Wednesday, April 25, 2018

All pain isn’t the same


Editor's note

Do redheads require more anesthesia than other patients? For years, that was the unconfirmed rumor in the medical community until a study confirmed it was true. In fact, your pain tolerance depends on a complex mix of genetics and your past experiences, explains Karen Sibert at UCLA. That can make it difficult for doctors – who are increasingly reluctant to prescribe opioids – to understand how much pain their patients are really in.

Malaria fatalities dropped 60 percent between 2000 and 2015. But hundreds of thousands of people – most of them children in sub-Saharan Africa – still die each year from this mosquito-borne infection. One reason is ineffective medicine: A team of Australian pharmaceutical researchers found that fake, expired and substandard anti-malaria drugs are widespread.

In case you didn't have it circled on your calendar, tomorrow is National Pretzel Day. So grab a bag of Snyder's and take in Colorado State food expert Jeffrey Miller's twisted history of the pretzel, from its European origins to Pennsylvania's path to becoming the pretzel capital of the world.

Aviva Rutkin

Big Data + Applied Mathematics Editor

Top stories

Every patient is different. TippaPatt/

Why it's so hard for doctors to understand your pain

Karen Sibert, University of California, Los Angeles

Each person experiences pain differently, depending on his or her genetic makeup. That makes it difficult to figure out what treatments patients need.

Fake medicines are a lucrative global business. When it comes to malaria drugs that don't work, they can be deadly. AP Photo/Martin Mejia

Fake drugs are one reason malaria still kills so many

Jackson Thomas, University of Canberra; Erin Walker, University of Canberra; Gregory Peterson, University of Tasmania; Mark Naunton, University of Canberra

Each year, 500,000 people die of malaria annually, a preventable disease. Most of them children in Africa, where many anti-malarial drugs are fake or substandard.

The pretzel has had a twisted path from Germany to global snack food. Craig Barhorst/

How the pretzel went from soft to hard – and other little-known facts about one of the world's favorite snacks

Jeffrey Miller, Colorado State University

Why are they shiny? And how did Pennsylvania become the pretzel capital of the world?

Science + Technology

  • Defending hospitals against life-threatening cyberattacks

    Mohammad S. Jalali, MIT Sloan School of Management

    In a complex environment with massive numbers of internet-connected devices, the key barrier to better cybersecurity isn't funding: It's ensuring staff at all levels take action against the threat.

Politics + Society

Environment + Energy


Ethics + Religion

Health + Medicine

  • How live liver transplants could save thousands of lives

    Abhi Humar, University of Pittsburgh

    April is National Donate Life Month, a time to emphasize the importance of organ donation. It is also a good time to learn about a major medical advance that allows liver transplants from living donors.

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Tuesday, April 24, 2018

Kellyanne's Audition

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From: The Daily Standard <>
Sent: Monday, April 23, 2018 3:43:38 PM
Subject: Kellyanne's Audition

Kellyanne's audition

Today on the Daily Standard Podcast, Michael Warren and Jonathan V. Last discuss Kellyanne Conway's CNN audition to be White House communications director, the funeral of Barbara Bush, Kevin Williamson's post-Atlantic exit op-ed, and the state of play with Trump's nominations.

Does Trump Understand Judicial Conservatism?

Last week, the Trump administration got a pointed lecture about the separation of powers and a reminder of what conservative jurisprudence actually looks like. Apparently, the president is none too happy about it, which suggests he understands neither the constitutional principle nor the role of conservative judges.

Mitt Romney Lost at Utah's GOP Convention, But He'll Still Win

On Saturday, Mitt Romney, former Republican presidential nominee and current senatorial candidate in Utah, came in second place at the Utah State Republican Convention. Republican state legislator Mike Kennedy bested him by 1.8 percentage points.

Editorial: What about Socialism?

For the last year and a half, many American liberals and progressives have been fretting the rise of fascism in America. Left-of-center commentators from Michael Kinsley to Paul Krugman have openly called Donald Trump a fascist, the gifted and accomplished Harvard historian Timothy Snyder has written not one but two books on the reemergence of fascism in the United States and Europe, and of course Sinclair Lewis's satirical It Can't Happen Here has had an enormous boost in sales.

Free Flag Pin

Trump Jumps the Gun on North Korean 'Denuclearization'

With the proposed diplomatic meeting between President Trump and Kim Jong-un in the works, the North Korean regime announced on Saturday it would cease missile testing and close a nuclear test site. "Under the proven condition of complete nuclear weapons, we no longer need any nuclear tests, mid-range and intercontinental ballistic rocket tests," Kim said in a statement announced by state news agency KCNA. "The nuclear test site in northern area has also completed its mission." North Korea did not say it would agree to give up its weapons, but said they will not use them "unless there is a nuclear threat or nuclear provocation to our country."


