Wednesday, August 13, 2014

The Challenger: Can Shenna Bellows ’97 stun the political establishment by upsetting an entrenched incumbent and winning a U.S. Senate seat in Maine?

Published in Middlebury Magazine

Shenna Bellows ’97 is cold. This is not the sort of brief chill that passes now and again: It’s the deep, bone-shaking kind that both racks her slight frame and causes others nearby to shiver in sympathy. I am surprised for two reasons: First, Shenna knows Maine weather well. She grew up here, in a house that didn’t get electricity or running water until she was in fifth grade. When she and her siblings got home from school, their chore was to relight the woodstove. As often as not, though, they would huddle under the bedclothes, doing their homework until their parents got home. It is also surprising because the feeling she usually exudes is not contagious cold but rather infectious, friendly warmth.
Right now, though, Shenna is freezing. We have just gotten in the car after an election-campaign visit to Mount Desert Island Biological Laboratory, right on the Maine coast. She didn’t check the weather this morning and didn’t bring a coat on this blustery, sprinkling spring day.
As the heat comes on in the car, she settles into the backseat; her staffer-driver and I ride up front to give her space to work. She stops shivering, takes off her shoes, tucks her feet under her, and resumes her most frequent activity: typing on her iPhone.
Sending texts and emails whooshing into the ether is key to Shenna winning what she admits is “an uphill battle” against United States Senator Susan
Collins, a three-term Republican incumbent with a big bankroll, who is widely expected to win handily. Even more crucial will be Shenna’s idea of what a candidate and a campaign can be.
Her vision has paid off before. While heading the American Civil Liberties Union of Maine, she co-led the 2012 statewide same-sex marriage referendum that made Maine the first state to approve marriage equality at the ballot box. (Maryland did the same that day.)
The ACLU of Maine lobbied for and won major legislative victories too: passing a first-in-the-nation law requiring police to get a warrant before tracking suspects with cell-phone data, defending transgender Mainers’ rights, limiting police use of drones, and protecting women’s reproductive health rights.
She is still campaigning—and gaining national media attention and donations—for civil-rights protections, economic opportunity and justice, constitutional freedoms, and environmental protection. She is bringing together what she calls “an unusual coalition” of people who, like her, hold positions that transcend stereotypical political divides.
On the left of most Democrats, she backs universal single-payer health care, legalizing marijuana, “bold, visionary action” on climate change, and student-loan debt reform as a means to boost the economic prospects of young college graduates, who face the toughest job market in decades.
In the middle, she supports Internet neutrality and equal pay for women.
And well to the right—at times on turf occupied only by the libertarian wing of the Republican Party—she insists on ending the National Security Agency’s domestic-spying program and repealing the USA PATRIOT Act.
We have been friends for years; when she asked me what I thought would be the hardest thing about her running, I told her she would have to ask people for money not to support a cause, but to back her.
***
As a Peace Corps volunteer in Panama from 1999 to 2001, Shenna helped give microloans to artisans in a remote community. And, more recently, as executive director of the ACLU of Maine for more than eight years, she was responsible for raising its annual budget of around $750,000, as well as for contributions to the various campaigns the group joined.
But even now, Shenna is not running for herself. She says that she wants her candidacy to be viewed as a revolutionary rethinking of how campaigning—and politics—can and should work. And her plan for victory is very much like her previous public-service efforts, most notably that 2012 same-sex marriage campaign.
Then, supporters had hundreds of thousands of individual conversations with their friends, neighbors, and communities, making personal connections to explain the importance of marriage equality. The strategy gave backers strong talking points they could repeat in their own words, multiplying the effectiveness of the campaign’s direct appeals to the broader public.
Shenna’s fundamental idea, one adopted by few on the left (though many on the far right), is that elections can be won by the power of human connection and fidelity to one’s ideals. (And integrity. Having spent years working for marriage equality, she refused to get married until all Maine couples could; her September 2013 emailed wedding announcement ended with a request: “And please… no gifts. For real,” with a link to the Federal Election Commission’s campaign-finance rules.)
And she believes that beyond being funded by small, individual donations for regular-person candidates (which Tea Party candidates espoused), campaigns should be staffed by actual humans, who have real lives and families amidst the fray.
Hearing Shenna talk about both unseating Maine’s senior senator and upending a broken electoral system is strange not because it’s so divergent from cynical national political punditry, nor because critics might call it naïve, but because it’s oddly empowering. It sounds rational, reasonable, possible. It’s an idea whose time, like Shenna’s, may at long last have come.
The execution of Shenna’s impossibly possible candidacy is being shepherded by campaign manager Katie Mae Simpson ’02, a native of rural Washington County, Maine. She’s the type of person for whom political science was too philosophical a major; religion was not.
A lifelong progressive activist and campaigner, Katie Mae was on maternity leave with her second child when Shenna came to her house to ask her to run the campaign. She declined; an all-consuming job running a campaign for U.S. Senate was not compatible with meeting the needs of her young family.
So Shenna went to work employing those skills of connection and persuasion that would go on to make her such an attractive candidate. She told Katie Mae that she wanted her to embody the campaign’s beliefs, to be the standard bearer for a candidacy based on fairness and equality and concern for the everyday Mainer. (To that end, all Shenna’s campaign workers are paid above minimum wage and have health-insurance benefits.)
“The pop culture picture you get of politics is not right for 99 percent of people,” Katie Mae says. So Shenna’s campaign manager (yes, she was quickly persuaded to join the campaign) has set out to reclaim it for the rest of us, which can include breastfeeding her son while conducting an interview. Two other campaign staffers are working mothers whose partners also work full time. Striking a balance is important—teammates who are exhausted from the spring’s battles are of little use come fall’s crunch time.
The same is true of the candidate herself. Her husband, Brandon Baldwin ’98, initially shielded himself from the campaign, hoping to create a refuge where Shenna could escape from the 12-plus-hour-days, seven-days-a-week effort. It wasn’t that he didn’t want Shenna to run— quite the opposite. He’s been supportive of her ambitions ever since she revealed on their fourth or fifth date in 2009 that she was going to run for U.S. Senate some day, possibly soon.
A watershed moment came in February 2012. With the announcement that Olympia Snowe would not run for a fourth Senate term that fall, Maine’s political circles went into a frenzy, handicapping potential successors to the state’s senior senator.
Shenna took a week of unpaid leave from the nonpartisan ACLU to explore her options. But then former independent governor Angus King joined the race (ultimately winning Snowe’s seat handily). Shenna went back to the ACLU, but with a new fire inside.
What surprised her husband about that week was how enthusiastic he felt about the prospect of her being a candidate. It was a powerful realization. “It didn’t feel like it was taking you away from me,” he tells her during a joint interview.
Though removed from the campaign at first, Brandon has slowly become more involved. “It’s tapped into everything that I hold to be important,” he says, admitting that her candidacy has awakened his “somewhat dormant love of politics.” He spoke on Shenna’s behalf at caucuses and house parties, where he would write “campaign spouse” on his nametag sticker. Crucially, he has found himself able to disengage, too. So has she.
“We take one day a month that is our day,” Shenna says. They hike, read, watch movies, sleep in, relax. It’s a private—and vital—aspect of the campaign they both say.
During this joint interview, Shenna suddenly stands up and walks to the fridge, retrieving a card that has been hanging there since she started campaigning. On the front is an inspirational quote: “Be the change you wish to see in the world.” It is a note from Shenna to herself.
Brandon is surprised: He has seen the card daily for months, without realizing there was a message inside. Shenna wrote herself resolutions as she began the campaign. Highlights include “have fun,” “be your authentic self,” and, finally, what Shenna declares as “the most important rule of this race: ‘Love matters most.’”

