Labor and Working – Page 66 – The Tarbabys Blog

The Trials Won’t Stop Donald Trump From Becoming President Again. Here’s What Might.

Slate

The Trials Won’t Stop Donald Trump From Becoming President Again. Here’s What Might.

Dahlia Lithwick – January 19, 2024

Any conversation currently happening around legal accountability for Donald Trump is quickly caught up in the riptide of a very different sort of conversation about electoral strategy: Should states be allowed to remove Donald Trump from the ballot, as the plain meaning of the 14^th Amendment suggests that it was designed to do? Or will that drive his supporters to commit further acts of vigilante justice in response to being disenfranchised? Should we run our democracy based on such potential threats, and more abstractly: Should judges presiding over the myriad Trump trials that the former president uses to incite stochastic terror and demean the judicial system allow him to speak freely? Or should they make every effort to limit his use of their courtrooms as campaign stops and hate rallies? Should prosecutors in these cases make every effort to have them done and dusted before the presidential election? Or is there something unseemly in the haste to bring about accountability timed to some external political event? Should the judicial system proceed at its own pace, or should it find a way to move faster, with the recognition that it might (only might) be able to do what the other branches of government have chosen not to do, in glacial legal units of time?

The biggest brains in both the legal and political spheres are currently engaged in a near-daily exploration of questions that posit law and the rule of law not so much as ends in themselves, but as tactics—often Hail Mary, last-ditch, desperate-times-call-for-desperate-measures tactics in a presidential contest. We are in an existential battle to save democracy from the single most profound threat it has faced since at least the Civil War. And Americans who have become all too familiar with opening arguments and jury selection and civil fraud and conspiracy law have somehow convinced themselves that the justice system alone can somehow be deployed—or, in the parlance of the insurrectionists, “weaponized”—into becoming the shiny entity that could preserve democracy as we know it. Principally, because nothing else seems positioned to do the trick.

The asymmetry here is that of course the American legal system is not a tactic, or a strategy, or a party trick, although, sure, any one trial is built on tactical decisions. The American legal system, indeed any legal system, is a search for truth, facticity, conclusion, and resolution. When legal systems are working, they are largely backward-looking excavations of what happened and why. One of the reasons Donald J. Trump has managed to evade legal accountability throughout his lifetime is that this is not his objective: He doesn’t allow the legal system to look backward at facts—indeed, he disputes facts literally as they are happening, and even adjudicated facts, including his sexual abuse of E. Jean Carroll, are perpetually reopened for public appeal. His objective is to use the mechanisms of the legal process as tactics toward a larger end—to make himself richer or more famous, or to vanquish his opponents. And we all know that should he get himself elected as president in 10 months, he will use the law to prosecute Joe Biden, stay in office indefinitely, strip non-Americans of their rights, and do almost anything he wishes to remain in power. For Trump, law isn’t the endgame—it’s just the ladder that gets him somewhere better.

Here is the problem: When we engage in tactical intramural debates about about how best to deploy the American legal system to stop Trump, we are in a sense engaging in a mirror image of that same Trumpist project. We say we want accountability and findings of fact and conclusions of law and injunctions and gag orders and, ultimately, convictions. But above all, what we want is for him to go away, to stop, to unravel all the harm he has done to the myriad institutions and principles upon which the rule of law once relied. The purists among us argue that in so doing, we will at least have given it a shot. The worriers fret that in so doing, we further rip the country asunder because, uh, what if it doesn’t work out the way the purists had hoped?

For my part, I worry that we have imported far too much force into the idea that the law itself and law alone will curb Trump’s lawlessness, because no amount of gag orders and conclusions of law and even criminal convictions can stop someone hellbent on using those things as tactics on a tear toward fascism. As Jeff Sharlet put it on last week’s Amicus podcast, “The one thing Trump has made clear is we don’t know yet how to stop Trumpism.” The rule of law may be a component in the war against Trumpism, but if it isn’t plain by now, I will say it here: The rule of law exists not to stop Trumpism. It exists to promote the rule of law.

For those who note that Trump has the ability to delay, drag out, undermine, and even capitalize on his legal troubles but can’t escape the voting booth, the very existence of the Colorado 14^th Amendment appeal at the Supreme Court shows the extent to which the law and the voting both are bound up together, and the degree to which both may be profoundly incapacitated when we expect either to create Cold, Hard Facts in a world that has fundamentally put truth out with the recyclables. Trump’s supporters in the conservative legal movement have been using the law to suppress and subvert elections for years, and they have already amassed literally billions of dollars to do so again. Subverting the vote is a tactic. It is also the single most effective way to subvert the rule of law.

This is by no means a call to abandon the pursuit of legal accountability for Trump and his supporters in every single forum possible. Of course the law should attempt to impose every last consequence this man deserves, and of course the fact that this makes his cultists angry is never a reason to stop. It is simply a caution to those who have convinced themselves that the law exists to keep Trump from winning the 2024 election. Because the law alone may not suffice.

Paradoxically, to the extent the law can be usefully deployed as a tactic, the 14th Amendment itself is a tactical enterprise that exists to protect us from tyranny. But we tie ourselves in knots deploring how slow and technical and mincing legal accountability can be. (Consider emoluments! It took eight years to get those numbers reported out! But there is still no accountability!) The challenge isn’t exclusively that law takes too long. The challenge is that, unfortunately for all current citizens of America and quite frankly the world, the law can’t be boiled down to a distillate, reconstituted as a vitamin, then chugged down with a Gatorade to save us from an authoritarian strongman.

Donald Trump is nothing but an amalgam of tactics with hair. Purposive lying is a tactic, distraction is a tactic, bullying is a tactic, threats of violence is a tactic, running out the clock is a tactic, all with the incredibly simple objective of amassing power. And Trump’s promise to use the law to terrorize and jail political adversaries, to further immiserate those he dislikes, to suppress speech and protest? All of this is about using the law to further an authoritarian agenda.

Ensuring that Trump is driven from public life requires tactical thinking and execution that involves so much more than the tactical use of legal remedies. It involves structural election reform, expanded voting rights, democracy building, rethinking the way the media covers elections, and a thousand other tactics that protect constitutional democracy and free and fair elections. Law can be weaponized to do all of these things, by the way. But this would require the work of millions of people for thousands of days, pushing every lever. It cannot be readily swapped out for a single victory in a civil fraud trial, as important as such victories may be toward the greater end.

If the rise of authoritarian strongmen around the planet in recent years proves anything, it’s that the law alone was not designed to restrain authoritarian strongmen. What we grouse about as the slowness of the law is in fact the absence of the fast fix to fascism.

The relevant legal question in the coming months cannot be limited to How do we best use the law to hold Donald Trump to account? Even holding Donald Trump to account will not necessarily save us from electing Donald Trump the dictator—it could be too slow, or too unpersuasive, or totally steamrolled by his own destruction tactics. The relevant question is: Whether we realize in time that the law alone cannot save us, are we directing all our efforts, right now, to doing everything and anything else that will?

