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How to Live in the Face of Fear: Lessons From a Cancer Survivor
As the coronavirus pandemic spreads, the normal touchstones of everyday life have vanished without so much as a warning. In their place are terrifying thoughts about the future, about loss and about mortality.
For Kate Bowler, a historian at Duke Divinity School, this is familiar terrain. In 2015, when she was 35 and a new mother, Dr. Bowler was diagnosed with incurable cancer, and uncertainty became a way of life. She explores what it is to be human in dark times in her best-selling memoir, “Everything Happens For A Reason (and Other Lies I’ve Loved),” and her podcast of the same name.
During the pandemic — which has intensified during the Christian season of Lent — Dr. Bowler has been offering daily reflections on social media about living in fear. In a conversation with The Times, which has been edited for length, Dr. Bowler reflected on why forcing yourself to stay positive is not always best, the human longing to love and be loved and why living in constant fear makes it important to have two different routines: one for day and one for night.
How are you feeling your way through this new moment of mass fear and uncertainty?
It feels so familiar. That feeling of waking up in the morning and for a moment you don’t believe it’s real — I remember that feeling of not remembering I had cancer, and then remembering all over again, every day. I think so many people are waking up each day and forgetting that they are scared that they can’t hold their mom’s hand in the residential care facility they’re at. Or their sister is about to have a baby, and there are concerns that people can’t even have their partners in the room with them as they have what they hope will be a perfectly healthy birth.
On the other hand this situation is totally new to me. It’s very bizarre to share that feeling with everyone and realize: Wow, we are all feeling especially delicate, at the same time.
What is that revealing about the collective soul of the country, or the world, right now?
I think it’s painful for everyone to know that there’s just not a lot of room between anybody and the very edge. It really does run counter to the whole American story. It’s a story about how scrappy individuals will always make it, and it’s a story about how Americans’ collective self-understanding will always build something that will save the nation. And currently both things are not true. Everyone else in the world will suffer too, but I don’t think they will suffer nearly the same cultural disillusionment because they didn’t have that account of exceptionalism.
What do you make of the idea that we should all just “stay positive” through this?
The idea that we’re all supposed to be positive all the time has become an American obsession. It gives us momentum and purpose to feel like the best is yet to come. But the problem is when it becomes a kind of poison, in which it expects that people who are suffering — which is pretty much everyone right now — are somehow always supposed to find the silver lining or not speak realistically about their circumstances.
The main problem is that it adds shame to suffering, by just requiring everyone to be prescriptively joyful. If I see one more millionaire on Instagram yell that she is choosing joy, while selling journals in which stay-a- home moms are supposed to write joy mantras, I am going to lose my mind!
You’ve been sharing daily wisdom in your Instagram stories, giving people permission to feel and just be. In one post you say, “Today it is OK to be limited.” Tell us about that.
You mean when I’m lightly crying and sitting in my pajamas?
Especially when you’ve drunk too deeply from the wells of invincibility, you get in a time like this and I think we feel confused. Like it’s 8 a.m., why am I still tired?
There was a rhythm I got into with cancer that has served me well right now. Every day sort of has an arc to it. There’s a limited amount that you’re going to be able to face as you stare into the abyss. Being able over the course of the day to track your own resources will help you know how to spend them.
There’s just a minute where you know, OK, I’m starting to hit the wall. Time to turn the boat around. There’s only so much we can do, and in the face of unlimited need we have to not just wildly oscillate between sort of intense action and then narcolepsy.
How do we how feel the day and allow ourselves to be human inside of it? I think that’s really tricky work.
You’ve said people who live with a lot of fear have taught you to have two routines: daytime and nighttime. What are they?
Daytime: My eyes open. There is a six-year-old boy in pajamas. I feed him cereal, then we snuggle. Then I decide there’s only a couple things I can do in the day. Then I launch myself toward them. Then I get overwhelmed midway through the afternoon. You just take a minute. You see who’s left to care about. Then at some point you’ll realize that you’re about to hit the wall.
Nighttime: What’s most important, at least in my little routine, is you pick a time and then you call it. So like 7 p.m., no more new information. No more starting sentences with, “Did you hear about the….” And then start this sort of gentleness. I have positive music and cheese ball movies and more snuggles, and then go to bed earlier than it seems socially acceptable. Because if you violate that rule, then you’ll break the next day.
What are other practical survival tips for living in fear?