***
Love is a strange value to want to bring to Washington, D.C. Congressman Mike Michaud, a Democrat now running to be Maine’s next governor, says that Shenna would do well in the nation’s capital, working hard to forge connections in spite of the heightened partisanship that has infected the city.
Shenna says that she’d bring activist organizing tactics to Congress, meeting with lawmakers as a colleague, while facilitating conversations between legislators and regular citizens. She wants other legislators to hear about the mother Shenna met who is a student and has a full-time job, but still can’t cover all of her bills. “She eats one meal a day so her son can eat three,” Shenna says, tearing up.
At a recent political rally, a woman told Shenna her house had just been foreclosed upon. And there she was, offering to volunteer for Shenna’s campaign, hoping for change. “There are people who are persevering in really horrible situations,” Shenna says. “That is humbling.”
Shenna’s personal touch goes a long way. On an evening in Lewiston, in a room full of Democratic supporters, Shenna makes sure to talk to each one, working the room with a smile, a ready hug for friends, and a laugh audible across the gathering. At one point she leaps with joy and shouts “Yay!” The next second, she regains composure and says soberly, “I’m sorry. That wasn’t very senatorial.” But she is beaming: She has just learned that she was endorsed by the Maine People’s Alliance, a statewide progressive grassroots organization.
Her support is broader, though. Chuck Quintero, the director of the Maine Democratic Party’s coordinated statewide campaign, says of Shenna’s appeal across the political spectrum: “She kind of puts a wrench in our partisan politics. . . .We have to reach out to lots of people we might not otherwise.”
Just hours before Quintero’s half-complaint, some party faithful were lamenting—to Shenna’s face—her insistence on meeting with people she often disagrees with. Shenna had begun the day sparring amiably with popular Maine conservative Ray Richardson on his talk-radio show. Long a fan of Shenna’s, particularly on privacy and limited-government issues, he has announced on the air that he is not voting for Collins. (Cagily, he hasn’t endorsed Shenna—yet.)
Alienation and division get in the way of the important work she wants to do, Shenna says. When she learned that independent U.S. Senator Angus King was about to endorse Collins, Shenna was gracious, but worked to defuse any partisan angst. Moving quickly, she set up interviews on early morning TV and radio programs, so viewers and listeners would hear the news from her. It defused a problem political commentators might have harped on for months.
While still firmly in underdog territory, Shenna’s campaign is on solid footing. She outraised Collins in the first quarter of the race and has already hit $1 million in total fundraising, with the vast majority of that money coming from Maine residents giving under $100.
It’s late May, and Shenna and I are heading south on I-295 when we spot a “Shenna Bellows – U.S. Senate” bumper sticker on a car ahead of us.  As we pass it, she looks carefully at the driver and exults, half-kidding: “And I don’t even know him!” The driver must be a big fan: Our rear-view mirror shows a Bellows sticker on the front bumper too.
***

