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Best of The Atlantic
When Fakeness Is a Good Thing
Arguably, no mode of writing has influenced the past decade of novels more than autofiction, a catchall term for books that call themselves fiction while claiming to be rooted, in some way, in their authors’ real lives. Amid this boom, critics and readers alike have shown a certain anxiety over how based in fact a novel can be—and how anyone might know, given that no autofiction writer purports to be telling the complete, unadulterated truth. Is reality identifiable on the page? Is it ferret-out-able? Is it relevant? As narratives professing to be true-ish gain in popularity, critics seem sometimes inclined to either deride their gestures at veracity or declare them all basically fake. One cynical interpretation of either impulse would be to say that, in a social-media-addled culture, everyone is comfortable assuming falsity. Another would be to see readers as a cranky panel of judges demanding sworn testimony every time they crack a book claiming to hold some similarity to the writer’s life. A more forgiving analysis, though, is that many fiction lovers remain attached to the idea of writers inventing stories, and feel anxious about reading novels full of not only emotional but literal truth. Some of us, in short, like fakeness. I know I do.Two new novels, Joshua Ferris’s A Calling for Charlie Barnes and Claire Vaye Watkins’s I Love You but I’ve Chosen Darkness, react to this anxiety by flaunting both their fakeness and their debt to autofiction, if not to reality. Watkins loans her name and biography to her protagonist, though the details of their lives seem to differ. Ferris, meanwhile, names his main character after Hemingway’s Jake Barnes; the character’s father is inspired by Ferris’s own father, who died from cancer in 2014, but the connection between novel and writer can seem loose. As their naming choices indicate, the two authors approach autofiction differently: Watkins riffs lovingly on it while Ferris both mimics and critiques it. But both works suggest that, valuable though truth telling may be, invention and fakery are necessary sources of possibility and relief in relentlessly difficult moments. Reading these two books side by side shows that autofiction, as much as any other mode of writing, can be escapist.[Read: The surprising value of a wandering mind]A Calling for Charlie Barnes often reads like a wild search for hope in the face of bleak reality. It opens with Jake’s father, Charlie, a serial self-reinventor still aiming to hit it big, awaiting a doctor’s call: He’s about to be diagnosed with pancreatic cancer, which he expects will be terminal. When Jake, a successful novelist living on the East Coast, hears the news, he speeds home to the Chicago suburbs to care for his dad—and, soon enough, to write about him. Charlie signs off on the latter, but with a constraint: He asks Jake to write a “factual account,” adding, “You’d do me an honor if you just told the truth.” Jake tries, but he chafes at the confines of truth. Usually, he gripes, he’s “free to move a character around at will, to swap the cat in the window for a dog at his feet”—he can do anything he likes. Limited by his promise to “tell it straight this time,” though, Jake feels he has no relief from Charlie’s illness and looming death.Of course, no novel can save anyone from terminal cancer, or from the pressures of caring for a sick parent. Whatever life-giving properties fiction may have are psychological. (Perhaps this is why Charlie, who gives no sign of caring about mental health, informs his son that “make-believe” is “a very silly occupation for a grown man.”) Still, Jake clearly needs a respite from the dark experience of living with his dying father—and, as many writers might, he needs fiction to be that respite. Before the novel is over, he cracks, abandoning fact for an explosion of metafictional possibilities. At this point, the plot more or less becomes nonsensical: I cannot in good conscience recommend the final act of this book. But Ferris’s central idea—that fiction offers the fantasy of escape from mortality—remains both convincing and clear. It’s hard not to sympathize when Jake, hating his efforts at autofiction, starts yearning for “new adventures, happy ends.” Who doesn’t want to pretend death isn’t coming for us all?[Read: An emotional framework for understanding the end of the pandemic]The promise of immortality—setting aside cryogenic freezing for billionaires, I guess—is peak fakery. Death is, as Jake puts it, the “harsh truth” of all life. Even so, many of us could use breaks from acknowledging it. Every day, my fiancé and I tell our dog how glad we are that she’s immortal. We make up Wishbone-style tales about her eternal life. We are, usually, rational adults; we’re aware that our little mutt never lived with Diogenes in his barrel or stole Marie Antoinette’s cake. But we have fun claiming that she did—and we welcome the vacation from knowing better. A Calling for Charlie Barnes is an ode to precisely this sort of emotional breather. Charlie may consider “make-believe” childish, but to Jake (and, I would wager, to Ferris himself), nothing could be further from the truth. Being an adult means understanding, likely from experience, the awfulness of death and grief. Nobody needs to carry the weight of that understanding nonstop. Jake Barnes tries. It doesn’t go well.If Ferris’s novel dramatizes the urge to look away from reality, Watkins’s explores an altogether more drastic impulse: to break from the confines of one’s life altogether. I Love You but I’ve Chosen Darkness is a fake-it-’til-you-make-it book, emphasis on fake. At its start, its protagonist, Claire, is feeling very confined indeed. She’s suffering from postpartum depression; she’s grieving for her father, who died of cancer when she was a child, and her mother, who overdosed when Claire was a young woman; she hates her tenure-track job in Ann Arbor; her marriage is collapsing; she might be in love with an elusive van-life bro who lives halfway across the country—oh, and she’s convinced that her vagina has teeth. At first, the teeth upset her, but before long she comes to see them as a “secret companion” in her loneliness: “I loved the teeth,” Watkins writes, “and