This is an edition of Up for Debate, a newsletter by Conor Friedersdorf. On Wednesdays, he rounds up timely conversations and solicits reader responses to one thought-provoking question. Later, he publishes some thoughtful replies. Sign up for the newsletter here.

Question of the Week

What are your thoughts on cities versus suburbs?

Feel free to discuss their past, present, or future; their pluses and minuses; their respective roles in American life; or where you choose to live and why. As always, I encourage but do not require answers that draw on your own life experiences, so feel free to opine on specific cities or suburbs. And if nothing immediately comes to mind, perhaps the fodder below will prove inspiring.

Send your responses to conor@theatlantic.com

Conversations of Note

I grew up in the suburbs. And I have lived in the city––in New York City; Los Angeles; Washington, D.C.; Paris; and Seville, plus significant stretches in San Francisco, Munich, and Berlin.

I see the appeal of both kinds of places. My “hometown” of Orange County, California, is about as good as it gets for suburbia: It has the best stretch of beaches in Southern California and a significant immigrant population from Mexico, Vietnam, Korea, Japan, China, India, which provides cultural diversity—and also better food than many metropolises.. And my 20s and 30s happened to coincide with an urban renaissance that I didn’t see coming as an adolescent in the high-crime 1990s.

Gangsta rap, movies about the crack wars, and the Rodney King beating and the riots that followed were my earliest impressions of city life. Then I graduated from college in 2002 into a country where cities were suddenly safer than they’d been in a generation––and to the surprise of many, they kept getting safer and safer for years.

“No place feels so changed as the city of Los Angeles,” the journalist Sam Quinones wrote in late 2014. He explained:

In 2014, the Los Angeles Police Department announced that gang crime had dropped by nearly half since 2008. In 2012, L.A. had fewer total homicides (299) citywide than it had gang homicides alone in 2002 (350) and in 1992 (430). For the most part, Latino gang members no longer attack blacks in ways reminiscent of the Jim Crow South. Nor are gangs carjacking, assaulting, robbing, or in a dozen other ways blighting their own neighborhoods.

Quinones described the significance of the change this way:

This has amounted to an enormous tax cut for once-beleaguered working class neighborhoods. Stores are untagged, walls unscarred. Graffiti, which sparked gang wars for years, is almost immediately covered up. Once-notorious parks—El Salvador Park in Santa Ana, Smith Park in San Gabriel, Bordwell Park in Riverside are a few examples—are now safe places for families … The changes on Southern California streets over the last few years are unlike anything I’ve seen in my decades of writing about gangs. For the first time, it seems possible to tame a plague that once looked uncontrollable—and in doing so allow struggling neighborhoods, and the kids who grow up in them, a fighting chance.

Unfortunately, homicides in cities across the country spiked with the onset of the pandemic. Additionally, rising homelessness and addiction pose challenges to many city-dwellers’ quality of life.

In the Los Angeles Times, Rachel Uranga captures the consequences in a harrowing article about drug use and crime in L.A.’s public-transportation system:

Drug use is rampant in the Metro system. Since January, 22 people have died on Metro buses and trains, mostly from suspected overdoses—more people than all of 2022. Serious crimes—such as robbery, rape and aggravated assault—soared 24% last year...

“Horror.” That’s how one train operator recently described the scenes he sees daily. He declined to use his name because he was not authorized to talk to the media. Earlier that day, as he drove the Red Line subway, he saw a man masturbating in his seat and several people whom he refers to as “sleepers,” people who get high and nod off on the train.

“We don’t even see any business people anymore. We don’t see anybody going to Universal. It’s just people who have no other choice than to ride the system, homeless people and drug users.”

Commuters have abandoned large swaths of the Metro train system … For January, ridership on the Gold Line was 30% of the pre-pandemic levels, and the Red Line was 56% of them. The new $2.1-billion Crenshaw Line that officials tout as a bright spot with little crime had fewer than 2,100 average weekday boardings that month … The Los Angeles County Department of Public Health reported deaths linked to fentanyl rose from 109 in 2016 to 1,504 in 2021, amounting to a 1,280% increase.