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Where Spring Breaks Eternal

Writer Jen Doll and photographer Eva O'Leary spend five days at the Lani Kai, a resort in Fort Myers, Florida where spring break has been going strong for over two decades.

It's only 20 miles from Southwest Florida International Airport to the Lani Kai Island Resort on Fort Myers Beach, but on the last Tuesday in March it takes more than an hour to get there. Beach traffic is already thick at noon, and we slow to a crawl as we approach the bridge to Estero Island. Of course, most people come to the beach to slow down—but spring break is more about speeding up in a new direction, abandoning daily life in favor of having as much fun as possible. As soon as you get over that damn bridge.

I'm not 100-percent confident about my spring-break skills; my suitcase doesn't even contain a swimsuit. At least I had the wherewithal to pack a tube of SPF 50 Hawaiian Tropic along with my jean shorts last night. I'm here with photographer Eva O'Leary, who is 28 to my 42. We're well out of college, but like most spring-breakers since the beginning of time, we're fleeing the endless snowstorms of the wintry north—in our case, New York City—and I can feel the tension in my shoulders ease as pastel bungalows and T-shirt shops appear on the other side of the bridge.
The resort, circa 1980s. (Courtesy of Lani Kai Island Resort)
In 1978, the year the Lani Kai was built, Fort Lauderdale was the spring-break capital of Florida, attracting college students by the hundreds of thousands to engage in the sort of performative partying popularized by the Porky's and National Lampoon movies. Across the state, on the Gulf Coast, Fort Myers Beach was still a relatively blank canvas. It had just 9,000 permanent residents and seven miles of beach, which drew another 9,000 tourists yearly—families seeking seashells and budget travel, rather than rowdy coeds hell-bent on bacchanalia.

Bob and Grace Conidaris, a married couple from New York, scooped up a 2.7-acre swathe of pristine beachfront property on which to build their family-run resort. The Lani Kai didn't set out to become a spring-break destination. The Conidarises started by catering to families and adult tourists, like everyone else in the area, but by the early 1990s, spring-break spots like Fort Lauderdale and Daytona Beach were cracking down on college students. That's when Bob Conidaris decided to take in the kids. He'd offer them the sort of party they could no longer find elsewhere, a mix of family fun and beach games and raunchy hijinks, drink specials, and the freedom to do whatever they wanted—within reason.

Since the Lani Kai's opening, both spring break and college students have changed dramatically: legal medical marijuana has replaced illicit joints on the beach, and vape pens are more popular than cigarettes. The college students are still drinking plenty, but they're more careful about having their pictures taken while doing keg stands. In the 45 days between late February and early April each year, at least 100,000 of them pass through the resort's property.

What is spring break? The concept has always been murky. It's a last hurrah before settling down; a whatever-happens-in-Vegas-stays-in-Vegas sort of legitimized debauchery; a time and place to break free from the pressures of high-school or college life; a hedonistic (and capitalistic) supply-and-demand cycle. It's part cultural myth, part farce, part plain old vacation. Its pleasures often seem to transcend age, race, class, geography, and personality type.

It's fun. Or is it? Perhaps it's the vacation equivalent of fast food: tasty but ultimately something you need to recover from or quit altogether. Maybe it's a manifestation of our obsession with youth, our fear of aging and death. An opportunity to behave badly without repercussions. Or is spring break a valuable, fleeting moment during which you might be who you really are, or who you really want to be?

Eva and I have five days at the Lani Kai. Maybe we'll never want to leave.
Day 1: Tuesday

Our Lyft driver pulls up to the Lani Kai, which is friendlier than I expected: very Florida, very lived-in, with plenty of colorful flair. Homespun murals by a local artist stretch across its six floors on the street-facing side of the hotel. As we approach, I spot an American flag painted above a tropical scene that's closer to the Lani Kai's Hawaiian namesake—a white-sand beach near Honolulu, the name of which means "heavenly sea"—than anything in southwest Florida. The Lani Kai is one of the larger properties on Estero Boulevard, across the street from a 7-Eleven and its own overflow parking lot, where local sheriffs maintain three reserved spots at all times. (The police also keep a paddy wagon in the 7-Eleven parking lot, just in case—but I'm assured that they've chosen the spot for its proximity to the beach, not to the Lani Kai.)