was unafraid of that love.” Smartly, Watkins introduces them early in the novel, before readers can settle too cozily into thinking Watkins and Claire are one and the same. (They could be, of course; far be it from me to make assumptions about another woman’s teeth.) The vagina dentate serves as a warning. No matter how much the fictional Claire may seem like the real Watkins, readers can’t just decide the two are the same.Watkins doesn’t create this sort of implied division between her protagonist’s parents and her own. If anything, she reverses course. Both character and creator are the eldest daughter of Martha and Paul Watkins, the latter of whom was once one of the cult leader Charles Manson’s right-hand men. Letters from Martha—which Watkins has told interviewers are real—function as primary sources of a sort; Watkins also includes real excerpts from her father’s 1979 memoir, My Life With Charles Manson. These additions give Claire’s parents an aura of reality, just as the teeth give Claire an aura of made-up-ness. Adding to this effect, Watkins gives Paul and Martha linear, heavily foreshadowed narratives that work in stark contrast to the chaotic one she constructs for her protagonist. Claire is terrified of becoming her mother, who spent much of her life battling addiction; she also cannot stand the stifling conventionality of marriage and professorhood. Unable to visualize an alternate life, she flees to the Mojave Desert, determined to find one for herself.As with the teeth, whether Claire’s trajectory is invented or not isn’t especially relevant. Watkins underscores the truthfulness of her protagonist’s past, of which she writes, early in the book, “You must remember that this was real,” but such reminders do not appear in the novel’s present day, once Claire leaves Michigan. Watkins seems to use Claire’s flight westward to dramatize fiction’s improvisatory potential: Her novel becomes structurally looser and shaggier with every chapter. As Claire shakes herself free from the narratives she already knows, she realizes that her life can take any shape she likes, or no known shape at all.Watkins’s freewheeling excavation of her family’s story may be frustrating to readers seeking more allegiance to reality: So many of us feel irreversibly beholden to loved ones, history, or convention. But I Love You but I’ve Chosen Darkness, like A Calling for Charlie Barnes, is not slickly false. Both are messy, bighearted books that prioritize emotional searching. Jake dreams of fiction as a deathless space, one where he and his dad can briefly escape the inescapable. Ferris comes close to allowing him that dream. Watkins’s Claire, haunted by memories of her parents, knows better than to imagine dodging death, but she, even more than Jake, is an escape artist, constantly wriggling from the clutches of life as she knows it. Perhaps together these two characters are—or prefigure—the future of autofiction: characters fleeing the worst and least-escapable parts of their writers’ own lives. What other kind of fiction could be better equipped for this task?
theatlantic.com
Trauma Self-Help Books Won’t Save You
Nothing about The Body Keeps the Score screams “best seller.” Written by the psychiatrist Bessel van der Kolk, the book is a graphic account of his decades-long career treating survivors of traumatic experiences such as rape, incest, and war. Page after page, readers are asked to wrestle with van der Kolk’s theory that trauma can sever the connection between the mind, which wants to forget what happened, and the body, which can’t. The book isn’t academic, exactly, but it’s dense and difficult material written with psychology students in mind. Here’s one line: “The elementary self system in the brainstem and limbic system is massively activated when people are faced with the threat of annihilation, which results in an overwhelming sense of fear and terror accompanied by intense physiological arousal.”And yet, since its debut in 2014, The Body Keeps the Score has spent 150 weeks—nearly 3 years—and counting at the top of the New York Times best-seller list and sold almost 2 million copies globally. During the pandemic, it seems more in demand than ever: This year, van der Kolk has appeared as a guest on The Ezra Klein Show, been profiled in The Guardian, and watched his book become a meme. (“Kindly asking my body to stop keeping the score,” goes one viral tweet.)After all the anxiety and social isolation of pandemic life, and now the lingering uncertainty about what comes next, many people are turning to a growing genre of trauma self-help books for relief. The Body Keeps the Score is now joined on the best-seller list by What Happened to You?, a compilation of letters and dialogue between Oprah Winfrey and the psychiatrist Bruce D. Perry. Barnes & Noble, meanwhile, sells about 1,350 other books under the “Anxiety, Stress & Trauma-Related Disorders” tab, including clinical workbooks and mainstream releases. Sometimes, new installments in the genre seem to position themselves as a cheat code to a better life: Fill out the test at the back of the book; try these exercises; narrativize your life. One blurb I read, on the cover of James S. Gordon’s Transforming Trauma, basically said as much: “This book could give you back your life in unimaginable ways, whether you think of yourself as a trauma victim or not.”