Though Shenna is still a relative unknown, those who know her like her—indeed, many Mainers agree with her positions on key issues, and, perhaps more important, disagree with Collins. Tasked with becoming better known every day, she is giving a nod to a state political tradition of sorts: She has planned a month-long, 350-mile walk across Maine to draw media attention and connect more directly with all stripes of voters.
Being the underdog energizes her. “The only way to win is to outwork my opponent. The only way to do that is to organize and inspire,” she says.
Brandon chimes in: “Then if you win, it’s an endorsement” of that approach by the voters. “It’s the best possible way to win.”
It is a winning strategy, whether Shenna beats Collins or not, says Geoffrey Skelley, associate editor of Sabato’s Crystal Ball, an election analysis website at the University of Virginia’s Center for Politics that calls Collins’s seat safe.  Skelley points out in an email that though Maine leans Democratic at the federal level and despite Republicans’ national image problems, Collins’s reelection margins have been high. “In a midterm cycle with a Democrat in the White House, Republicans are naturally positioned to do better,” he says. “About the only way to change that would be for a scandal to develop that centrally involves Collins.”
Nevertheless, Skelley sees a silver lining for Shenna. “While she may deny this, a failed Senate run against a powerful politician like Collins may serve as a stepping stone for her political future,” he says. “If Bellows acquits herself well enough in a difficult race where she stands little chance to win, she might get another electoral shot in the future in more favorable circumstances.”
For the long term, Shenna believes her campaign is on “the right side of history” on the crucial issues facing the nation and the world. But the short term is here. And she is hoping two parallels in Maine’s political history are on her side. In 1964, the unsinkable Republican senator Margaret Chase Smith was beaten by Democrat Bill Hathaway. And more recently, Angus King entered the governor’s race as a relative unknown, and beat, yes, Susan Collins.
“A lot can happen between June and November,” Shenna says.

