/Ukraine conflict into one coherent hour, Matthew Rojansky can do it. Rojansky, Director of the Kennan Institute and an expert on the region, proved that in a recent presentation at San Francisco’s Commonwealth Club. A listener who blinked could miss a paragraph, but Rojansky’s fast-paced illustrated lecture had most of his audience too engaged to blink. What follows is an abbreviated summary of the presentation.

Yanukovich estate

Yanukovych Estate

For openers, Rojansky explained that Ukraine, under now-deposed leader Viktor Yanukovych, was “a society absolutely primed for revolt. A few years ago,” Rojansky said, “I moved to Kiev with my family, (finding) Yanukovych one of the most corrupt politicians in history – and that’s saying something.” Illustrating his point, Rojansky showed slides taken during his time in Kiev including views of some of Yanukovych’s perks: a heli-pad; a palace with gold, jewel-encrusted design, 3-lane bowling alley, billiard room, private floating pirate-themed restaurant reported to have cost a few billion dollars – a rather definitive picture of excess. Rojansky also mentioned the stuffed lion guarding a corridor leading to the nail salon and spa, and a collection of exotic cars and animals. It was not just personal excess, he said, “there was government corruption on a grand scale.”

By the fall of 2013, Ukranian citizens were tiring of this. A peaceful protest known as the Euromaidan began in the square Rojansky and his family could see from their apartment window. “It was surreal.” Public sentiment favored closer connections to Europe, Rojansky said, but Yanukovych instead signed an agreement with Russia’s Vladimir Putin. Thus began the increasing protests fueled largely by social media, with help for the needs of Euromaidan solicited via constant Facebook postings.

Matthew Rojansky

Matthew Rojansky at the Commonwealth Club 3.6.15

Initially, Rojansky explained, the movement was not political. But also thanks to social media – Twitter users began receiving messages letting them know they were registered as protesters – things quickly changed. And on January 16, 2014, the dictatorship laws were passed: No protests, no groups, no gatherings. The movement against abstract corruption became ‘Yanukovych Must Go.’ Things came to a crisis when someone gave the order to fire and all-out shooting began. Despite the European Union intervening to broker a deal in late February, Yanukovych escaped – with boxcars of treasure – though leaving behind the exotic animals still being cared for on his former palatial estate outside Kiev.

Soon came the time of “the little green men” in Crimea, a significant chunk of Ukraine on the Black Sea. Rojanksy explained that there have always been Russians in Crimea; the little green men wore Russian military garb minus the insignia, carried Russian weaponry, but Putin at the time denied they were sent by Russia.

Donetsk airport

Donetsk Airport

By May of 2014, Rojansky said, regions of Ukraine that are heavily Russian-speaking began to hold referenda to break away – not to become independent, but to become part of Russia. Things accelerated significantly with the downing of a Malaysian Airlines plane in July, 2014, and the ground war began. “This was not World War II,” Rojanksy explained, but guerilla warfare with terror tactics, firing on civilian buildings, the destruction of the once-beautiful Donetsk airport. “This is insane stuff.”

As to what Mr. Putin wants out of all this? Rojansky listed three main points;

1 – Domestic politics are life-or-death. If the idea that when regular people take to the streets life gets better catches on, Russians might say “What about us?”

2 – Putin has a major image issue. He’s the tsar. He is never wrong. There’s God, and then there’s the Tsar.

3 – Geopolitics are important. If Russia and Crimea get together, Putin’s bargaining power is greater.

Rojanksky characterizes Ukraine as being between a rock and a Russian hard place. The hard place is boosted by the fact that half the people in Ukraine speak Russian, and many more watch Russian TV with its decidedly nationalist fervor.

For now, Rojansky says the wise course is “Don’t show up giving out cookies. Get observers on the ground as fast as possible, and eyes on the ground on the borders. Watch to see if sanctions are working.

And in the very long term: “Ukraine matters. We have to help Ukraine defeat corruption. Things we can do include letting Ukrainians come here, and knowing about the region.” In the end:

“There are no easy answers.”

Disclaimer: This writer knows as little about Russia and Ukraine as a few long-ago college courses and one unforgettable trip from Moscow to St. Petersberg might suggest. But listening to Matthew Rojansky’s take on the current situation is enough to convince one to pay attention.

 

 

 

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