“You can kind of understand why the sales of these books are going up in this stressful, pressurized situation,” Edgar Jones, a historian of medicine and psychiatry at King’s College London, told me. In a moment of personal and collective crisis, the siren song of a self-help book is strong.There’s just one problem. In spite of their popularity, trauma books may not be all that helpful for the type of suffering that most people are experiencing right now. “The word trauma is very popular these days,” van der Kolk told me. It’s also uselessly vague—a swirl of psychiatric diagnoses, folk wisdom, and popular misconceptions. The pandemic has led to very real suffering, but while these books have one idea of trauma in mind, most readers may have another.The Greek term for “wound,” trauma was initially used to refer to physical wounds. Although today’s best sellers seem to provide all the answers, psychiatrists began to widely embrace the notion of purely psychological trauma only around World War I. But the disorder has evolved since the days of shell shock. The current diagnosis of PTSD dates back to only 1980, applied to the flashbacks experienced by some soldiers who had served in the Vietnam War.In the decades since, trauma has come to signify a range of injuries so broad that the term verges on meaningless. The American Psychological Association, for example, describes trauma as “an emotional response to a terrible event like an accident, rape or natural disaster”—like, but not only. “Like weeds that spread through a space and invasively take over semantic territory from others,” trauma can be used to describe any misfortune, big or small, Nicholas Haslam, a psychology professor at the University of Melbourne, told me. That concept creep is evident on TikTok, where creators use “trauma response” to explain away all kinds of behavior, including doomscrolling and perfectionist tendencies.In the pandemic, trauma has become a catchall in the U.S. for many varied, and even competing, realities. Some people certainly are experiencing PTSD, especially health-care workers who have dealt with the carnage firsthand. For most people, however, a better description of the past 19 months might be “chronic stressor,” or even “extreme adversity,” experts told me—in other words, a source of immense distress, but not necessarily with severe long-term consequences. The whole of human suffering is a lot of ground for one word to cover, and for trauma best sellers to heal.Today, a comprehensive shelf of trauma self-help includes the biophysicist Peter Levine’s Waking the Tiger, which argues that a lack of trauma in wild animals can offer insight into how humans might overcome their seemingly unique susceptibility to it; The Deepest Well, by the surgeon general of California, Nadine Burke Harris, who uses personal experience to draw a direct line from childhood stress to a host of physical and social ills; and It Didn’t Start With You, in which the author, Mark Wolynn, makes the controversial claim that trauma can be inherited from distant ancestors.These books tend to follow a reliable arc, using the stories of trauma survivors to advance a central thesis, and then concluding with a few chapters of actionable advice for individual readers. In The Body Keeps the Score, van der Kolk writes about people he refers to as Sherry, a woman who was neglected in childhood and kidnapped and repeatedly raped for five days in college, and Tom, a heavy drinker whose goal was to become “a living memorial” to his friends who had died in Vietnam. For patients like these, van der Kolk eventually turned to yoga, massage therapy, and an intervention called eye-movement desensitization and reprocessing, or EMDR, which specifically treats the traumatic memories that pull people with PTSD back into the past.Those experiences are remarkably different from what most Americans have endured in the pandemic. Although almost everyone has struggled with the risk of contracting a deadly virus and the resulting isolation and potential loneliness, a remote worker’s depressive episode, or an unemployed restaurant worker’s inability to pay their bills, has little in common with stories like Tom’s and Sherry’s. They are no less important—no less deserving of attention—but we need better words to describe them, and other remedies to treat them.Even van der Kolk himself is wary of some of the ways in which trauma is used today. When I asked him whether he thinks The Book Keeps the Score is useful for all the readers turning to it during the pandemic, he objected to the premise of my question: The readers he hears from most, he said, are those who grew up in abusive households, not those who feel traumatized by COVID-19. “When people say the pandemic has been a collective trauma,” van der Kolk said, “I say, absolutely not.”Still, the trauma books keep selling. Some lessons they contain are universally applicable, if a little trite. In What Happened to You? Oprah and her co-author dedicate a chapter to their spin on the idea of “post-traumatic growth,” a concept popular again in the pandemic, as people search for a silver lining to what they’ve been through. But sometimes, there is no wisdom to glean or personal growth to uncover—what happened happened, and people move forward anyway. Other recommendations, as with van der Kolk’s emphasis on EMDR, are specific to people with more typical symptoms of PTSD. Most people just don’t need those kinds of interventions, says George Bonanno, a clinical-psychology professor at Columbia University and the author of The End of Trauma. In the aftermath of disasters such as 9/11, Bonanno has found remarkable resilience, despite the odds. Yet people “don’t seem to want to let go of the idea that everybody’s traumatized,” he told me.Surely some people find solace in these books, whatever their reason for reading. And not all trauma books have these pitfalls. In My Grandmother’s Hands, the therapist Resmaa Menakem examines the physical and emotional toll of racism and white supremacy, and his advice charts a different course. When people feel they have experienced a collective trauma, Menakem writes, “our approaches for mending must be collective and communal as well.” When it comes to the challenges Americans now face—as varied as responding to the pandemic and acting on climate change—that’s advice worth taking.Ultimately, talking about trauma isn’t just a semantic matter. “Having a tight, limited idea of what mental illness looks like is a recipe for stigma; it’s a recipe for not seeking help for oneself [and for] not offering help to others,” Haslam said. The desire to validate other people’s suffering “is a good corrective,” he added. “It just happens to be a pretty blunt object in this concept of trauma.” And that is the major lesson you’ll learn if you can make it to the end of this grueling syllabus: We still have so much to understand about trauma. If we want a shot at addressing the real consequences of the pandemic, we will need not only more research but a new language—one that expresses terrible experiences that aren’t strictly traumatic and leads to solutions that are bigger than any one of us in isolation. Until then, trauma books will just keep flying off the shelves.