Monday, July 14, 2014

What's "The Best" Way to Get from Point A to Point B?

Would you rather take a five-minute walk on crowded sidewalk next to four lanes of honking traffic on a clogged urban artery, or a seven-minute stroll down the leafy neighborhood street two blocks over?

Much of the time, we determine “the best” way to get somewhere as a function of either time or distance – seeking out the fastest drive, the nearest bus stop, or the shortest walk, for example. We ask ourselves if it is quicker to drive or walk, or whether it’s easier to ride or take the subway.

If speed is your thing, then check out the latest installment in the You Are Here series at the MIT Media Lab’s Social Computing Project. The new package, called “Best Mode of Transportation,” still defines “best” as “fastest,” but it offers a data-driven comparison of modes, against which we can check our mental calculations.

The results might surprise you. As Emily Badger writes on the Washington Post’s Wonkblog, “Cycling is a much more efficient mode of transportation than many people realize. And transit is startlingly not so. Seldom will it get you farther, faster, than a bike will.”

Behind bicycling, driving is nearly always the second-fastest way to get most places within cities. Transit is, for the most part, a distant third. This does vary by location – the Manhattan model shows the substantial impact of a dense transit network (as well as the effect of an urban corridor that is extremely long and very narrow).

But for most of us, at least sometimes, speed isn’t always the top consideration.

If beauty is your thing, Yahoo Labs in Spain tells us how we can be less concerned with arrival, and more focused on enjoying the trip.

Instead of determining the fastest route, these researchers have found a way to measure the most beautiful (or quietest, or even happiest) paths between destinations. It involves a lot of crowdsourcing, including data-mining Flickr (which is owed by Yahoo) for geotagged photos and then measuring the moods of words those photos have been tagged with. You can read the full paper here, and a less technical description here, but the high-level message is that it is often possible to find a route from where you are to where you want to be that will be significantly more enjoyable to travel, and only slightly longer than the fastest way.

There are other factors in play in choosing how to get from point A to point B, of course. Not only might different people make different choices based on their own tendencies, but given other aspects of the decision (such as cost, safety, personal comfort, reliability, where you have to go next), you might yourself choose different priorities on different days or at different times of day.

We should aspire to give people choices that enable as many of them as possible to have their desired outcome, whether that is a fast arrival, a quiet stroll, a scenic bike ride, or something else altogether. If these two data-driven approaches can be combined, it might just give us the ability to design transportation options that strike the right balance among all the various attributes that travelers are looking for when taking a trip.

Thursday, May 15, 2014

New Science on Sea-Level Rise Is a Call to Immediate Action

The announcement Monday that several key glaciers that form part of the West Antarctic Ice Sheet are in an irreversible cycle of melting, and will raise global sea levels significantly by the end of the century and disastrously over the course of several centuries, was widely reported. As it should have been, given the effects global warming are having, and will continue to have, on life here on Earth.
But none of the coverage I saw included the fact that parts of the Greenland Ice Sheet had entered the same sort of cycle as much as a decade ago. In fact, just one glacier – the Jakobshavn Isbrae – on its own contributed 3 percent of worldwide sea-level rise over the past 10 years.

Back in March, when I was working as a freelance journalist, I interviewed the two scientists whose research is central to yesterday’s announcement, and found them both concerned about what their data were showing.

There is uncertainty about just how quickly these cycles can move. Exposure to ocean currents and warming waters dramatically accelerates calving and melting of glaciers, in part because the water pushes the ice around, whether it is floating or grounded on the sea floor.

As a result of these effects, Jakobshavn, for example, has tripled its speed toward the ocean in 20 years. You might have seen this glacier calve in the 2012 film Chasing Ice: It was the glacier that calved a mile of ice in a single event, a scene spectacular in its power and scary in its import for those of us who live near the ocean.

