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Anabolic steroids in a syringe — Simon Hausberger / Getty

A Warning From a Doctor Who Has Done Thousands of Steroid Injections for Arthritis

James Hamblin

The extremely common treatment might be causing more harm than previously thought.

After giving birth to a baby, a young woman told her nurses at Boston Medical Center that she was having pain in her hip. That happens sometimes after births, says Ali Guermazi, one of the doctors involved. As he recounts the case from a few years ago, he looked at X-rays and saw a small amount of extra fluid in the joint. Otherwise things looked normal. “We injected her hip with steroids, hoping to help with the pain,” Guermazi says. They seemed to help, and the women went home with her baby.

Guermazi didn’t think more of it until the woman returned to the hospital six months later, unable to walk. “The head of her femur was gone,” says Guermazi, who is now the chief of radiology at VA Boston Healthcare System. The bone appeared to have simply vanished. The new mother needed a total hip replacement. “We didn’t know what happened, and still can’t know for certain,” Guermazi says. “But I feared it was related to the injection.”

Why You Never See Your Friends Anymore

Judith Shulevitz

Our unpredictable and overburdened schedules are taking a dire toll on American society.

Just under a century ago, the Soviet Union embarked on one of the strangest attempts to reshape the common calendar that has ever been undertaken. As Joseph Stalin raced to turn an agricultural backwater into an industrialized nation, his government downsized the week from seven to five days. Saturday and Sunday were abolished.

In place of the weekend, a new system of respite was introduced in 1929. The government divided workers into five groups, and assigned each to a different day off. On any given day, four-fifths of the proletariat would show up to their factories and work while the other fifth rested. Each laborer received a colored slip of paper—yellow, orange, red, purple, or green—that signified his or her group. The staggered schedule was known as nepreryvka, or the “continuous workweek,” since production never stopped.

Brendan McDermid / Reuters

The Not-Com Bubble Is Popping

Derek Thompson

The unicorn massacre unfolding today is exactly the opposite of what happened in 2000.

It is easy to look at today’s crop of sinking IPOs—like Uber, Lyft, and Peloton—or scuttled public offerings, like WeWork, and see an eerie resemblance to the dot-com bubble that popped in 2000.

Both then and now, consumer-tech companies spent lavishly on advertising and struggled to find a path to profit.
Both then and now, companies that bragged about their ability to change the world admitted suddenly that they were running out of money.
Both then and now, the valuations of once-heralded tech enterprises were halved in a matter of weeks.
Both then and now, there was a widespread sense of euphoria curdling into soberness, washed down with the realization that thousands of workers in once-promising firms were poised to lose their jobs.

Uber Eats worker — Carlos Jasso / Reuters

The Millennial Urban Lifestyle Is About to Get More Expensive

Derek Thompson

As WeWork crashes and Uber bleeds cash, the consumer-tech gold rush may be coming to an end.

Several weeks ago, I met up with a friend in New York who suggested we grab a bite at a Scottish bar in the West Village. He had booked the table through something called Seated, a restaurant app that pays users who make reservations on the platform. We ordered two cocktails each, along with some food. And in exchange for the hard labor of drinking whiskey, the app awarded us $30 in credits redeemable at a variety of retailers.

I am never offended by freebies. But this arrangement seemed almost obscenely generous. To throw cash at people every time they walk into a restaurant does not sound like a business. It sounds like a plot to lose money as fast as possible—or to provide New Yorkers, who are constantly dining out, with a kind of minimum basic income.

‘Get Over It’

David A. Graham

The administration has a single answer for every question about its policies and behavior.

Who knows what acting Chief of Staff Mick Mulvaney had in mind when he stepped to a lectern in the White House briefing room Thursday? (Not Trump’s legal team, apparently.) Whatever his goal, Mulvaney delivered a succinct credo for both the Trump administration and the Trump 2020 campaign.

“I have news for everybody: Get over it,” Mulvaney said.

The specific context was Mulvaney’s peculiar decision to admit that, yes, the Trump administration had conducted a quid pro quo with the government of Ukraine—not for an investigation into the family of Joe Biden, Mulvaney insisted, but for a bogus conspiracy theory about Ukraine’s role in the hacking of the 2016 election.

“There’s going to be political influence in foreign policy,” Mulvaney chided reporters. “That is going to happen. Elections have consequences, and the foreign policy is going to change from the Obama administration to the Trump administration.”

Rendering by Patrick White; Andrew Harrer / Bloomberg / Getty

Jeff Bezos’s Master Plan

Franklin Foer

What the Amazon founder and CEO wants for his empire and himself, and what that means for the rest of us.