theatlantic.com
The Volcanologist’s Paradox
On March 16, 2017, Mount Etna almost killed Boris Behncke. He was on the volcano’s snow-covered flanks, accompanying a film crew from the BBC. Serpents of lava were slithering out of a southeastern crater, but Behncke, a volcanologist at Italy’s National Institute of Geophysics and Volcanology, felt no need to take his hard hat out of his bag. They were more than a mile away from the crater, seemingly far from harm’s reach.Suddenly, flashes of steam erupted from the ice—lava had snuck into the snowbank and was violently vaporizing it, launching red-hot debris into the air. Everyone bolted downslope; some were knocked off their feet by the blasts, others pelted by a Hadean hail of volcanic rock. A small, scorching-hot chunk of matter shot at Behncke, careening through his backpack like a bullet through Jell-O. That he had not whipped out his hard hat proved oddly fortunate: If he had put it on his head, that volcanic shard would have sliced through his abdomen.That day, Behncke thinks, “haunted all of us for a while,” he told me. But the same evening, he watched the eruption unfold on TV and said to himself: “This is beautiful. It’s spectacular!”This is the volcanologist’s emotional paradox. Eruptions “are very spectacular. I do admire them,” Behncke, who lives on Etna’s slopes, 13 miles from the summit, told me. “But we are things in their way.”Roughly 40 volcanoes are erupting on Earth at any given moment. Most do so harmlessly. Some cause great devastation. Right now, lava is cascading out of the Cumbre Vieja volcano, on the Spanish island of La Palma, and every day lives are upturned and homes are lost.Somewhat perversely, this ongoing destruction is accompanied by a kaleidoscope of aesthetic wonders: Incandescent ink, with hues of crimson and burnt orange, pours into the cerulean sea; streaks of purple lightning dance around skyscraper-high lava fountains; curtains of molten rock spill out of a newborn lithic coliseum, creating the youngest land on Earth.When volcanologists watch eruptions like this, the boundary between awe and horror “is a very narrow edge,” Behncke said.Some eruptions tip easily over that edge, in one direction or the other. The 1985 eruption of Colombia’s Nevado del Ruiz volcano, for example, triggered mudflows that killed 23,000 and still haunts many volcanologists to this day. “There was nothing beautiful there,” Behncke told me. In contrast, this past March, the first eruption in 800 years on Iceland’s Reykjanes Peninsula was forecast well in advance, fully expected to be nonexplosive and nonthreatening, and seemed likely to be confined to uninhabited valleys. Locals and volcanologists alike greeted it with wonderment, and the baby volcano—which had built itself from scratch from a series of lava-spewing fissures—was soon the backdrop to gigs, wedding proposals, and impromptu lava-fueled cooking; researchers had countless chances to conduct cutting-edge science.But between these two endpoints are dangerous eruptions, the most deleterious effects of which can be curtailed through forensic examination of a volcano’s history, scientific documentation of eruptions in real time, and monitoring by an array of technologies. No amount of preparation, though, prevents all harm. There is often some degree of loss—of communities, livelihoods, or lives—and managing and studying these active volcanoes during their outbursts can bring up a mélange of emotions. Emily Mason in 2018, walking towards the origin point of a lava-seawater interaction plume (Evgenia Ilyinskaya / USGS) Take Cumbre Vieja. Since it started erupting on September 19, its first outpouring after a half-century interregnum, the southwestern corner of La Palma has been invaded by molten rock. Hundreds of homes and plenty of farmland have been annihilated, but careful monitoring and preemptive mandatory evacuation orders have so far prevented any fatalities. Similarly, when Hawaii’s Kīlauea volcano expunged 320,000 Olympic-size swimming pools’ worth of lava from fresh wounds in its eastern flank in the spring and summer of 2018, it destroyed more than 700 homes, but thanks to the work of scientists and the authorities, no one perished. No volcanologist would disagree that Kīlauea’s outburst, like the eruption at La Palma, was ruinous. But it was the first time that many volcanologists who made it to Hawaii had seen lava up close—and it granted them an otherworldly, often breathtaking experience.At the time, Emily Mason was a doctoral student of volcanology at the University of Cambridge, and her visits to the rivers and fountains of molten rock gushing from Kīlauea’s eighth fissure—by that stage, the focal point of the eruption—gave her an emphatic introduction to the double-sided emotion an eruption can raise. “When you’re stood in front of something as phenomenal as the lava flows coming out of fissure eight … it was like a river rapid, a torrent of lava … It’s hard to think of anything else, despite the fact that you’re acutely aware that you’re probably standing on top of someone’s house that’s been buried,” she told me. “It’s very surreal.” Jessica Ball, a volcanologist at the U.S. Geological Survey’s California Volcano Observatory, felt much the same way. “I had a moment where I