The Supreme Court looks set to make Steve Bannon’s dream come true

Salon – Opinion

The Supreme Court looks set to make Steve Bannon’s dream come true

Conor Lynch – January 20, 2024

Steve Bannon; Donald Trump; Clarence Thomas Photo illustration by Salon/Getty Images

Not long after Donald Trump was sworn in as president back in 2017, his chief strategist, Steve Bannon, made an incendiary statement vowing that the new administration would fight an unending battle for the “deconstruction of the administrative state,” raising fears that the new president would carry out a blitzkrieg assault on the federal bureaucracy. While the former TV host likely had no inkling of what his more ideological strategist meant by the “administrative state,” it would not be long before Trump himself would embrace similar rhetoric aimed at what he derisively coined the “deep state.” Unlike his advisor (and many libertarian-leaning Republicans), Trump’s hostility towards the federal government stems less from any ideological opposition to “big government” than from his own personal resentment and paranoia. With his agenda stalled early on his term, the president came to blame all of his woes on this supposedly omnipotent deep state, which denoted a quasi-invisible and demonic cabal of entrenched bureaucrats allegedly sabotaging his presidency.

Fortunately for those who believe in a strong and independent federal bureaucracy, the Trump administration largely failed to follow through on these early threats. Within six months of his inflammatory remark, Bannon was out of a job in the White House, while the embattled president had more pressing concerns than attempting to dismantle the federal bureaucracy. By the time he left office, Trump had done irreparable damage to American democracy and its institutions, but the so-called “administrative state” — an ideological shorthand for the numerous departments and independent agencies inside the federal government, from the Environmental Protection Agency (EPA) to the Securities and Exchange Commission (SEC) to the National Labor Relations Board (NLRB) — remained standing, if not mostly unscathed.

Still, more than three years after Trump left the White House, the so-called administrative state is under assault like never before — in large part due to the enduring legacy of the Trump administration. This was evident this week, when the Supreme Court heard oral arguments that challenged a forty-year-old case that had established judicial deference to federal agencies like the EPA in their implementation of “ambiguous statutes.” In other words, the philosophy that it is best for judges who know little about environmental standards or the derivatives market or drug development to defer to the “reasonable interpretation” of statutes by experts in their respective agencies. If this challenge to what is known as the Chevron Doctrine is successful, it would open up a floodgate of potential legal challenges to regulations across the federal government, crippling the ability of agencies like the SEC or the EPA to carry out their missions. Not surprisingly, it currently looks like at least two of the three Supreme Court justices nominated by Trump will help to repeal this doctrine and open up the anti-regulatory floodgates. It’s Steve Bannon’s dream come true.

Trump’s toxic legacy is not only felt in the judiciary. Indeed, it is clear from the Republican primaries that the entire GOP is now fully devoted to the once-fringe cause of dismantling the administrative state. Recall Florida Gov. Ron DeSantis’ vow to “start slitting throats on day one.”

While Trump largely failed to carry out his own threats against the “deep state” as president, his final year in office offered a dress rehearsal for what to expect if he — or any Republican — returns to the White House next year. Over the course of his term, Trump’s obsession with the “deep state” intensified, as did his Nixonian quest to root out his enemies. Shortly after his first impeachment trial, the president tapped loyalists to carry out a purge of any officials who displayed even the slightest hint of dissent. Spearheading the effort was Trump’s former body man, 29-year old Johnny McEntee, who the president appointed to run the Presidential Personnel Office (PPO). Overseeing the hiring and vetting of the roughly 4,000 political appointments in the executive branch, McEntee quickly pushed out officials deemed disloyal and earned the moniker of Trump’s “loyalty cop.”

This purge was only a preview of what the administration had planned for his second term. Weeks before the 2020 election, the president signed an executive order known as “Schedule F,” which would have stripped civil service protections from tens or even hundreds of thousands of employees had it been implemented. Though promoted as a measure to enforce accountability, Schedule F was an overt attempt to politicize the bureaucracy. It would have empowered the president to easily purge the civil service of any senior or mid-level officials deemed politically suspect or insufficiently loyal.

Today Schedule F has more or less become doctrine on the right. Donald Trump’s rise thus ushered in a more radical and dangerous phase in the conservative movement’s decades-long struggle against the federal government. All the major Republican presidential candidates have promised to reinstate some version of the executive order, which President Biden rescinded upon entering office. Indeed, most candidates have even tried to outdo Trump in both their policies and rhetoric. \ The supposed “moderate” in the race, former South Carolina governor and UN ambassador under Trump, Nikki Haley, has put forward an even more radical plan than Schedule F that would not just strip civil service protections but introduce five-year term limits for all positions in the federal workforce — from air traffic controllers and public health inspectors to park rangers and Social Security administrators. As Washington Post columnist Catherine Rampell notes, this would effectively “destroy the basic machinery of government” — which might just be the point.

Across the board, then, Republicans have embraced the Trumpian vow to “destroy the deep state.” They have also adopted the former president’s conspiratorial rhetoric about the federal bureaucracy and civil service, which is now depicted as a national fifth column. The traditional Reaganite critiques of big government waste, inefficiency and onerous regulations have been increasingly supplanted by radical fulminations against the “deep state” that sound more like The Turner Diaries than The Road to Serfdom.

This is evident throughout Mandate for Leadership, the 920-page manifesto published earlier this year by the Heritage Foundation-led 2025 Presidential Transition Project (or Project 2025), which aims to recruit and vet up to 20,000 potential staffers for a future Republican administration after the anticipated purge. Writing in the book’s introduction, project director Paul Dans, who served in Trump’s Office of Personnel Management during his final year, breathlessly proclaims that the “long march of cultural Marxism through our institutions has come to pass,” giving credence to a notorious conspiracy theory that has long floated around white supremacist circles. With the federal government ostensibly captured by “cultural Marxists” and “globalists,” Dans frantically proclaims that it has been “weaponized against American citizens and conservative values, with freedom and liberty under siege as never before.”

This kind of siege mentality has become the official posture of the right since the rise of Trump. “Either the deep state destroys America or we destroy the deep state,” proclaimed the Republican frontrunner last March at his first campaign rally, which he symbolically held in the city of Waco, Texas, just seventeen miles from where the FBI got into a deadly standoff with the apocalyptic Branch Davidians cult almost three decades before. Besides inspiring the far-right terrorist Timothy McVeigh in his bombing of a federal building in Oklahoma City in 1995, the “Waco siege” also galvanized various anti-government militia movements that would ultimately contribute to the storming of the capital more than a quarter century later. The symbolism of holding his opening rally in Waco was not lost on Trump’s allies. “We’re the Trump Davidians,” Bannon quipped to ABC News journalist Jonathan Karl when asked why the Trump campaign would choose Waco for its opening act. The rhetoric of both Trump and his “Davidians” leaves little room for doubt about their intentions if he wins in November.

For the millions of MAGA zealots, Trump’s election is less about achieving specific ideological aims than about satisfying their thirst for revenge. On the other hand, the authors of Project 2025’s manifesto have more concrete ideological goals that happen to align with Trump’s revenge fantasy. In his forward to Mandate for Leadership, Heritage Foundation president Kevin Roberts alludes to the unifying goal when he states that the “top priority” for the next Republican president must be to “dismantle” the “administrative state.” Or as Dans puts it, the goal is to “assemble an army of aligned, vetted, trained, and prepared conservatives to go to work on Day One to deconstruct the Administrative State.”

Republicans have been harboring fantasies about gutting the federal government since the Reagan era. But what distinguishes today’s right from the past is its greater willingness to employ explicitly authoritarian means to achieve their ends. Indeed, a growing number of conservatives now appear convinced that the next Republican president must be granted something close to dictatorial power if their movement is to stand a chance against the “cultural Marxists” who allegedly control the state.