Josh Barro argues in Very Serious that such transit-system woes in L.A. and elsewhere ought to be of greater concern to leftists who ostensibly want more Americans to live in cities and take public transportation. He writes:

People on the left have simply grown uncomfortable talking about the idea that crime—even less-serious crime—imposes significant social costs and requires policing and sometimes incarceration to address it. It’s more fun to talk about zoning. But this isn’t a problem that will be fixed with zoning. What’s needed on the subways is enforcement of rules: We need to go back to arresting people for illegal activity on transit, including fare-beating and for public drug use. If you’re using the subway as a place to sleep instead of as transportation, you’re trespassing. The subway is some of the most expensive and useful public infrastructure we have, and moving problems of homelessness and drug use and other disorder elsewhere, even into the streets, is not simply passing the buck—it’s moving the buck to a place where it imposes a lower social cost...

I realize that sounds cold, but letting homeless people and addicts take over the subway does not address problems of homelessness or addiction. It would be great if LA could move everyone without a home into permanent supportive housing, but the city has been unable to translate billions of dollars of taxpayer funds into an effective solution to the problem of homelessness. The immediate options facing LA are that it can have a terrible homelessness and addiction problem and a subway that people are willing to ride, or it can have a terrible homelessness and addiction problem and a subway that people are unwilling to ride. So far, the city is choosing the latter.

Meanwhile, in San Francisco, where I have personally had my car window smashed while it was parked overnight, S.F. local Snehal Antani took to Twitter last week to complain about how a colleague was treated while visiting the city:

A teammate visiting San Francisco for an offsite called me frantically last night. After dinner at Fisherman’s Wharf they came back to a smashed car window and 2 stolen backpacks. $10K in gear lost, passports gone, etc. … “Laptop bags were in the trunk, nothing visible from the street”, a typical description of a smash & grab, yet thieves were able to find the specific car and knew to pull the rear seat down and reach into the trunk… how?

I explained, “these aren’t homeless [randomly] smashing windows. These are professionals using blue tooth [sic] scanners to find laptop bags. And idle iPad, Bose headphones, etc all emit Bluetooth. And let me guess, it was the rear window facing the street, because thieves drive up to the car, open their door, then smash+grab. A witness must be directly behind the thieves [to] see anything, all other views are blocked.”

My teammate said his companion was on the phone with the police, to which I said, “they don’t care. Maybe they’ll show up in a few hours, they’ll likely make you go to the station, but this happens thousands of times per week.” [Editor’s note: According to San Francisco crime data from across 2022, thefts from vehicles averaged less than 400 a week last year.] So now I need to include a pre-visit security brief to people traveling San Francisco. This is a big reason I’m hesitant to open an office in the city versus keeping a remote team and occasionally meeting up at a location to whiteboard. And my teammates will be scarred forever, being robbed hits you at your core, especially when it’s thousands of dollars of loss. There is no downtown recovery without an aggressive push for safety @LondonBreed. The next mayor will win by running on a simple platform: 1, safe neighborhoods; 2, Clean Streets; 3, great public schools

In a series of replies (some of which have since been deleted), John Hamasaki, a former San Francisco police commissioner and a current district-attorney candidate, wrote:

Interesting. Would getting your car window broken and some stuff stolen leave you “scarred forever”?

Is this what the suburbs do to you? Shelter you from basic city life experiences so that when they happen you are broken to the core?

I’ve had my window broken 2x when I was living paycheck to paycheck. It sucked financially, but it had zero impact on my sense of public safety.

I can’t even imagine the world one must live in where this would be the most traumatizing incident in their life.

Again, not to say it doesn’t suck. But maybe city life just isn’t for you. It’s not the suburbs. There is crime.

I’m grateful most of it is property crime instead of violent crime. But I’ve always felt safe in San Francisco, even after being on the wrong side of violent crime.

Hamasaki also wrote, “Name a big city in the US where you can just leave 10k worth of stuff in your car? It’s not San Francisco these people hate, it’s cities.”

In UnHerd, Joel Kotkin suggests that, contra the wishes of urbanists, the suburbs are once again the future:

London, New York, San Francisco, Chicago, Los Angeles—these urban centres epitomised what Jean Gottmann described in 1983 as “transactional cities”. Based on finance, high-end business and IT services, they were defined not by production and trade in physical goods, but by intangible products concocted in soaring office towers. For years, academic researchers, both on the Left and Right, envisioned a high-tech economic future dominated by dense urban areas. As The New York Times’s Neil Irwin observed in 2018: “We’re living in a world where a small number of superstar companies choose to locate in a handful of superstar cities where they have the best chance of recruiting superstar employees.”