just stopped and said: ‘I can’t believe I’m seeing this,’” she told me. “It’s incredible; it’s dangerous. And you’re standing in the middle of this apocalyptic-looking neighborhood.”At the same time, the eruption presented researchers with a bounty of volcanological treasure: a chance to listen to a seismic soundtrack to determine changes in upcoming explosivity; an opportunity to see how this giant volcano’s dramatically deflating summit forced lava out of its flanks; a front-row seat to a massive, lava-spewing eruption that made future effusive eruptions more forecastable around the world. To be able to conduct so much revelatory research was unquestionably thrilling.These more positive emotions can sit uneasily with volcanologists. But it isn’t difficult to see where their involuntary astonishment comes from. “There is this sense of us waiting for these eruptions with bated breath,” Mason said. “We’re so excited for when they do actually happen that it is easy, momentarily, to forget how devastating they are.”“Scientists like to sometimes divorce themselves from emotions, but it’s impossible to do that,” Ball told me. “This is your career; this is what you’ve worked toward all your life, and suddenly it’s in front of you.” Penny Wieser and Emily Mason collect fresh lava channel overflow samples at Fissure 8. (Evgenia Ilyinskaya / USGS) For Richie Robertson, a volcanologist at the University of the West Indies, this notion of waiting a lifetime for an idiosyncratic fireworks show is especially apt. La Soufrière, on the Caribbean island of St. Vincent, blew its top in 1979—when Robertson was in his senior years of high school. He decided to become a volcanologist after noticing that none of the scientists dealing with the response hailed from St. Vincent and thinking, as he recalls: “How is it we, as people in St. Vincent, don’t have anybody here who knows enough about the volcano?”In December 2020, a toothpaste-like slurry of lava began to ooze from La Soufrière’s peak, and the following April, a seismic cacophony and a hyperventilating summit suggested that an explosive eruption was incoming. An evacuation was ordered on April 8—and the booms began the very next day. After it became clear that the evacuation had prevented a loss of life, Robertson’s initial nerves faded somewhat, and he could not help but marvel. “Those mushrooming clouds going up in the air and expanding, and looking like they’re alive, and at night you see lightning flashing and you can see the pyroclastic flows snaking in the valleys—all of that is spectacular to see,” he told me. The volcano is far quieter today, but he remains in awe of La Soufrière. “It’s still as majestic and dangerous and interesting as it ever was—perhaps even more so now.”The unyielding power of eruptions, which affect every single sense, gives volcanoes a somewhat deific status. They are akin to giant, primordial, tempestuous beasts. As they go about their business, hissing and writhing, they remain “impervious to the lifetimes of humans,” says Ailsa Naismith, a volcanologist at the University of Bristol. And, like the gods of old, they seem omnipotent: They make new land, tinker with the atmosphere, incubate life, and, sometimes, trigger biocidal cataclysms.Eruptions “show that the planet is alive,” Stavros Meletlidis, a volcanologist at Spain’s National Geographic Institute, told me. They are the outward expression of a planet’s healthy geologic heartbeat. It is only human to be moved by their presence.Yet, especially in the early days of an eruption, as emotions seesaw between awe and lamentation, the danger that volcanoes pose can exert a stronger pull. Meletlidis, who has been monitoring and responding to the eruption on La Palma, understands that the fountains and rivers of lava appear beguiling from a distance. But conditions on the ground have become a litany of desolation. He went to visit a friend one recent Saturday; the next day, lava bulldozed through his friend’s house. “Right now, we’re in an emergency, and we should treat it like an emergency,” he told me.This attitude, shared by many of his peers, seems to stem at least in part from his own origin story. Many were inspired to become volcanologists by the lethal eruption of America’s Mount St. Helens on May 18, 1980, whose jaw-dropping dimensions and astounding ferocity shocked the nation. Meletlidis was 15 years old and living in Greece. In the pre-internet age, he first saw the scale of the devastation in an issue of National Geographic.As he surveyed the images of the eruption-sterilized landscape, he became enamored of the scientists who gave everything—including, in that case, their lives—trying to monitor the convulsing volcano and provide lifesaving data to the public. That’s when he decided to join their ranks and do his best to outsmart these godlike, lithic entities.At the moment, Meletlidis is trying to outmaneuver Cumbre Vieja. Any thought of exciting scientific advances will wait. “People are more important than the eruption,” he said. Eruptions, he told me, can be hypnotizing, enchanting, and spectacular—but right now, when he looks at those streams of molten rock eroding and demolishing neighborhoods, all he sees is a calamity.
theatlantic.com
What If mRNA Vaccines Could Cure Cancer?