To legitimize an autocratic power grab by Trump or any other Republican president, many conservatives will no doubt employ the dubious legal theory of the “unitary executive,” which was first popularized during the George W. Bush administration to justify the president’s illegal policies in the war on terror. The unitary executive theory asserts that the president is effectively above the law and has absolute control over all departments and agencies in the federal government (including independent and quasi-legislative agencies like the EPA or the NLRB). This controversial interpretation of Article II grants the president something close to dictatorial power, giving him or her total control over the hiring and firing of two million federal employees and “complete authority to start or stop a law enforcement proceeding,” as one of the theories leading proponents, Bill Barr, wrote in a memo shortly before Trump appointed him attorney general.

While most conservatives continue to cloak their vision of a strongman executive in contentious legal theories, a growing contingent on the right has more or less abandoned such pretenses. Since Trump’s defeat, the idea of a so-called “Red Caesar” coming to rescue the beleaguered republic has caught on in more reactionary milieus. “Red Caesar” was first coined by conservative author and former national security official in the Trump administration, Michael Anton, who in a 2020 book predicted that a “red America that feels sufficiently imperiled by the leftist coalition might well look to unify behind one man with authority.” For Anton, the coming of Caesarism — defined as “authoritarian one-man rule partially legitimized by necessity” — appears almost historically determined. “Just as tyrannies give way to aristocracies and republics on the upswing, so do democracies collapse into decadence, anarchy, and back to tyranny on the downswing,” he writes. In Anton’s telling, the cyclical historical forces at work in America today are no different than those in ancient Rome, where Caesar and his successors restored order and — for a time — greatness to a decadent republic. “When and where Caesarism comes, it arises only because liberty is already gone,” writes Anton, offering a preemptive justification of a Trumpian assault on the country’s exhausted democratic institutions.

With the now widespread acceptance among conservatives that the federal government and other major institutions have been captured by “cultural Marxists,” “globalists,” and “wokeists,” Republicans are now pre-programmed to accept more authoritarian leadership. This is especially the case among a younger coterie of Republicans who have come to prominence in the post-Trump era. Unlike some of their older Republican colleagues, these young Trumpians are more open to employing post-Constitutional or “extra-Constitutional” means to achieve their reactionary goals.

Consider Ohio Senator J.D. Vance, a Trump supporter who echoed Anton’s analysis of contemporary America on a far-right podcast in late 2021, noting that “we don’t have a real constitutional republic anymore” but rather an unaccountable “administrative state.” With America currently in its “late republican period,” Vance suggested that resisting woke tyranny will require Republicans to get “pretty wild” and go in “directions that a lot of conservatives right now are uncomfortable with.” While sympathetic to the cause of “deconstructing” the administrative state, Vance offered a more Caesarist alternative: “I tend to think that we should seize the institutions of the left…and turn them against the left. We need like a de-Baathification program, a de-woke-ification program.” If Trump is wins this fall Vance suggested that he immediately fire “every single mid-level bureaucrat” and “civil servant in the administrative state” and replace them with “our people.”

Ultimately, the point of the planned purge is not to replace every civil servant who is forced out but to derail the federal government before stripping it down and selling it for parts, like private equity vultures fresh after a hostile takeover. In the words of the authors at Project 2025, the “only real solution is for the national government to do less: to decentralize and privatize as much as possible…” The Trumpian innovation comes in the effort to weaponize the agencies and departments that remain after the right-wing assault on regulatory agencies like the EPA and the Consumer Financial Protection Bureau (CFPB). The Republican frontrunner has already promised to weaponize the justice department and is reportedly mulling over deploying troops against domestic protests on day one. Trump would return to Washington with more experience and an entire team of “loyalty cops” working to enforce fealty across the executive branch. And as recent hearings at the Supreme Court have shown, he would also return with increasingly politicized courts that are sympathetic to both his assault on the “administrative state” as well as his quest for more “unitary power” over the executive branch.

The growing belief in the necessity of “authoritarian one-man rule” on the right stems from the fact that their ideological project is broadly unpopular with the American people. The majority of Americans do not support dismantling environmental protections or criminalizing abortion or eliminating child labor laws or registering teachers and librarians as sex offenders for espousing so-called “transgender ideology.” Neither do they support the modern right’s crusade to “dismantle” or “deconstruct” the “administrative state.”

While it is true that public trust in the government is currently close to an all-time low, conservative critics tend to greatly exaggerate how much of this stems from disapproval for career civil servants and government agencies. In reality, low ratings for the “federal government” tend to reflect the population’s disdain for Congress and national politicians from both parties. Conversely, most individual departments and federal agencies receive favorable ratings from Americans, whether it’s the National Park Service (+74%), the U.S. Postal Service (+57%), NASA (+65%), the Social Security Administration (+33%), the EPA (+24%), or the Department of Health and Human Services (HHS, +25%). The same is generally true for federal employees. A 2022 survey by the Partnership for Public Service found that while only 30 percent of people view members of Congress favorably, more than 6-in-10 have a favorable view of civil servants.

Dismantling the “administrative state,” then, is not a goal that most Americans or even most Republican voters would knowingly support. For Trump, destroying the nebulous “deep state” is part of a personal crusade. In all likelihood, he would be satisfied if he could simply weaponize the justice and defense departments to go after his enemies. But for the ideologues who have hitched themselves to his star, the mission is far more ambitious. In the event of a Trump victory in 2024, one can expect the worst of both worlds: an assault on essential agencies that would recall the worst neoliberal policies of the Reagan years, and the weaponization of those “deep state” agencies that would recall the worst abuses of the Nixon and Bush years.

Trump pushes back on claims of mental missteps

The Hill

Trump pushes back on claims of mental missteps

Filip Timotija – January 20, 2024

Former President Trump, the current GOP frontrunner, pushed back on claims of mental missteps during his Saturday rally in New Hampshire, after his main rival in the state, former U.N. Ambassador Nikki Haley, raised concerns about his mental fitness.

Trump deflected the criticism that arose after he appeared to mix up Haley and former House Speaker Nancy Pelosi (D-Calif.) on Friday while talking about Jan. 6, 2021, stating his reliance on sarcasm during speeches and emphasizing that he aced a cognitive test that he claimed he took “a few months ago.”

“A lot of times I’ll say that President Obama is doing a lousy job, meaning that Obama is running the show,” Trump said during his rally. “They’ll say, Donald Trump doesn’t know who our president is. No, no. A few months ago I took a cognitive test my doctor gave me, I said give me a cognitive test just we can, you know, and I aced it. I also took one when I was in the White House.”

The 45th president has often raised concerns over President Biden’s age, claiming he is “cognitively impaired” and “in no condition to lead” the country.

During his rally on Friday, Trump appeared to have mixed up Haley and Pelosi while talking about the insurrection on the Capitol, to which the former U.N. Ambassador responded by saying that she was concerned to have somebody whose “mental fitness” is questioned while serving in the Oval Office.

“The concern I have is, I’m not saying anything derogatory, but when you’re dealing with the pressures of a presidency, we can’t have someone else that we question whether they’re mentally fit to do this,” Haley said.

During the Saturday rally, Trump continued the defense of his mental acuity, stating that he will let people know when he “goes bad.”

“I’ll let you know when I go bad,” Trump said. “I really [don’t] think I will be able to tell you because someday we go bad.”

He also refuted Haley’s claims, saying he does not mind being his age, possibly referencing when the former South Carolina governor called for “mandatory competency” tests for politicians over 75.

“They always say, like Haley, she talks about, ‘yeah, we don’t need 80-year-old,” Trump said. “Well, I don’t mind being 80, but I am 77, that’s a big difference.”