We drag our bags inside. There's no glitzy lobby or besuited doorman—just a simple front desk up a flight of stairs. Behind the clerk hangs a large photograph of the Conidaris family: Bob and Grace surrounded by their eight kids, everyone smiling for the camera. From the feathered hair and striped polo shirts, I'd date it to the 1980s. On either side of the photograph there are T-shirts for sale: "I PARTIED AT SPRING BREAK CENTRAL—DRINK. PARTY. SLEEP. REPEAT." For $20, I can't say I'm not tempted.

It's only noon and our room's not ready yet, so we wait outside at one of the resort's four restaurants, the Sabal Palm, and let the sun warm our skin. I watch a yellow "Spring Break 2018" flag wave in the distance and peruse a drink menu that offers a $2.50 happy hour from 8 a.m. to 1 p.m. and shots with names like "Gummy Bear," "Cinnamon Toast Crunch," "Piece of Ass," and "Liquid Marijuana."

Below us, on the ground floor, a wooden stage stretches into the sand. This is where the Cincinnati Firemen, a group of up to 30 Ohio-based firemen and EMTs who've been vacationing on Fort Myers Beach since 1987, perform. In 1996, they began putting on raucous, crowd-pleasing variety shows to raise funds for local charities; in 2010, they moved their performances to the Lani Kai. Alas, the Firemen went home last week, and the separate booty-shake competition—which, during spring break, attracts women and men to do exactly what you think for a $100 prize—is over for the year, due to the large number of high schoolers who've descended for vacation.

As we order lunch, I hear the unmistakable sound of Pitbull emanating from the DJ booth. On the beach, people are playing "life-size beer pong": trash cans are painted like red Solo cups, and teams take turns trying to throw beach balls into them. It's reminiscent of Dirty Dancing's Kellerman's resort in the Catskills, but with lots of bare skin and plenty of tattoos.
I'd heard that students hang their school flags over the beach-facing balconies, creating a United Nations of Midwestern and mid-Atlantic colleges. I look up to check—there are a few!—and that's when I notice an older man seated behind us, wearing a neat button-down and jeans. I suspect it's Bob Conidaris, who everyone calls "Mr. C." He's got the tan skin of a Florida local, a shock of white hair, and a contagious smile. For a second, I feel like I'm in the presence of spring-break royalty.

Melissa Schneider, Lani Kai's marketing director, comes down to say hello and introduces us: it is indeed Mr. C, who grew up with five brothers and sisters in Brooklyn and once made extra money for his single mom as a shoeshine boy. As an adult, he got into the contracting business in New York, then Florida. Now, at the age of 86, he still makes near-daily appearances at the Lani Kai, where most of his children and 25 grandchildren have worked. "I love having people from New York," he tells me and Eva. His wife Grace died ten years ago, but her presence can be felt throughout the hotel: there's a picture of the couple in the elevator, and, near one of the downstairs bars, the red fabric tops of wooden glider chairs imported from Amish country are inscribed with "R.C. LOVES G.C.," in a heart.

We're informed that our room is ready. In the hallway, we're greeted by a painted alligator with open jaws, part of a marshy Everglades-like mural. Our room is clean and bright, with comfortable beds and walls painted the same sea-foam green I adored in middle school. I flip over a painting of a parrot to see that someone has written "SPRING BREAK" on the back in dark ink.

My favorite part of the room is the private balcony, a window onto whatever's happening on the beach below. I take some notes: Bikinis are in. Thongs are super-in. Bikini tops with sleeves are a thing. People love volleyball! Garth Brooks's "Friends in Low Places" is still being played in public. I notice that people do take their phones to the beach; the women use the sides of their bikini bottoms as makeshift holsters. "You've got to see this!" I yell to Eva, who's fiddling with her camera. We stand on the balcony and stare, taking in families, high schoolers standing around awkwardly, college-aged women photographing each other's butts and their own faces, leathery-skinned locals, and retirees.

We have dinner on the top floor at the Island View, the hotel's least spring-break-like restaurant, where students sometimes come for date night. We get to talking to our waiter, who recommends we day-drink with college students for a real spring-break feel, then brings over another staffer to share stories. We learn about a woman who visited the hotel with her family for her 50th birthday and took some spring-breakers back to her room to have sex. Her relatives walked in on the group, assumed the woman was being raped, and called the cops. No charges were pressed, but "they checked out the next day." The resort is a "weird place," these staffers say, but in a way that indicates love rather than derision.

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