Two years ago, approximately nobody on Earth had ever heard of mRNA vaccines. This was for the very good reason that no country had every authorized one. As a scientific experiment, synthetic mRNA was more than 40 years old. As a product, it had yet to be born.Last year, mRNA technology powered the two fastest vaccine developments in history. Moderna famously prepared its COVID-vaccine recipe in about 48 hours. And then there’s BioNTech, a German biotech firm that originally partnered with Pfizer to develop flu therapies but moved quickly to produce its own shot for the new disease. Within 24 hours of the genetic sequencing of the coronavirus, BioNTech had built eight potential vaccine candidates. The company eventually tested more than 20. One of them has now been administered more than 1 billion times around the world—including more than 200 million doses in the United States alone.[Derek Thompson: How mRNA technology could change the world ]Messenger ribonucleic acid—or mRNA—is a tiny molecule that instructs our cells to make proteins that keep us alive. Synthetic-mRNA technology, which powers the COVID-19 vaccines from Moderna and Pfizer-BioNTech, sends specialized instructions to our cells to manufacture specific proteins: in this case, the spike protein that encircles the coronavirus. Our immune system trains itself against these harmless spike proteins so that later, if we confront the real coronavirus, our bodies are primed to destroy it. BioNTech’s founders, the husband-and-wife team of Uğur Şahin and Özlem Türeci, compare this to displaying a Wanted poster of an outlaw to our immune system, so that he can be swiftly eliminated when he shows his face.The fact that mRNA technology had never delivered an authorized therapy before the coronavirus pandemic could tell us one of two things. Perhaps synthetic mRNA is like a miraculous key that humankind pulled out of our pockets in this pandemic, but it was so perfectly shaped for the coronavirus that we shouldn’t expect it to unlock other scientific mysteries any time soon.Or perhaps mRNA is merely in the first chapter of a more extraordinary story. This month, BioNTech announced that it had initiated Phase 2 trials of personalized cancer vaccines for patients with colorectal cancer. It is working on other personalized cancer vaccines and exploring possible therapies for malaria using a version of the mRNA technology that had its breakout moment in 2020.Last week, I spoke with Şahin and Türeci about the history of their COVID vaccine and the promise of mRNA. Our conversation left me feeling optimistic about the future of biotechnology, humbled by the extraordinary challenge of commandeering novel technology to eliminate complex diseases, and deeply fortunate that mRNA tech emerged at the perfect moment in the pandemic. This conversation has been edited for length and clarity.Derek Thompson: BioNTech was founded in 2008 to focus on cancer therapies. How did you wind your way to mRNA technology?Uğur Şahin: In the early 1990s, we were both cancer physicians working in parallel on taking care of cancer patients by day and working in labs in the evening. At the time, we could only offer chemotherapy and radiation, and very often we had to tell our patients there were no more options for further treatment. But in the lab, we were seeing the promise of new immunology treatments. There was a clear gap between what we could offer patients, on the one hand, and the emerging science, on the other hand. We wanted to overcome this gap.Özlem Türeci: In the late 1990s, we became interested in mRNA and its potential for vaccination. You could essentially present to our immune system the blueprint of a wanted foe, in this case the cancer and its specific molecules. Then you could deliver instructions to act upon that wanted poster and destroy the foe.We thought mRNA had huge potential but also many flaws. In the late 1990s, its potency was very low. There was very little effect on the immune system. So that was our research focus for 30 years. Today’s COVID-19 vaccine uses just 30 micrograms of mRNA. That is a tiny amount of mRNA to activate the immune system of the whole body. It’s almost magic to generate billions of immune cells from such a small amount of mRNA.Thompson: What did you learn that was so special about mRNA technology?Türeci: Through years of research, we learned we can treat infectious diseases with mRNA by showing our immune system a wanted poster of a foe—like the spike protein on the coronavirus—and instructing the immune system to target that outlaw for destruction. We’ve also learned that, in addition to showing the wanted poster, we can also modify the message that we send to the body. It’s possible that we can treat autoimmune diseases with mRNA by sending a message that tells our cells to do nothing when they see a certain protein.[Read: The mRNA vaccines are looking better and better]Thompson: Moderna has a very famous origin story for its COVID-19 vaccine, which is that it finalized the vaccine recipe in 48 hours. Did you design your vaccine in 48 hours too?Şahin: Actually, we did it in less than 48 hours! In 24 hours, we generated the genetic sequence of the first eight vaccine candidates.Thompson: Why make eight different vaccines?