Rep. Elise Stefanik (R-N.Y.), who has endorsed the former president and is rumored to be in circulation for a potential vice president pick, pushed back on Haley’s claims, stating that “the reality is Nikki Haley is relying on Democrats, just like Nancy Pelosi, to try to have a desperate showing.”

In November, Forbes noted that Trump mixed up Biden and Obama at least seven times in recent months.

The 1 Thing Sleep Doctors Never, Ever Do In The Morning

HuffPost

The 1 Thing Sleep Doctors Never, Ever Do In The Morning

Leigh Weingus – January 19, 2024

You’ve likely heard that a good night of sleep starts in the morning, and sleep experts agree with this statement wholeheartedly. This is because of our circadian rhythm, or our body’s natural sleep-wake cycle, which is a 24-hour process.

“The circadian rhythm, your internal biological clock, operates on a roughly 24-hour cycle and dictates when you feel awake or sleepy, largely influenced by light exposure,” explained Dr. Chester Wu, a double-board certified psychiatrist and sleep medicine specialist. “Health behaviors in the morning reinforce a strong circadian rhythm, promoting wakefulness during the day and sleepiness at night.”

Conversely, according to Wu, irregular sleep patterns, excessive evening light exposure and sedentary lifestyles can disrupt this rhythm and sleep pressure balance, leading to sleep issues.

Considering they’ve dedicated their careers to helping people sleep better, it’s safe to say the morning routines of sleep doctors are ones we want to emulate. So, what do sleep experts avoid doing in the morning to ensure they get a good night’s sleep?

They never lie in bed after their alarms go off.

In what may be the most unrelatable (but definitely smart) action ever, sleep doctors don’t lie in bed, scrolling on their phones for 15 minutes before dragging themselves out of bed. “I try not to linger in bed because I definitely feel like that causes me to feel more lazy or groggy,” Wu said.

Chelsie Rohrscheib, a neuroscientist and sleep expert, also doesn’t do this. “I never stay in bed and do activities that aren’t related to sleep and intimacy. This means when I wake up, I get out of bed immediately and go somewhere else in my house,” she said. “This helps to maintain my brain’s association that the bedroom is only a place of rest, which promotes high-quality sleep.”

“I never remain in my dark bedroom,” added Dr. Chris Winter, a neurologist and sleep health expert. “It is essential to get into the light. Light effectively shuts off your brain’s production of melatonin and lets your body know the day has begun.”

While not lying in bed was the most popular tip among the sleep experts we consulted, Carleara Weiss, a sleep specialist and research assistant professor at the University at Buffalo, State University of New York, gave a slightly different answer: For her, in addition to getting up as soon as she wakes up, she makes sure not to sleep in.

“The reasoning for that relates to the circadian rhythms,” Weiss said. “Regular wake-up times help the biological clock regulate physiological functions, not just sleep. Sleeping in on the weekends leads to social jet lag and causes difficulty concentrating, fatigue, irritability, and headaches.”

Dr. Raj Dasgupta ― a physician who is a quadruple board-certified physician in internal medicine, pulmonary, critical care and sleep medicine ― is also wary of sleeping in.

“While occasionally sleeping in is unlikely to have a lasting impact on your overall sleep quality, it may affect your ability to fall asleep later in the evening,” he said. “Maintaining a consistent sleep schedule, where you wake up and go to bed at the same time every day, is really important for ensuring you have a good night of quality sleep.”

Staying in bed after your alarm goes off can be doing more harm than good.

What do sleep doctors do in the morning instead?

We know what they don’t do in the mornings. So, what do sleep doctors do? One thing that came up consistently was ensuring they were exposed to light early in the morning.

“One of the first things I do in the morning, usually within 30 minutes of waking, is exposing myself to natural sunlight by going outside or sitting by a window,” Rohrscheib said. “Light during the day is very important for keeping our circadian rhythm well-regulated. Studies have shown that a lack of sunlight exposure can reduce the quality of your sleep, contribute to insomnia, and negatively impact mood.”

Dasgupta also makes sure to get sun exposure first thing in the morning. “Getting sunlight exposure first thing in the morning upon waking up can increase alertness and energy during the day, leading to improved sleep at night,” he said.

Another big tip that came up? Exercise. “Getting active quickly is a fantastic way to signal to your brain that the day has begun,” Winter said. “The exercise does not have to be particularly intense. I start my day off by walking my dogs every day or walking with my wife to work.”

Interestingly, another thing Winter always makes sure to do is make his bed. “It’s not only symbolically powerful, but it’s also a great deterrent for individuals who might want to slip back into bed during the day and feel the napping might adversely affect their sleep the upcoming night,” he said.

As far as we’re concerned, the fact that sleep doctors don’t say anything about giving up coffee is a big win. As long as we can have our coffee, we don’t mind dragging ourselves out of bed before checking emails and scrolling through Instagram.

Related…

Send Channel migrant boats to Ukraine to help war effort, Government urged

The Telegraph

Send Channel migrant boats to Ukraine to help war effort, Government urged

Danielle Sheridan – January 19, 2024

Boats used by migrants to cross the Channel to the UK should be sent to Ukraine to help the war effort, a volunteer organisation has told the Government.

Since October, British and Ukrainian volunteers have delivered 15 inflatable dinghies and rigid inflatable boats to soldiers fighting along the Dnipro River.

The small boats, which were in relatively poor condition, were driven from the UK to the south of Ukraine, where they were refurbished. This included the installation of new engines and painting the vessels khaki.

They have provided a lifeline to the Ukrainian soldiers holding three established bridgeheads on the occupied eastern side of the river, by carrying vital supplies and evacuating wounded soldiers.

When MissionUkraine, the organisation leading the small boats initiative, initially appealed to the Government for boats used by migrants to cross the Channel to be sent to Ukraine, it was informed by Border Force that this would not be possible.

Officials said: “The majority of boats are not fit for re-sale or to ever go to sea again, because they arrive in very poor condition. These boats also deteriorate and perish over the period, and are therefore often destined for recycling.

“The boat engines might also be sold at auction, but again, over time, they are no longer operational, or require additional funds to bring their condition back to normal.”

A small boat that was taken from the UK to Ukraine, repaired and then delivered to the front line – Alex Kruglyak/MissionUkraine UK

A government spokesman told The Telegraph that while it was “committed to supporting Ukraine” it “cannot donate unsafe and dangerous small boats which will put more lives at risk”.

However, Alex Kruglyak, one of the leaders of MissionUkraine, said poor quality boats were still useful to troops because marine engineers in Ukraine were able to refurbish them to a decent operating standard, meaning they were seaworthy again.

“All of the boats we deliver go through a boat maintenance procedure which is done by marine experts and all the engines go through an engine testing and maintenance procedure done by guys with decades of experience,” he told The Telegraph. “We will pay for all transport and maintenance costs – we are not asking for a penny.”

In June last year, the Kakhovka Dam in Ukraine was breached, causing widespread flooding that stopped Ukrainian troops advancing via the Dnipro River.

By October, troops had started to cross the Dnipro, but were using rowing boats in order not to attract attention from the Russians.

There are now three established bridgeheads on the occupied eastern side of the river, with the Ukrainian troops at those secured areas dependent on small boats.https://www.youtube.com/embed/viYOh8tkwJY?enablejsapi=1&modestbranding=1&origin=http://www.telegraph.co.uk&rel=0

To date, MissionUkraine has delivered second hand boats to Kharkiv, Zaporizha, and Dnipro, which have then been transported to soldiers on the frontlines.

Mr Kruglyak, 35, originally from Odesa but living in London, added that it “made sense” for the Government to donate the boats confiscated from migrants, which are currently in a pound in Dover.