… Migration to dense cities started to decline in 2015, when large metropolitan areas began to see an exodus to smaller locales. By 2022, rural areas were also gaining population at the expense of cities. The pandemic clearly accelerated this process, with a devastating rise in crime and lawlessness: notably in London, Paris, Washington, New York, Los Angeles, San Francisco, Philadelphia and Chicago. In some parts of Chicago and Philadelphia, young men now have a greater chance of being killed by firearms than an American soldier serving during the Afghanistan or Iraq wars.

The fading allure of the big city—further undermined by the post-pandemic shift to remote work in many sectors—is also taking place against the backdrop of an urban economy that has increasingly rewarded the few ... almost a fifth of residents in the 50 largest US cities live below the poverty line. Contrast this with the historic role of cities as engines of upward mobility. Even the addition last year of a few thousand migrants forced New York Mayor Eric Adams to declare a state of emergency; in other words, New York, a city largely built on the labour of newcomers, now seems too weak to house and employ a substantial number of immigrants. Amid this failure, perhaps it’s unsurprising that migrants and minorities are heading to America’s suburbs, sprawled sunbelt cities and smaller towns. So what is the urban future? The answer lies less in the central business districts than the suburbs and exurbs.

And this presents a nightmare for the traditional urbanist.

Is he right, or is another urban renaissance ahead?

Provocation of the Week

At a press conference hosted by the Internet Archive, its founder, Brewster Kahle, addressed Hachette v. Internet Archive, a Supreme Court case that addresses digital lending and copyright. Kahle argued that digital libraries ought to be free to operate much as brick- and-mortar libraries do:

The Internet Archive is a library I founded 26 years ago. This library has brought hundreds of years of books to the wikipedia generation, and now 4 massive publishers are suing to stop us.

As the world now looks to their screens for answers, what they find is often not good. People are struggling to figure out what is true and it is getting harder. Digital learners need access to a library of books, a library at least as deep as the libraries we older people had the privilege to grow up with.

The Internet Archive has worked with hundreds of libraries for decades to provide such a library of books. A library where each of those books can be read by one reader at a time. This is what libraries have always done.

We also work with libraries that are under threat. We work with many libraries that have closed their doors completely—libraries with unique collections: Claremont School of Theology, Marygrove College of Detroit, cooking school of Johnson & Wales Denver, Concordia College of Bronxville NY, Drug Policy Alliance’s library of NYC, the Evangelical Seminary of Pennsylvania. I have looked these librarians in the eye and told them that we are there for them.

They entrust their books to us, as a peer library, to carry forward their mission. Most of the books are not available from the publishers in digital form, and never will be. And as we have seen, students, researchers and the print-disabled continue to use these books for quotations and fact checking. And I think we can all agree we need to be able to do fact checking.

Here’s what’s at stake in this case: hundreds of libraries contributed millions of books to the Internet Archive for preservation in addition to those books we have purchased. Thousands of donors provided the funds to digitize them.

The publishers are now demanding that those millions of digitized books, not only be made inaccessible, but be destroyed.

This is horrendous. Let me say it again—the publishers are demanding that millions of digitized books be destroyed.

And if they succeed in destroying our books or even making many of them inaccessible, there will be a chilling effect on the hundreds of other libraries that lend digitized books as we do. This could be the burning of the Library of Alexandria moment—millions of books from our community’s libraries—gone.

The dream of the Internet was to democratize access to knowledge, but if the big publishers have their way, excessive corporate control will be the nightmare of the Internet. That is what is at stake.

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Since fall 2021, Daniel Lemoi has been a central figure in the online community dedicated to experimental use of the antiparasitic drug ivermectin. “You guys all know I’m not a doctor,” he often reminded them. “I’m a guy that grew up on a farm. I ran equipment all my life. I live on a dirt road and I drive an old truck—a 30-year-old truck. I’m just one of you.” Lemoi’s folksy Rhode Island accent, his avowed regular-guy-ness, and his refusal to take any money in exchange for his advice made him into an alt-wellness influencer and a personal hero for those who followed him. He joked about his tell-it-like-it-is style and liberal use of curse words: “If you don’t like my mouth, go pray to God, because he’s the one that chose me for this mission.”