Şahin: When we started the project, this was a new virus without any proven vaccine. So it was not clear what was the best molecule to target. From the beginning, Moderna bet on the full spike protein. But at that time, it wasn’t obvious to us that targeting the spike protein was the best. So we developed one vaccine to target the spike and other vaccines to target other parts of the virus.We ultimately tested about 20 vaccine candidates on mice. We injected animals and varied the dose to understand which vaccines provided the strongest antibody response and T-cell response and protein-antigen production in the mice. Then we took the four most successful candidates to Phase 1 trials. Those Phase 1 trials told us the single vaccine that worked the best. That’s the final vaccine that showed more than 90 percent efficacy in Phase 3 trials and was authorized by the FDA.Thompson: Obviously, mRNA’s success was a wonderful surprise. But I think it’s underrated just how surprising it really was. It’s doubly surprising to me not only that this technology worked but that it crushed all these land-speed records for vaccine development with extraordinary effectiveness. That mRNA technology was so well suited for this pandemic seems quite wonderful to the point of being almost miraculous. How do you explain why this technology worked so well for this foe?Şahin: Nobody has ever asked us the question like that before. I think it may be the mother of all questions. Before corona, there was Ebola, and a different vaccine technology that was viral-vector-based was sufficient. [Editor’s note: Viral-vector vaccines, such as the Johnson & Johnson shot, use a harmless version of an unrelated virus to deliver information that teaches cells to produce an antigen, such as the spike protein, that the immune system learns to neutralize.] Ebola was low-hanging fruit for viral-vector-vaccine technology.The coronavirus is a very different virus. It has these spike proteins that bind very strongly to the receptors [of our cells]. It turned out that mRNA vaccines were particularly excellent for boosting the immune system’s response. So maybe the coronavirus was lower-hanging fruit for mRNA technology.Thompson: This is why it’s so important to fund different kinds of vaccine technology. Different tools work for different problems, and there’s no guarantee that mRNA will be the perfect tool for the next epidemic.I want to ask about the other mRNA vaccines you’re working on. Let’s start with malaria. This year, Yale researchers patented an RNA-based technology to vaccinate against malaria. Reuters reported that you plan to start clinical trials for a malaria vaccine by the end of next year. Why do you think mRNA is a good candidate for malaria?Şahin: Malaria is a field where scientists have been working for decades. This is a pathogen with many escape mechanisms that have eluded other vaccine technologies. Our strategy is to identify new molecular targets that other scientists have overlooked. We are now testing more than 40 malaria-vaccine candidates in preclinical settings. We believe that mRNA vaccines could, if developed properly, provide a lot of opportunities to prevent infection and disease.Thompson: I also read that you recently dosed your first patient in a 200-person trial of a new cancer vaccine. How do your cancer vaccines work?Türeci: We have two types of mRNA vaccines for cancer. First, we have our off-the-shelf vaccines, where we’ve identified molecular features of tumors that are shared by many patients. These are molecules that are broadly present in cancer cells but not in normal cells. By targeting these molecules, you can fight the cancer without getting collateral damage to healthy cells. Second, we have highly personalized vaccines. We identify cancer mutations that are unique to every patient. Every cancer patient has their own mutations, like a fingerprint. We biopsy the tumor, sequence it, and design a unique, individualized vaccine for each patient.For both types of therapies, we have shown, in early clinical trials, that they are safe and that the tumors shrink. We have moved our vaccine development into Phase 2 trials for melanoma and head and neck cancers. We have also started our treatment for individualized vaccines for high-risk colorectal cancer.Thompson: So you’re working on two types of cancer vaccines. Are they meant for different kinds of cancers?Şahin: For personalized vaccines, we’ve come to think that focusing on the stage after surgery might be best. After surgery to remove a tumor, about 60 percent of patients are cured. But 30 to 40 percent see regrowth of that tumor. Certain cancers, like lung and liver cancer, are particularly likely to relapse post-surgery. mRNA vaccines could be perfectly suited to block this recurrence by specifically targeting the molecules associated with regrowth and metastasis.Thompson: Given that vaccines historically have taken years to be developed, how fast can you reasonably produce an individualized cancer vaccine?Türeci: mRNA technology is fast enough that we can really accelerate this turnaround time. From tumor biopsy to delivery, we can do this in four to six weeks. Every production of an individualized vaccine is a race against that patient’s tumor.Thompson: How promising are the data so far?Şahin: We have hundreds of patients worldwide, and the data in the early trials are convincing. That’s why we’ve moved to Phase 2 trials. But it’s important to say that the Phase 2 stage is where we have to prove that our therapy beats the standard of care that the patient would otherwise get. It would only be scientifically sound to gauge the vaccines after this head-to-head comparison. We think we can make major advances in the next five years, but it really depends on what these Phase 2 studies show us.