His calls were echoed by Paul Watson, 69, from Bridgend, Wales, who has driven to Ukraine’s front line numerous times with his friend Martin Blackwell, 70, to deliver both 4x4s and small boats.

Mr Watson said that the rigid inflatable boats they had transported so far were purchased from private owners for prices ranging between £1,500 and £4,000, with money raised through their local church.

Some of them were “in a very bad state when we first took them out,” he said, adding: “In any time of crisis, people can be very versatile and alter things to become usable. If one boat saved one life it was worth it.”

The US is struggling to handle an immigration surge – here’s how Europe is dealing with its own influx

The Conversation

The US is struggling to handle an immigration surge – here’s how Europe is dealing with its own influx

Tara Sonenshine, Tufts University – January 19, 2024

Workers from the Spanish nonprofit Open Waters rescue 178 migrants from different countries, off the coast of Italy in September 2023. <a href= — Workers from the Spanish nonprofit Open Waters rescue 178 migrants from different countries, off the coast of Italy in September 2023. Jose Colon/Anadolu Agency via Getty Images

As record-high numbers of undocumented migrants cross the United States-Mexico border illegally, one key question is how the U.S. got into this situation, and what lessons can be learned from how other countries respond to border security and immigration problems.

Having worked both inside the U.S. government and in the private sector, I have observed the growing importance of welcoming foreign citizens to one’s country for improving economic growth, scientific advancement, labor supply and cultural awareness.

But migrants entering and staying in the U.S. without visas or proper documentation can create problems – for the migrants themselves, and for overtaxed governments that lack the ability to quickly process asylum cases in immigration courts, for example, or to provide temporary shelter and other basic services for large numbers of arriving migrants. These strains are happening now in many places in the U.S.

Immigrants arrive at Ellis Island in 1923, one year before Congress reformed immigration laws in the U.S., making it harder to enter the country. <a href= — Immigrants arrive at Ellis Island in 1923, one year before Congress reformed immigration laws in the U.S., making it harder to enter the country. Underwood & Underwood/Underwood Archives/Getty Images

U.S. immigration trends

In 1924, after decades of the U.S. welcoming foreign-born citizens to its shores, Congress passed the Immigration Act, restricting the numbers and types of people who could legally enter and stay in the U.S.

That legislation ushered in even more xenophobia and division in the U.S. over the ethnic origins of immigrants – cutting off large-scale immigration, especially from Europe and Asia, until jobs needed to be filled – and there weren’t enough people in the U.S. to fill them.

In the 1960s, immigration laws were reformed again, ushering in waves of immigration from Asia because the U.S. needed people to work at unfilled jobs.

Today, once again, some U.S. politicians are pushing for new ways to restrict immigration. Much of their work focuses on making it harder for migrants to get asylum – meaning legal permission to remain in the U.S. if they have a legitimate fear of persecution in their home countries.

Overall, U.S. border officials encountered more than 1.1 million people illegally crossing the U.S. border from April 2022 through March 2023 – a sharp rise from previous years, when the number of people illegally crossing each year hovered at less than 300,000.

U.S. authorities are now stepping up deportations, quickly sending more undocumented people back to their home countries.

A shifting response to immigration

Globally, international migration to rich countries reached an all-time high in 2022.

So, how do other countries, including Canada and Germany, respond to migrants crossing their borders without a visa or proper documentation?

One answer has been to reform their immigration systems to make deportation easier.

Germany, for example, has been wrestling with increases in undocumented immigration.

Germany Chancellor Olaf Scholz announced at the end of 2023 that he supports large-scale deportations for migrants who are rejected for asylum.

Germany deported close to 8,000 people, many of them fleeing the war in Ukraine, in the first part of 2023. In total, an estimated 92,119 immigrants entered Germany illegally from January through September 2023.

New German government reforms will increase that figure and no longer require officials to announce deportations in advance.

Italy, which is also battling a huge influx of undocumented migrants from North Africa, recently doubled the amount of time that it can detain undocumented migrants, rising from three months to at least six months. This decision is seen as an effort to deter more migrants from illegally entering Italy.

In November 2023, Italy signed an agreement to build two new immigration detention centers across the Adriatic Sea in Albania.

This allows Italy to skirt a European Union policy that requires its member countries to consider and process all asylum applicants’ requests within a year of their arrival. Since Albania is not part of the European Union, it could quickly deport the migrants that Italy sends there.

In December 2023, the European Union’s 27 countries also voted on a major overhaul of asylum laws. These changes will make it easier for countries to deport migrants who fail to get asylum. They also direct the European Union to give money to countries that allow more asylum seekers to stay in those countries.

Other approaches

Right now, Italy and Greece bear much of the brunt of migration in the EU.

More than 31,000 undocumented migrants, mainly from Syria, crossed into Greece in 2023, up from 18,000 undocumented people who entered the country in 2022.

The parliament in Greece is considering new laws that would enable the country to issue tens of thousands of undocumented migrants residence and work permits to address labor shortages.

Greece is also pushing the European Union to slap economic sanctions on countries, like Pakistan, that refuse to take back the undocumented migrants that Greece deports to their home countries.

Closer to home, Canada is also experiencing a surge of undocumented migration into Quebec and other places, prompting some Canadians to feel growing anxiety, in part because of perceptions that the sudden population growth is also raising the country’s already-high housing costs. Canada deported 7,232 undocumented people in the first six months of 2023 – a rise compared to the 7,635 deportations Canada carried out in the entire year of 2021.

Canada also announced in December 2023 that it is planning to allow people who entered the country with valid, short-term visas, and who continue living in Canada after these visas expire, to apply for permanent residency. This would mainly affect foreign students and temporary workers.

A Canadian officer speaks to migrants as they arrive in Quebec in March 2023. <a href= — A Canadian officer speaks to migrants as they arrive in Quebec in March 2023. Sebastien St-Jean/AFP via Getty Images

An uncertain way ahead

Back in the U.S., the fight over immigration continues, with Republicans eager to crack down and Democrats who generally want to avoid harsh new standards that could lead to more deportations and mass roundups of undocumented immigrants.

Traditionally, Democrats have been supportive of immigration and the rights of undocumented immigrants in the U.S.

But the wave of migrants who arrive in cities like New York and Chicago without any money, jobs or places to live is severely straining city governments’ capacity and budgets. Local leaders like New York Mayor Eric Adams are pleading with the federal government to help with a crisis that, as Adams said in September 2023, has no clear end in sight.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and analysis to help you make sense of our complex world.

It was written by: Tara Sonenshine, Tufts University.

Read more:

Tara Sonenshine does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

I Was Diagnosed With Colon Cancer at 32. Here Are the First Symptoms I Had

Self

I Was Diagnosed With Colon Cancer at 32. Here Are the First Symptoms I Had

Julia Ries – January 18, 2024

Raquel A./powerofforever/Getty Images

Raquel A., 33, never guessed she had cancer, even though she had symptoms that worried her. A few years ago, her bowel movements became increasingly frequent and abnormal, which she figured was due to undiagnosed irritable bowel syndrome (IBS) or a food intolerance. She didn’t have health insurance, so she put off going to the doctor and tried to ease her discomfort with fiber supplements and dietary changes. After getting a job that offered medical coverage, she saw a primary care physician, who told her she likely just had anxiety. Her symptoms worsened, and in 2023, she was diagnosed with stage four colon cancer. Raquel has been sharing her experience with the condition—as well as what she wants others to know about seeking help as early as possible—on TikTok. Here’s her story, as told to health writer Julia Ries.