Where in the pantheon of American commercial titans does Jeffrey Bezos belong? Andrew Carnegie’s hearths forged the steel that became the skeleton of the railroad and the city. John D. Rockefeller refined 90 percent of American oil, which supplied the pre-electric nation with light. Bill Gates created a program that was considered a prerequisite for turning on a computer.

At 55, Bezos has never dominated a major market as thoroughly as any of these forebears, and while he is presently the richest man on the planet, he has less wealth than Gates did at his zenith. Yet Rockefeller largely contented himself with oil wells, pump stations, and railcars; Gates’s fortune depended on an operating system. The scope of the empire the founder and CEO of Amazon has built is wider. Indeed, it is without precedent in the long history of American capitalism.

President Donald Trump points his finger at the crowd at a recent 2020 campaign rally. — Brendan Smialowski / Getty

The Unraveling of Donald Trump

Peter Nicholas

As the impeachment inquiry intensifies, some associates of the president predict that his already erratic behavior is going to get worse.

The country is entering a new and precarious phase, in which the central question about President Donald Trump is not whether he is coming unstrung, but rather just how unstrung he is going to get.

The boiling mind of Trump has spawned a cottage industry for cognitive experts who have questioned whether he is, well, all there. But as the impeachment inquiry barrels ahead on Capitol Hill, several associates of the president, including former White House aides, worry that his behavior is likely to get worse. Angered by the proceedings, unencumbered by aides willing to question his judgment, and more and more isolated in the West Wing, Trump is apt to lash out more at enemies imagined and real, these people told me. Conduct that has long been unsettling figures to deteriorate as Trump comes under mounting stress. What unfolded Wednesday inside the West Wing’s walls might be only a foretaste of what House Speaker Nancy Pelosi described that day, after a meeting with Trump, as a presidential “meltdown.”

© Yongqing Bao / Wildlife Photographer of the Year

Winners of Wildlife Photographer of the Year 2019

Alan Taylor

Winning images from the annual photo competition produced by the Natural History Museum in London

The Wildlife Photographer of the Year competition, founded in 1965, is an annual international showcase of the best in nature photography. This year, the contest attracted more than 48,000 entries from 100 countries. Wildlife Photographer of the Year is developed and produced by the Natural History Museum, London. The owners and sponsors have once again been kind enough to share the following 15 winning images from this year’s competition. The museum’s website has images from previous years and more information about the current contest and exhibition. Captions are provided by the photographers and WPY organizers, and are lightly edited for style.

Democratic candidates — Aaron Josefczyk / Reuters

Democrats Are Hypocrites for Condemning Trump Over Syria

Peter Beinart

Presidential hopefuls blasted Trump for abadoning the Kurds—but want the U.S. to pull out of Afghanistan under similar conditions.

On Tuesday night, the Democratic presidential candidates vied with one another to offer the harshest condemnation of President Donald Trump’s abrupt withdrawal of American troops from northern Syria. Joe Biden called it “the most shameful thing that any president has done in modern history … in terms of foreign policy.” Elizabeth Warren said Trump “has cut and run on our allies,” and “created a bigger-than-ever humanitarian crisis.” Kamala Harris announced, “Yet again Donald Trump [is] selling folks out.”

Pete Buttigieg’s denunciation was the most personal. Recalling his military service in Afghanistan, the South Bend, Indiana, mayor asked whether America’s wartime allies would ever trust it again. “When I was deployed,” he declared, “not just the Afghan National Army forces but the janitors put their lives on the line just by working with U.S. forces. I would have a hard time today looking an Afghan civilian or soldier in the eye after what just happened over there” in Syria.

A young woman holds her neck in pain. — GBALLGIGGSPHOTO / Shutterstock

A Strange New Culprit Behind Eating Disorders

Olga Khazan

Common infections such as strep throat might have a mysterious link to anorexia and bulimia.

In 2007, Carlo Carandang, then an attending physician at a hospital in Halifax, Nova Scotia, saw a most unusual patient: an 8-year-old boy who had recently adopted some strange beliefs, all while losing 18 pounds. The boy thought that nurses were “evil,” and that he could inject other people with his fat cells simply by walking past them.

The boy’s symptoms had begun a few months prior. After his school held a lesson on healthy eating, he started to scrutinize food labels and avoid fat and carbs, according to Carandang, who now works as a data scientist. The boy worried that he was too fat, and he would examine his stomach in the mirror throughout the day. He grew suspicious of what his mother might be putting in his food and began preparing all of his own meals. Before long, he was eating just 200 calories a day.