If the days are really full and heavy, to focus on the absurdity is so great. Small delight is really fun. I’ve been in onesie Star Wars pajamas so much more this week. Get really in to a reality show that people would lose respect for you if they knew that you watched it. Make a commitment to something unbelievably dumb right now — now’s the time.
There’s the light things. How do you find meaning amid all the terrible?
The trick is to find meaning without being taught a lesson. A pandemic is not a judgment, and it will not discriminate between the deserving and the undeserving. I think moments like this reveal to me God’s unbelievable love for us.
The second I see all these nurses and doctors going out there trying to save somebody else’s life, I realized it’s such a window into how gorgeous it is to be a human being. And the more we see fragility, sometimes the more we understand what an incredible miracle it is to have been created at all. So I think just having a higher and higher view of our gorgeous and terrible humanity.
We’re learning right now in isolation what interdependence feels like and what a gift it is, and the more we’re apart the more we realize how much we need each other. We’re allowed to be like beautifully, stupidly needy right now. We’re allowed to FaceTime people and be like, I feel like a mess, and all I want to do is be loved.
I’ve been thinking about how this is happening in an increasingly secular America, and how there are people who have these deep resources in their religious communities and there are others who don’t. What if you are someone right now who doesn’t pray?
For me part of the joy of prayer is having abandoned the formula. I have no expectation that prayer works in a direct way. But I do hope that every person, religious or not, feels the permission to say, “I’m at the edge of what I know. And in the face of the sea of abyss, someone out there please show me love.” Because that’s to me the only thing that fills up the darkness. It’s somehow in there, the feeling that I am not for no reason. And that doesn’t mean anything better is going to happen to me, but in the meantime that I will know that we all are deeply and profoundly loved. That’s my hope for everybody.
Inspector General Fired by Trump Urges Whistle-Blowers ‘to Bravely Speak Up’
WASHINGTON — The intelligence community inspector general whom President Trump fired late Friday night has called on whistle-blowers to overcome any fears and come forward with information about waste and illegality in the government despite the administration’s reprisals.
“The American people deserve an honest and effective government,” the fired official, Michael K. Atkinson, said in a lengthy statement late on Sunday. “They are counting on you to use authorized channels to bravely speak up — there is no disgrace for doing so.”
He added: “Please do not allow recent events to silence your voices.”
Mr. Atkinson, who was appointed by Mr. Trump in 2018, drew the president’s ire last year after he received a whistle-blower complaint from an intelligence community official accusing the president of abusing his power over foreign policy to coerce Ukraine’s government into announcing investigations that could deliver him personal political benefits.
Mr. Atkinson deemed the complaint to be credible and to have raised an “urgent concern.” Under a federal whistle-blower law, if the intelligence community inspector general makes such a determination, the Office of the Director of National Intelligence “shall” disclose it to Congress.
But the Trump administration initially attempted to withhold it from lawmakers, before reversing under political pressure. The impression that the White House was trying to cover something up supercharged the dispute, which quickly prompted the impeachment inquiry.
While Mr. Trump’s letter to Congress gave no reason for firing Mr. Atkinson, he made clear at a news briefing about the coronavirus pandemic on Saturday that he dismissed Mr. Atkinson because he was angry that the inspector general had pushed to tell Congress about the whistle-blower complaint in the first place.
“He did a terrible job, absolutely terrible,” Mr. Trump said, adding: “He took a fake report and he brought it to Congress with an emergency, OK? Not a big Trump fan, that I can tell you.”
Although witness testimony during the impeachment inquiry confirmed the essential facts of the complaint, Mr. Trump also continued to portray it all as a hoax. He also continued to assert that the issue was only a “perfect” phone call he had with Ukraine’s president — in which a rough transcript shows he pivoted from discussing the prospect of military aid to asking for political investigations as “a favor, though” — even though the impeachment inquiry and news media reports showed it was instead a monthslong pressure campaign on Kyiv by his proxies.
Adding that he knew the whistle-blower’s identity — although Mr. Atkinson protected it, as he was required to do by law — the president also suggested that the whistle-blower be sued.
In his statement, Mr. Atkinson stressed that protecting whistle-blower identities should be a nonpartisan issue and defended his handling of the Ukraine matter as fulfilling his obligations under the law.
Democrats have decried Mr. Trump’s firing of Mr. Atkinson as corrupt. Republicans have largely been silent, although Senator Charles E. Grassley, Republican of Iowa and long a defender of whistle-blower protections, has said he wants more “written reasons” about Mr. Trump’s reasoning for removing the inspector general.