I first started having noticeable gastrointestinal issues in 2019, right before the pandemic. I was living with a roommate, and one day we started talking about how I was going to the bathroom all the time. I could go number two 8 to 10 times a day and never feel like I had a complete bowel movement. I told my roommate I suspected I wasn’t getting enough fiber, or perhaps I simply wasn’t eating “healthy enough.” Maybe I had irritable bowel syndrome (IBS), or a gluten or dairy sensitivity. It never occurred to me that I might have cancer.

I didn’t have health insurance. As a result, going to the doctor—unless I had an absolute emergency—wasn’t something I did in my 20s. Instead of checking in with a primary care doctor, I started intermittently taking Metamucil, a fiber supplement, to help regulate my bowel movements and treat random bouts of diarrhea. This helped, at least for a little while.

In 2021, I moved to the greater Seattle area, where I landed a job in the tech industry and, with it, good health insurance. My symptoms remained quiet until they came back in 2022. I was going to the bathroom a lot again, and my bowel movements became uncomfortable. My stools were pencil-thin, sometimes orangish-red in color, and occasionally there’d be a little blood. I got abnormally full after eating. I was bloated, no matter what I ate—I tried being dairy-free, then gluten-free. Looking back, these were major warning signs that something was wrong, and I wouldn’t find out until later that they were classic signs of colorectal cancer.

I scheduled a physical—my first in over a decade—in May of 2023. I told my doctor about the digestive issues I’d been experiencing since 2019: the frequent—and sometimes painful—bowel movements, the bloody stools, the early satiety. I shared that it felt like my symptoms were getting worse, and she said I likely had anxiety—and maybe gas—and scheduled a psychiatric appointment for me.

I believed her. I thought, “Maybe she’s right: I’m worrying too much about these symptoms and should just let it go.” In retrospect, she was incredibly dismissive, which I think was a result of my being so young at the time—I was 32, a woman, and a minority. Statistically speaking, people who fall into any of those categories, let alone all three of them, tend to have their health issues dismissed by doctors.

Three weeks after that exam, I developed severe abdominal pain. It wasn’t just localized to my lower stomach or my side—the pain radiated throughout my entire abdomen and toward my lower back. It was unbearable. I nearly fainted in my apartment. I’m not somebody who’s quick to take medication or go to the doctor, but I knew something was wrong, so I went to the emergency room. Again, I doubted myself and thought that perhaps I was making a big deal out of nothing. Fortunately, my ER physician took my pain seriously—she ordered a CT scan, scheduled an abdominal ultrasound, and ran a full panel of blood work. When the results came in, she sat down and told me they found cancer on my ovaries and liver. I was diagnosed with ovarian cancer.

I met with an oncologist and had a liver biopsy. That’s when they discovered that the cancer, adenocarcinoma, had originated in my colon and metastasized, or spread, to other organs. I was diagnosed with stage four colorectal cancer. I had an endoscopy and a colonoscopy so the doctors could get a better look—my colorectal cancer was so large and so advanced that they had trouble getting the scope through my colon.

I learned that colorectal cancer is very slow-growing. I could have had cancer for 8 to 10 years, potentially all of my 20s, without knowing it. With colon cancer, you usually don’t start having noticeable (or even severe) symptoms until it’s progressed to stage three or four. Plus, the symptoms, like nausea, constipation, diarrhea, or difficulty going to the bathroom, can be due to so many other conditions—some serious, like ovarian cancer, but others more benign, such as IBS.

After my diagnosis, I started chemotherapy. The cancer had caused a buildup of fluids in my stomach, the source of the bloating, that I had to have drained. I met with a GI specialist who advised me to tweak my diet—for example, I had to limit how much meat I was eating, cut out raw fruits and vegetables, and stick to soft foods, like pudding and mashed potatoes—which immediately improved my bowel movements. I’ve done various blood tests that assess how my cancer is progressing—including a CEA (a marker for colorectal cancer), CA125 (a marker for ovarian cancer), and CA19 (another cancer marker) tests—and have undergone genetic testing to better understand how my genes may have contributed to the cancer.

I continue to get chemotherapy biweekly, though I’ve switched to another chemotherapy drug because I experienced unpleasant side effects with the first type, and the cancer on my liver and lungs wasn’t responding to that treatment. My doctors informed me that eventually the chemo will stop working because my condition is terminal. I don’t qualify for surgery, since my cancer has spread so deeply, but I’m continuing to look into surgical options along with new treatments and clinical trials I can participate in. My chances of reaching survival two years after the diagnosis was 20%. At five years, that drops to 5%, but I’m determined to beat the odds.

Throughout this entire experience, I’ve learned how to advocate for myself. After I received my diagnosis, doctors took my condition very seriously and quickly scheduled multiple procedures and appointments for me—but that wasn’t always the case. I’d been dismissed for years, and even after I started chemotherapy, I felt as though my doctor wasn’t listening to my concerns, so I found a new oncologist who has been very responsive and attentive. I’ve learned how important it is to get a second opinion—all you need is that one doctor who is going to listen and fight for you. You might not find that person right away, but keep pressing: Getting screened could be a matter of life or death.

If I hadn’t followed my intuition—if I skipped going to the ER that day in 2023, or stuck with doctors who said nothing was wrong—there’s a chance I wouldn’t be alive. It’s so easy to doubt yourself, especially if medical professionals are downplaying your symptoms, but if you feel like something is wrong, go with your gut. It’s usually right.

Related:

Tax Us, Daddy?

Reason

Tax Us, Daddy?

Liz Wolfe – January 18, 2024

Taxes are the only way to get rid of excess money? “We ask you to tax us, the very richest in society,” reads an open letter to the world leaders assembled in Davos, Switzerland, penned by 250 millionaires and billionaires who seem to be gluttons for punishment.

“We’d be proud to pay more,” declares their website, which is thusly named. “This will not fundamentally alter our standard of living, nor deprive our children, nor harm our nations’ economic growth. But it will turn extreme and unproductive private wealth into an investment for our common democratic future.” Signatories include Disney and Rockefeller heiresses, as well as actor Brian Cox.

Currently, nobody is forcing them to keep their earnings. They have full freedom to do whatever they’d like with their money—including giving it away to charity or coordinating with other similarly rich people to pool money together to tackle specific issues that might be too large for just one billionaire to handle.

“Inequality has reached a tipping point, and its cost to our economic, societal and ecological stability risk is severe—and growing every day,” reads the letter, which in no way substantiates how “inequality” has reached this “tipping point” or what exactly happens if inequality continues to grow. (Absolute wealth is infrequently mentioned in these types of calls to action. It’s always relative wealth, which allows signatories to ignore the vast standard-of-living gains that have been made over the last century.)

“If our elected officials refuse to address this concentration of money and power, the consequences will be dire,” warned Cox.

Speaking of concentrations of power: The impetus for the open letter is the World Economic Forum’s meeting in Davos, which is happening now and drawing leaders from across the globe—frequently arriving on their private jets. (“Private jet emissions quadrupled during Davos 2022,” reads a Guardian headline from last year, which put the total number of private jet flights at 1,040. Fascinating that those who are so concerned with climate change still feel comfortable flying private.)

The bright spot, amid the calls for coercive wealth redistribution, was undoubtedly the speech given by newly elected Argentine President Javier Milei, who is so full of fiery takes that he might just singe your eyebrows off.