Eventually, perhaps in about 100 years, Jakobshavn will retreat so far that it will be landlocked and no longer a significant contributor to sea-level rise. But the topography beneath the West Antarctic Ice Sheet glaciers is very different, getting farther and farther below sea level as one moves toward the center of Antarctica, meaning that as the glaciers retreat their exposure to the melting and calving effects of the ocean will only grow. They will only melt faster and faster, until they are entirely gone.

These are only some of the effects of global warming that are already in the pipeline, resulting from emissions we have already released into the atmosphere. Monday’s announcement is a crucial reminder that we must both adapt to the changes that are already inevitable, and step up our efforts to forestall the even more calamitous and rapid changes scientists warn are in store if we fail to reduce our emissions of greenhouse gases.

Wednesday, April 9, 2014

Making clinical trials more diverse

Published in Drug Discovery News

WASHINGTON, D.C.—Hoping to expand both statistical validity of clinical trials and access to experimental therapies beyond their current confines, major medical-industry players have united to launch a campaign called “I’m In,” encouraging minorities and their doctors to find out about, and participate in, clinical medical-research trials.
 
While encouraging African Americans, Asian Americans, Hispanics and members of other ethnic groups to join medical research, speakers at a March 12 press event announcing the initiative were cognizant of the shadow of the Tuskegee syphilis experiments, an unethical and long-condemned study of the spread of untreated syphilis in African-American men that ran from the 1930s to the 1970s.
 
While Dr. Carlos Cardenas, board chairman of Doctors Hospital at Renaissance in Edinburg, Texas, alluded more vaguely to the idea of “removing any and all stigma that is associated with being part of a clinical trial,” another speaker, Averl Anderson, a breast-cancer survivor and participant in clinical trials, mentioned Tuskegee by name as a reason “people have a lot of mistrust in medical research”—particularly in the African-American community, she said.
 
But they and others representing a range of partners in the new campaign stressed the importance of broadening participation.
 
“These breakthroughs do not happen on their own,” said John Castellani, president and CEO of Pharmaceutical Research and Manufacturers of America, but rather rely “very heavily on volunteer participation in clinical trials.”
 
Years of work by the pharmaceutical industry to increase diversity in trials have not borne the hoped-for fruit: “African Americans, Asian Americans, and Hispanics are still dramatically underrepresented in clinical trials,” he said.
 
As Castellani said, “the future of medicines is going to be aimed more and more at genetically homogeneous populations,” which means drawing more from minority populations to properly test drugs—especially those aimed at diseases those populations suffer from disproportionately.
 
For example, prostate cancer is twice as fatal for African Americans as Caucasians, according to material distributed in advance of the campaign kickoff—and yet only 4 percent of prostate-cancer clinical trial participants are African American. Cancer is the top cause of death for Asian Americans, but just 2.8 percent of cancer trials patients are Asian American. And despite the higher prevalence of diabetes in the Hispanic population, only 1 percent of all trial members are Hispanic.
 
Based on early glimpses, the campaign is centering on personal connections to family members and the wider community of each minority group. A video promoting the effort included lines like “It’s not enough to wait for someone else to act” and “We all have a responsibility to each other and future generations.”
 
Gary Puckrein, president and CEO of the National Minority Quality Forum, noted that by 2020, more than half of Americans will be members of groups now called “minorities,” leading him to argue that “underrepresentation of minorities affects everyone.”
 
He said this is a campaign to help test “medicines for a biodiverse America.”
 
Cardenas offered an example: When he started practicing medicine, there was just one medication for hypertension; he noticed, though, that it didn’t work the same in people with Hispanic backgrounds as it did in those with non-Hispanic heritage.
 
“How are we to know how our patients will respond to these medications?” he asked. “It’s something we should not leave to chance.”
 
Anderson, for her part, said she is a five-year breast-cancer survivor. She was diagnosed in 2009 with stage three, triple-negative cancer, “a very aggressive form of breast cancer that’s common in African-American women.” Her doctor suggested she participate in a trial, which she credits with her survival.
 
That’s another key element beyond encouraging individuals to participate, said Dr. Ho Luong Tran, founding president and CEO of the National Council of Asian Pacific Islander Physicians.
 