The Democratic-controlled House impeached Mr. Trump for abuse of power and obstruction of Congress in the Ukraine affair. The Republican-controlled Senate then swiftly acquitted him without hearing witnesses.
A key vote in protecting Mr. Trump from witnesses, Senator Lamar Alexander, Republican of Tennessee, said that the evidence proved Mr. Trump did withhold aid from Ukraine for personal political benefits, but said while that was “inappropriate,” it was not an impeachable offense. Several key Republicans said Mr. Alexander’s view was widespread.
Mr. Trump has subsequently been purging federal officials he sees as disloyal because they testified about what they knew when Congress subpoenaed them during the House inquiry phase. Mr. Atkinson became the latest, and Mr. Trump told congressional leaders that he had lost confidence in him.
“It is hard not to think that the president’s loss of confidence in me derives from my having faithfully discharged my legal obligations as an independent and impartial inspector general, and from my commitment to continue to do so,” Mr. Atkinson wrote, saying he was disappointed and saddened by the removal.
By law, the inspector general for the intelligence community cannot be removed until 30 days after Congress has been notified of the president’s intent, but the Trump administration circumvented that limit by also immediately placing Mr. Atkinson on administrative leave.
From 2016 until Mr. Trump appointed him as inspector general in 2018, Mr. Atkinson worked in the Justice Department’s National Security Division. Since his firing, some of Mr. Trump’s supporters have been trying to link Mr. Atkinson to responsibility for widespread problems with F.B.I. applications for national-security wiretaps or for the investigations into Hillary Clinton’s use of a private email server and into Russia’s election interference and the Trump campaign.
But Mr. Atkinson had no role in wiretap oversight or in the Clinton and Trump-Russia investigations, according to Mary McCord, the acting head of the division from 2016 to 2017. She said he instead worked on cybersecurity, economic espionage, export control and foreign investment review issues.
Hungary’s Leader Grabbed Powers to Fight the Virus. Some Fear Other Motives.
BUDAPEST — In the days since the Hungarian Parliament gave Prime Minister Viktor Orban the right to rule indefinitely by decree, nominally in the name of combating the coronavirus pandemic, his government has been energized by much other than the disease.
First, his deputy briefly toyed with a plan to strip powers from city mayors, many of whom represent opposition parties. Then he threw a cloak of secrecy over one of Hungary’s most expensive infrastructure projects, announcing a bill that would classify key information about a Chinese-funded railway for a decade. Next, he slashed bureaucratic obstacles to expedite a contentious construction project opposed by the opposition. Finally, he announced plans to scrap state recognition of gender transition.
By comparison, Mr. Orban took a gentler approach to testing for the coronavirus.
By Saturday, Hungarian officials had detected fewer than 700 cases, one of the lowest tallies in the European Union. The chief medical officer, Cecilia Muller, also said that the disease was still spreading only within clusters of people, rather than through the general population at large. On Sunday, reported cases grew to 733.
But some doctors fear that the numbers are so low only because the government has tested so few people. By Saturday, officials had conducted fewer than 20,000 tests — also one of the lowest totals, as a proportion of the national population, in the European Union.
“We do not have enough tests, so we do not know the realistic data,” said Balazs Rekassy, a former manager of a state health clinic who advises the Budapest mayor, an opponent of Mr. Orban, on medical matters.
“Mr. Orban is very smart — he’s taking this special situation to his advantage,” said Dr. Rekassy. “He’s trying to strengthen his power and create long-term political advantages.”
New restrictions on journalism that the government deems fake and harmful to the coronavirus response have made it harder to research the scale of the pandemic in Hungary. Many doctors are now reluctant to speak out publicly about specific problems, individual hospitals have been barred from releasing information and journalists are warier of publishing it.
But beneath the veil of silence, there are indications that the situation may be graver than records show.
The coronavirus may have begun to spread through the Hungarian population nearly a month ago, in a process technically known as community transmission, according to a secret readout written by a foreign diplomat who had been briefed in early March by the country director for the World Health Organization, Dr. Ledia Lazeri. The readout was later obtained by The New York Times.
Dr. Muller, the chief medical officer, said on Friday that Hungary was still in the cluster-spreading phase. She hinted that the country was on the threshold of community transmission.
But according to the diplomat’s secret readout, the W.H.O. privately believed that community transmission had begun by the second week of March, since the disease’s first known victims in Hungary moved freely through the country before being diagnosed and one even left for Serbia.