“Today I am here to tell you that the Western world is in danger, and it’s in danger because those who are supposed to defend the values of the West are co-opted by a vision of the world that inexorably leads to socialism, and thereby to poverty,” said Milei. “Unfortunately, in recent decades, motivated by some well-meaning individuals willing to help others, and others motivated by the desire to belong to a privileged class, the main leaders of the Western world have abandoned the model of freedom for different versions of what we call collectivism.”

But Argentina knows firsthand, he warned, just how bad of an economic situation can arise from state intervention: “We are here to tell you that collectivist experiments are never the solution to the problems that afflict the citizens of the world, rather they are the root cause.”

“Today’s states don’t need to directly control the means of production to control every aspect of the life of individuals,” he continued. “With tools like printing money, debt, subsidies, control of the interest rate, price controls, and regulations to correct the so-called market failures, they can control the lives and fates of millions of individuals.”

And, later on: “They say that capitalism is evil because it’s individualistic and that collectivism is good because it’s altruistic, of course with the money of others.”

You couldn’t engineer a better response to the taxation-hungry billionaires mentioned above if you tried. People are always free to give their own money away, but it takes a special breed to favor coercion.

“Do not be intimidated either by the political caste nor by parasites who live off the state. Do not surrender yourself to a political class that only wants to perpetuate itself in power and keep their privileges,” Milei added, closing with a forceful defense of value creators: “You [entrepreneurs] are social benefactors, you are heroes, you are the creators of the most extraordinary period of prosperity we have ever seen. Let no one tell you that your ambition is immoral.”

After all, “the state is not the solution, the state is the problem itself.”

It’s about time someone went into the lion’s den and forcefully defended free market capitalism.

Oh, and Milei? He flew commercial, saving taxpayers an estimated $392,000.

Hundreds of millionaires, billionaires urge politicians at Davos to tax their wealth

UPI

Hundreds of millionaires, billionaires urge politicians at Davos to tax their wealth

Darryl Coote – January 17, 2024

Actor Simon Pegg is among the millionaires urging world leaders congregating in Switzerland for The World Economic Forum to tax their wealth, warning of rising economic inequality. File Photo by John Angelillo/UPI

Jan. 17 (UPI) — Nearly 270 millionaires and billionaires urged world leaders congregating in Switzerland for The World Economic Forum on Wednesday to tax their wealth, warning that if their elected representatives don’t address the drastic rise in economic inequality, the consequences will be “catastrophic.”

“Our request is simple: we ask you to tax us, the very richest in society,” the letter signed by 268 millionaires and billionaires from 17 countries and published Wednesday.

“This will not fundamentally alter our standard of living, nor deprive our children, nor harm our nations’ economic growth. But it will turn extreme and unproductive private wealth into an investment for our common democratic future.”

The World Economic Forum is being held this week through Friday and will be attended by political leaders as well the world’s rich and powerful in the Swiss resort town of Davos where they will discuss global, regional and industry goals.

In their letter to the congregated world leaders, the hundreds of rich signatories said they are surprised their previous calls to be tax have yet to be heeded, stating they are not seeking drastic changes, only financial policies that will prevent society from further degradation.

Actor Brian Cox, who famously plays a wealthy media mogul in "Succession," is among the real-life millionaires urging world leaders congregating in Switzerland for The World Economic Forum to tax their wealth amid rising economic inequality. File Photo by Jim Ruymen/UPI — Actor Brian Cox, who famously plays a wealthy media mogul in “Succession,” is among the real-life millionaires urging world leaders congregating in Switzerland for The World Economic Forum to tax their wealth amid rising economic inequality. File Photo by Jim Ruymen/UPI

“Inequality has reached a tipping point, and its cost to our economic, societal and ecological stability risk is severe — and growing every day. In short, we need action now,” the letter states, adding that philanthropy and one-off donations will not fix the issue.

“Not only do we want to be taxed more but we believe we must be taxed more. We would be proud to live in countries where this is expected, and proud of elected leaders who build better futures.”

The letter’s signatories include filmmaker and Disney heir Abigail Disney, actors Simon Pegg and Brian Cox and Valerie Rockefeller of the U.S. Rockefeller family.

“We need our governments and our leaders to lead. And so we come to you again with the urgent request that you act — unilaterally at the national level, and together on the international stage,” they said.

The letter comes as a new poll published Wednesday shows that 74% of wealthy people support higher taxes on their fortunes, while 75% support the introduction of a 2% tax on billionaires, as proposed by the European Union Tax Observatory.

The poll by Survation on behalf of the nonpartisan Patriotic Millionaires surveyed more than 2,300 people from G20 countries who hold more than $1 million in investable assets, excluding their homes, making them the richest 5% of society.

A majority of respondents at 58% said they also supported the introduction of a 2% wealth tax for people with more than $10 million.

“Throughout history, pitchforks were the inevitable consequence of extreme discontent, but today, the masses are turning to populism, which is on the rise throughout the world,” Disney said in a statement.

“We already know the solution to protect our institutions and stabilize our country: it’s taxing extreme wealth. What we lack is the political fortitude to do it. Even millionaires and billionaires like me are saying it’s time. The elites gathering in Davos must take this crisis seriously.”

The World Economic Forum kicked off Monday, which is when Oxfam published its Inequality Inc. report that warned inequality has worsened since 2020, with the world’s richest five men seeing their fortunes double while the planet’s poorest 60% became poorer.

Cancer incidence rising among adults under 50, new report says, leaving doctors searching for answers

CNN

Cancer incidence rising among adults under 50, new report says, leaving doctors searching for answers

Jacqueline Howard, CNN – January 17, 2024

Josh Herting was on a business trip in Vermont when he received a phone call from his doctor that would change his life. On that cold winter day — a decade ago this week — his doctor told him that he had colon cancer.

After hanging up the phone, Herting wanted to keep working.

“I was very focused on work, and I was like, ‘I’ve got to finish this work trip, and then I’ll be home,’ ” he said. “I didn’t understand the seriousness of it.”

But moments later, he picked up the phone again and called his girlfriend, Amber. When he told her the news, she said it was time to come home.

Herting drove five hours to Boston. He arrived home at 2 o’clock in the morning and had medical appointments beginning six hours later.

“I was 34 years old, in what I would consider incredible health. I worked out five to six days a week, very low body fat, ate really healthy, and was in no pain or anything, but I noticed some clotted blood in my stool on a few different occasions,” said Herting, who is now 44 and married to Amber. He added that his father was diagnosed with stage I colon cancer in his early 50s but said he had no other known family history of the disease.

Herting’s journey of battling early-onset cancer is an experience shared by a growing proportion of young adults.

Cancer patients are “increasingly shifting from older to middle-aged individuals,” according to a report released Wednesday by the American Cancer Society.

Among adults 65 and older, adults 50 to 64 and those younger than 50, “people aged younger than 50 years were the only one of these three age groups to experience an increase in overall cancer incidence” from 1995 to 2020, says the report, which was published in CA: A Cancer Journal for Clinicians.

Even though the overall US population is aging, “we’re seeing a movement of cancer diagnosis into younger folks, despite the fact that there are more people that are in the older populations,” said Dr. William Dahut, chief scientific officer for the American Cancer Society.

“So cancer diagnoses are shifting earlier,” he said. “There’s something going on here.”

Herting’s diagnosis came after a gastroenterologist recommended that he get a colonoscopy due to the blood in his stool.