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theatlantic.com
The New Lost Cause
One of my favorite things about covering political rallies is that they typically start with a recitation of the Pledge of Allegiance. For anyone above school age, occasions to recite the pledge with a large group of people are irregular, and the ritual serves as a good reminder of what politics is about at its best, no matter how divisive what follows might be.The pledge at a rally for the Republican gubernatorial candidate Glenn Youngkin in Virginia on Wednesday night was different. At the beginning of the event, which Steve Bannon hosted and Donald Trump phoned into, an emcee called an attendee up onstage and announced, “She’s carrying an American flag that was carried at the peaceful rally with Donald J. Trump on January 6.” Attendees then said the pledge while facing the flag. (Youngkin didn’t attend, and later tepidly criticized the moment.)This is a bizarre subversion. The pledge affirms allegiance to the republic, indivisible and offering justice to all. This flag was carried at a rally that became an attack on the Constitution itself: an attempt to overthrow the government, divide the country, and effect extrajudicial punishment. Elevating this banner to a revered relic captures the troubling transformation of the events of January 6 into a myth—a New Lost Cause. This mythology has many of the trappings of its neo-Confederate predecessor, which Trump also employed for political gain: a martyr cult, claims of anti-liberty political persecution, and veneration of artifacts.Most of all, the New Lost Cause, like the old one, seeks to convert a shameful catastrophe into a celebration of the valor and honor of the culprits and portray those who attacked the country as the true patriots. But lost causes have a pernicious tendency to be less lost than we might hope. Just as neo-Confederate revisionism shaped racial violence and oppression after the war, Trump’s New Lost Cause poses a continuing peril to the hope of “one Nation under God, indivisible, with liberty and justice for all.”In the immediate aftermath of the failed January 6 insurrection, Trump flailed in his efforts to interpret the day’s events. He praised the participants even as the riot was ongoing, saying, “Go home; we love you.” He insisted (despite ample video footage) that what had happened was a peaceful protest—some demonstrators were pacific, while many others were not—though he has also falsely claimed that antifa and Black Lives Matter had instigated a riot. He praised the protesters for courageously fighting back against what he insists, again falsely, was a stolen election, but also criticized police for using excessive force.Out of this murk, a unified mythology has begun to form. Trump hasn’t so much resolved the contradictions as transcended them. To him and his movement, January 6 was a righteous attempt by brave patriots to take back an election stolen from them. The day’s events produced a martyr—Ashli Babbitt, an Air Force veteran shot and killed by a Capitol Police officer as she tried to enter the Speaker’s Lobby of the House. The rioters who remain imprisoned, meanwhile, are “political prisoners.” Now objects carried that day have become sacred too.[David A. Graham: Donald Trump’s lost cause]During his term as president, and especially during its last summer, Trump—though a lifetime New York City resident—celebrated the Confederate battle flag, praised Robert E. Lee’s generalship, and defended statues honoring Confederates. These statues were not erected immediately after the war. Rather, they first required the creation of the “Lost Cause” mythology late in the 19th century. As the law professor Michael Paradis wrote in The Atlantic, the Lost Cause recast the Confederacy’s humiliating defeat in a treasonous war for slavery as the embodiment of the Framers’ true vision for America. Supporters pushed the ideas that the Civil War was not actually about slavery; that Robert E. Lee was a brilliant general, gentleman, and patriot; and that the Ku Klux Klan had rescued the heritage of the old South, what came to be known as “the southern way of life.” Many of the monuments themselves were put up at times of conflict over civil rights for Black Americans. They took on a quasi-religious cast. At Washington and Lee University, where Lee served as president after the war, the chapel features a recumbent statue of the general where a church would typically have an altar. The building where General Stonewall Jackson was taken and died after being wounded at Chancellorsville was preserved, first by a local railroad and then by the National Park Service, and until 2019, was known as the “Stonewall Jackson Shrine.”After Congress decided in 1905 to send back flags captured during the Civil War to their home states, Virginia placed the ones it received in a Richmond museum that, as Atlas Obscura describes, “began as a shrine to the Confederate cause, filled with memorabilia sourced from Confederate sympathizers.” To Lost Cause adherents, these flags were hallowed because they had been carried by the boys in gray as they bravely fought against Yankee aggression.[From the June 2021 issue: Why Confederate lies live on]The paradigmatic moment for the Lost Cause myth is Pickett’s Charge at the Battle of Gettysburg, a bloody, hour-long Confederate onslaught later called “the high water mark of the rebellion.” As my colleague Yoni Appelbaum wrote in 2012, the label was unearned. The charge was a disaster, as was immediately clear to Lee, who told the survivors it was his fault. Its fate did not change the outcome of the war or even necessarily the Battle of Gettysburg. Though the assault was initially apotheosized by a pro-Union artwork, it was soon adopted by Lost Cause proponents as a moment of valor. “For every Southern boy fourteen years old, not once but whenever he wants it, there is the instant when it’s still not yet two o’clock on that July afternoon in 1863,” William Faulkner wrote in 1948.Like Pickett’s Charge, the January 6 insurrection was a disastrous error. It did nothing to prevent Congress from certifying Joe Biden’s election, and, in fact, several Republican members who had planned to object to the results decided against doing so after the riot. It got Trump impeached, a second time, and further tarnished his reputation, which hardly seemed possible.Martyrdom is not necessarily nefarious, and some who die in battle do deserve veneration. Some heroes deserve veneration. Answering Stonewall Jackson, the Union had its own martyrs, such as Elmer Ellsworth. Ashli Babbitt’s death was awful. It was perhaps unnecessary for Lieutenant Michael Byrd to open fire, and it was certainly unnecessary for her to be in the Capitol that day, where she died in the name of lies that Trump and others had told her. As the journalist Zak Cheney-Rice writes, Trump’s aggrandizement of her death is rooted not in any genuine affection—he is largely incapable of caring about anyone but himself—but in opportunism.The problem with these myths, the Lost Cause and the New Lost Cause, is that they emphasize the valor of the people involved while whitewashing what they were doing. The men who died in Pickett’s Charge might well have been brave, and they might well have been good fathers, brothers, and sons, but they died in service of a treasonous war to preserve the institution of slavery, and that is why their actions do not deserve celebration.The January 6 insurrection was an attempt to subvert the Constitution and steal an election. Members of the crowd professed a desire to lynch the vice president and the speaker of the House, and they violently assaulted the seat of American government. They do not deserve celebration either.
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theatlantic.com