“As physicians we must recognize our role as trusted healthcare providers,” she said. Doctors “owe it” to their patients to “share all possibilities” for treatment, including clinical trials. She said more than two-thirds of Americans report being likely to join a clinical trial if their doctor suggests it, but only 22 percent of people say they have had such a conversation.
 
Citing statistics that 38 percent of Hispanics, 36 percent of Asian Americans, 33 percent of African Americans and 42 percent of non-Hispanic whites say doctors have the greatest impact and the greatest responsibility to talk about trials and research, Tran called on her fellow doctors to learn about, support and encourage their patients to join trials. “If we don’t talk to them about clinical research, few others will,” she said.
 
Puckrein said the website for I’m In, at www.JoinImIn.org has options to register as a member of the public, an interested doctor, and even as a trial researcher, to allow all three groups to connect with each other more efficiently.

Merck HIV therapies make big news at CROI

Published in Drug Discovery News

NEW YORK—Two separate HIV therapies manufactured by Merck, one new and the other a groundbreaking favorite from the past, had big announcements at the 21st Conference on Retroviruses and Opportunistic Infections in early March.
 
It was just a peek at the newcomer, doravirine (MK-1439), looking at data from the first 24 weeks of the first part of a two-segment 96-week trial comparing doravirine to the current standard of care, efavirenz (Bristol-Myers Squibb’s Sustiva).
 
“This study is really the first data we have,” apart from a very small, very short monotherapy study, said Dr. Hedy Teppler, executive director, infectious diseases at Merck Clinical Research, who was also an investigator on the trial.
 
This was a Phase 2 trial (Phase 3 will come later in 2014), in which a range of once-daily doses, 25 milligrams, 50 mg, 100 mg and 200 mg, were used in combination with once-daily doses of emtricitabine/tenofovir disoproxil fumarate, Gilead Sciences’ Truvada.
 
“It certainly performed at least as well as efavirenz,” she tells DDNews. Merck is hoping doravirine will be better in terms of both tolerability and potency that existing drugs, and with less central nervous system toxicity.
 
“Each dose compared well,” according to Teppler—in fact, the data didn’t distinguish one dosage as being more effective than the others. Additional information, though, led to the choice of 100 milligrams to be the dose for the remainder of the 96-week trial and other further studies.
 
Teppler says those factors included providing a reasonable dosage level to discover potential negative drug interactions, and to explore the drug’s overall usefulness.
 
“Choosing the 100-milligram dose should protect against needing to do any dosage adjustment,” Teppler says.
 
For those not candidates for efavirenz (such as women of child-bearing age or people with central nervous system issues), another study offers hope. Merck’s drug Isentress (raltegravir), the first integrase inhibitor approved by the FDA (in 2007), featured in a new study by the AIDS Clinical Trials Group. It compared Isentress given twice daily against atazanavir (Bristol-Myers Squibb’s Reyataz) and darunavir (Tibotec’s Prezista), both given once daily. (All patients also got Truvada daily.)
 
While Merck itself had looked at Isentress versus efavirenz, and found positive results, the ACTG “felt there was a need to look at options in patients who were not candidates for efavarinz,” said Randi Leavitt, senior director, clinical research, global clinical development—infectious disease at Merck, such as women of childbearing age or people with central nervous system issues.
 
The 96-week ACTG study (ACTG 5257) looked at 1,800 treatment-naive patients, a quarter of whom were women, 34 percent non-Hispanic white, 42 percent non-Hispanic black and 22 percent Hispanic.
 
The study found encouraging news for Merck, Leavitt tells DDNews. First, “all three regimens were basically equivalent with regard to efficacy.” But when combining that result with tolerability, “raltegravir was superior to the other two regimens.”
 
And while Isentress has been criticized for being a twice-daily medicine up against once-daily competitors, the results showed that “if the drugs are well tolerated, people will be compliant with a twice-a-day regimen,” Leavitt said.
 
Nevertheless, the company is working on a reformulation to make a once-daily 1,200-mg dose available. That follows on the 2011 report of the failure of tests of an 800-mg daily dose; Leavitt said those results “provided a lot of information” that have improved expectations for the new formulation.