Herting had surgery, about a week and a half after his diagnosis, to remove the tumor and a foot of his colon. After the surgery and further testing, he said, his medical team at the Dana-Farber Cancer Institute estimated that the cancer had been in his system for about eight years and was stage IIIA. Stage III colon cancers are likely to have spread to nearby lymph nodes, but they have not yet spread to other parts of the body, according to the American Cancer Society.

Herting then had chemotherapy, and after five years of monitoring his recovery with CAT scans and blood work, his team declared him cancer-free. Amber remained by his side during his cancer treatments.

Josh Herting says he hopes cancer screenings are less intrusive by the time his children are grown. - Courtesy Josh Herting — Josh Herting says he hopes cancer screenings are less intrusive by the time his children are grown. – Courtesy Josh Herting

“But you’re never the same person,” Herting said of his cancer journey. He still has some fatigue and numbness in his fingertips and toes from chemotherapy, and he gets colonoscopies every three years – unless his doctor says otherwise – to make sure the cancer has not returned.

“Colonoscopies – I’ve had way more than I’d like to admit – they’re not fun. But at the same time, colon cancer and chemotherapy are a million times worse,” Herting said.

“There’s this stigma about colonoscopy. For people that have never had cancer, it’s kind of this taboo topic, and you’ve got to go through this process to prep for it, and that’s not fun,” he said. “But I can tell you firsthand, it is definitely worth doing.”

Among adults younger than 50, colorectal cancer has become the leading cause of cancer death in men and the second-leading cause in women, behind breast cancer, the new report says. In the late 1990s, it ranked fourth in both men and women younger than 50.

“It’s just different now than it used to be,” Dahut said. “This young adult trend is the thing that has me scratching my head the most.”

‘A call to arms’

Even though the rising cancer incidence among younger adults has been
“poorly understood” and raises more questions than answers, Dr. Scott Kopetz says he has seen the trend firsthand at MD Anderson Cancer Center in Houston.

“In our clinical practice, we’re seeing patients presenting younger and presenting before ages of screening for many cancers, so it’s certainly a continued concerning trend in the field,” said Kopetz, an associate vice president for translational integration and a professor of gastrointestinal medical oncology at The University of Texas MD Anderson Cancer Center.

For instance, it’s recommended that all adults start screening for colon and rectal cancers at age 45, but more cases are emerging among people at even younger ages.

“When one looks at the totality of the data, it really is a call to arms to really better understand the changing epidemiology of cancer,” Kopetz said.

“Colorectal is the most prominent one, but we’re also seeing that in cancers that don’t have as clear-cut screening guidelines – so things like pancreas, gastric cancer – are also seeing trends towards earlier ages,” he said. “Pancreas cancer, and to some extent gastric cancer as well, are ones that we just don’t have good screening methodologies currently, but we’re seeing a lot of the same trends occurring.”

Kopetz worries that the rising incidence of cancer in young adults will grow into a rising incidence of cancer in older age.

“There’s a concern that, as the population ages, that what is currently an increase in young-onset disease will turn into increases in mid-onset and late-onset disease as well. So if the epidemiology of this is changing, this could be the beginning of a wave of increased cancers that may persist or may continue to increase over the next decades,” he said.

The new American Cancer Society report projects that there will be about 2 million new cancer cases in the United States this year, equivalent to more than 5,000 diagnoses each day. It’s also projected that there will be about 600,000 cancer deaths in 2024.

“This is a call to better understand what’s driving these increases,” Kopetz said. “And a call also to accelerate efforts for early detection approaches that may provide screening for multiple different tumor types.”

Herting, who now has a 7-year-old son and a 5-year-old daughter, hopes that when his children are young adults, screening for cancers will be less intrusive, especially for colorectal cancer.

“I hope for the future that it’s made to be less invasive,” Herting said. “If we could find a way to make it less invasive, more and more people would be willing to do it, and most likely insurance might be more apt to cover it for more people.”

Other data has showed that the share of colorectal cancer diagnoses among adults younger than 55 in the US has been rising since the 1990s. Signs and symptoms of colorectal cancer include changes in bowel habits, rectal bleeding or blood in the stool, cramping or abdominal pain, weakness and fatigue, and unexplained weight loss.

A report released last year by the American Cancer Society showed that the proportion of colorectal cancer cases among adults younger than 55 increased from 11% in 1995 to 20% in 2019. Yet the factors driving that rise remain a mystery.

Some of the things known to raise anyone’s risk of colorectal cancer are having a family history of the disease, having a certain genetic mutation, drinking too much alcohol, smoking cigarettes or having obesity.

“People point to exercise, diet, types of food,” Dahut said, but there’s probably more than just one cause — and sometimes, younger people diagnosed with early-onset colorectal cancer are otherwise healthy, with a history of working out and eating healthy diets, and don’t have a family history or genetic mutations.

Some scientists have been looking into whether a woman’s obesity during pregnancy may be associated with an increased risk of colorectal cancer in her offspring and whether that association could contribute to increasing incidence rates in younger adults — but more research is needed.

“The continuous sharp increase in colorectal cancer in younger Americans is alarming,” Dr. Ahmedin Jemal, senior vice president of surveillance and health equity science at the American Cancer Society and senior author of the new report, said in a news release.

“We need to halt and reverse this trend by increasing uptake of screening, including awareness of non-invasive stool tests with follow-up care, in people 45-49 years. Up to one-third of people diagnosed before 50 have a family history or genetic predisposition and should begin screening before age 45 years,” Jemal said. “We also need to increase investment to elucidate the underlying reasons for the rising incidence to uncover additional preventive measures.”

Cases climb as deaths decline

Overall, the number of people dying from cancer in the United States continues to decline, but the incidence rates for several types of cancer — including breast, prostate, uterine corpus, pancreas, oropharynx, liver in women, kidney, melanoma, and colorectal and cervical in young adults — remain on the rise, according to the new American Cancer Society report.

Cancer deaths continued to fall in the United States through 2021, leading to an overall drop of 33% since 1991, the report says, largely due to fewer people smoking, more people detecting cancer early and major improvements in treatments for cancer, such as immunotherapies and targeted therapies.

“We’re encouraged by the steady drop in cancer mortality as a result of less smoking, earlier detection for some cancers, and improved treatment,” Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society and lead author of the report, said in a news release. “But as a nation, we’ve dropped the ball on cancer prevention as incidence continues to increase for many common cancers — like breast, prostate, and endometrial, as well as colorectal and cervical cancers in some young adults.”

The report adds that “progress is lagging in cancer prevention,” as six of the top 10 cancers in the United States have had increases in incidence.

The cancers with red bars are increasing. - American Cancer Society — The cancers with red bars are increasing. – American Cancer Society

Among the top 10 cancers, based on cases projected in 2024, those that are increasing are breast, prostate, melanoma of the skin, kidney and renal, uterine corpus and pancreas.

The new report says that incidence rates increased from 2015 through 2019 by about 1% each year for breast, pancreas and uterine cancers and by up to 3% annually for prostate, liver in women, kidney and HPV-associated oral cancers and melanoma. Incidence rates also increased up to 2% annually for cervical cancers in ages 30 to 44 and colorectal cancers in adults younger than 55, according to the report.

The report also highlights that racial disparities in cancer incidence and deaths continue, as people of color still face increased risks, and the report says this has “hampered” progress.

“Progress is also hampered by wide persistent cancer disparities; compared to White people, mortality rates are two‐fold higher for prostate, stomach and uterine corpus cancers in Black people and for liver, stomach, and kidney cancers in Native American people,” according to the report. “Continued national progress will require increased investment in cancer prevention and access to equitable treatment, especially among American Indian and Alaska Native and Black individuals.”