The main facility used for testing at that time, St. Laszlo Hospital in Budapest, was also helping to spread the disease rather than contain it, because infected people were unwittingly mingling there with those yet to catch the disease, the readout stated.
The W.H.O. also concluded that the Hungarian government’s data was unreliable, since so few people were being tested, the readout said.
Asked to comment on the readout, Dr. Lazeri denied making these assessments. An independent epidemiologist currently advising the government, Gergely Roth, also said the country had not yet entered the community transmission phase, and said the term had a contested definition.
But diplomats from other missions said they had heard troubling information from a W.H.O. official.
The W.H.O. did not comment when asked three times whether the organization believed Hungary had entered the community transmission phase. But a spokesperson said on Saturday night that the W.H.O. was “working with countries to define their transmission status according to a new ranking system,” and noted that as of Saturday night the Hungarian government considered the country to be “entering community transmission.”
As of Sunday, only 34 people are reported to have died from the virus in Hungary, but doctors worry that some deaths may have been attributed to other causes. A 99-year-old woman who died on March 11 in Budapest was reported to have died of pneumonia, even though her daughter, who visited her regularly and fell ill with similar symptoms at the same time, later tested positive for the virus.
The government has also quietly closed parts of the St. Imre Hospital in Budapest, after the disease spread among staff, two senior state doctors said on condition of anonymity. The hospital declined to comment, referring reporters to a government spokesman, who did not reply to two requests.
Some critics said the government had been slow to use the test facilities it already had at its disposal. Officials did not start testing at laboratories at the Semmelweis Medical School, which alone has the capacity to process at least 400 tests per day, until mid-March.
Like many other countries, “Hungary did not respond in time,” said Andras Falus, a professor emeritus at the school.
But other doctors praised the government as doing a good job in tough circumstances, at a time of profound economic upheaval in which no country has tested enough people, let alone perfected its response to the pandemic.
“I do not see right now, for the time being, that there is a big turd in the crepe,” said Gabor Zacher, an emergency doctor with the Hungarian ambulance service. Dr. Zacher has criticized the government’s health measures in the past, but praised its recent social distancing measures.
Hungary implemented social distancing measures earlier than several other European countries, said Gergely Rost, an epidemiologist whom the government recently enlisted to advise Mr. Orban on the likely spread of the virus.
“As a consequence, we still don’t have too many,” said Dr. Rost, a lecturer at the University of Szeged, a college in southeastern Hungary. “At the moment, the epidemic is pretty much suppressed.”
Because of a lack of tests, the real number of cases is likely to be up to nine times higher than the current tally of infections, Dr. Rost said. But “numbers are underestimated in every country, even those who have tested more.”
For some, the problems with Mr. Orban’s response to the pandemic stem less from his actions since the start of the crisis, and more from his systemic neglect of Hungarian health care since re-entering office in 2010.
Under Mr. Orban, his government’s health care budget dropped as a proportion of national economic output, even as state spending rose in other sectors. He also abolished the Health Ministry, assigning its responsibilities to a larger department.
Around 10 percent of Hungarian doctors left the country in the first seven years of Mr. Orban’s current tenure in search of better-paid work, senior doctors estimated. The salary of a Hungarian general practitioner, as a proportion of the average national wage, is one of the lowest in Europe.
Under Mr. Orban, the cancer death rate rose and is tied for the worst in the European Union. Even before the coronavirus outbreak, the government refused to disclose the number of infections contracted in state hospitals for fear of alarming the public.
In the context of the coronavirus, his government’s most unhelpful action was the dismantling in 2017 of a state-run health authority that included a dedicated team of epidemiologists. Following the authority’s closing, these experts on pandemics either left government or were dispersed to other parts of the health system, undermining the government’s ability to react to a disease like the coronavirus.
“The extremely well-functioning pandemic defense network was weakened in recent years,” says Erzsebet Pusztai, a health care expert. “The previous unified organization was taken apart and distributed under government offices, and many experts left. And this serious pandemic found it in a very weakened condition.”
Years of low funding have left health facilities under-resourced, and contributed to a recent row about whether the government or health care workers should pay for their masks and visors.
“Health care workers are going unarmed into battle — we hardly have any protective masks,” said Dr. Peter Lehoczky, the director of outpatient care in a district of Budapest. “The feeling is that we are trying to shoot down a rocket with a slingshot.”
Benjamin Novak reported from Budapest, and Patrick Kingsley from Berlin.
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