Last March, during an episode of his biweekly podcast, Dirt Road Discussions, he thanked his audience for their commitment to his ivermectin lifestyle: “I love that you guys are all here trusting my voice.” His group currently has more than 130,000 members and lives on Telegram, a messaging app that has become popular as an alternative social-media network. When Lemoi died earlier this month, at age 50, his followers found out via the chat. As first reported by Vice, Lemoi had given no indication that his health may have been failing. In fact, one of his last posts in the group was from the morning of the day he died: “HAPPY FRIDAY ALL YOU POISONOUS HORSE PASTE EATING SURVIVORS !!!”

Members of Lemoi’s family did not respond to requests for interviews, but according to his obituary, he was a heavy-equipment operator for a naval-engineering company. In the weekly podcast-style chats he hosted on his Telegram channel, he described working on the waterfront of the Narragansett Bay. He shared every detail of his ivermectin story with followers, starting on a Friday in August 2012 when he first started suffering from vertigolike symptoms. This kicked off a labyrinthine journey through the medical system, involving, he said, many huge courses of antibiotics, bouts of extreme illness and pain, and a significant financial burden. (“And alone, living alone, like this whole thing—it was just me,” he explained in a chat recorded in November 2022.) Finally, in January 2017, a doctor specializing in Lyme disease prescribed Lemoi hydroxychloroquine. He was shocked to learn that it would cost him $288 a month. “So I had no choice,” he told his followers. “I had to go with Plan B.” He got the idea to take ivermectin from a friend’s daughter, who was studying to be a veterinarian and had, according to Lemoi, written a paper about the genetic similarities between horses and people.

After Lemoi’s death, whoever took over the Telegram chat wrote to the group that “his heart was quite literally overworking and overgrowing beyond its capacity, nearly doubled in size from what it should have been.” Previously, Lemoi had claimed to have no side effects from ivermectin except for “herxing”—a term borrowed from the world of chronic Lyme disease, which he used to describe symptoms such as dizziness, chills, fatigue, sweating, headaches, and blurred vision. All of these, he told his audience, were temporary. Although ivermectin has not been cited as a cause of death, Ilan Schwartz, an infectious-disease expert at the Duke University School of Medicine, explained that it could have contributed to Lemoi’s health problems. “Incorrect use—mostly encountered in the last few years when people self-medicate, often with veterinary formulations of the drug—can cause damage to a wide range of organs, most notably the brain and gastrointestinal tract,” he told me. “Cardiovascular effects are occasionally seen, mostly low blood pressure and fast heart rate.” Regardless, the Telegram group has continued its daily routine of pro-ivermectin, antipharma posting—a sign that fringe content will continue to bloom on the fractured social web.

[Read: Twitter has no answers for #DiedSuddenly]

Ivermectin gained national attention during the pandemic, when it was touted by some Republican lawmakers as a possible treatment for the coronavirus—but Lemoi had already spent years self-administering the medication in the version intended for large mammals. “I still haven’t found anything the 1.87% horse paste won’t or can’t handle,” he wrote on the “About” page of his website, referring to a common formulation of the drug. “Except if you break a bone or fall out of a window!” Lemoi said that he’d gone off his prescriptions and that ivermectin was the only thing he needed to feel better than he had in years. He’d mostly kept his treatment to himself, until the pandemic changed everything. “I literally felt hands on my back pushing me forward because the media was talking about how bad ivermectin was,” he said in the chat from last November. He recommended the drug to people he knew, then to people on Facebook. “Facebook turned into Telegram, turned into this chat,” he summarized.

Lemoi’s fans have promised to keep his legacy alive. In the Telegram group, they’ve shared “Dannyisms” like “You have everything you need in the chats.” And in the comments on his online obituary, hundreds of group members have left condolences and thanks: “We were so blessed by his voice and tender heart,” one reads. “Ivermectin forever.” “My whole take on Danny is he’s just like me—he is a truth seeker,” one member, Diana Pilkington Barry, told me, when we spoke after his death. “I hold him in very high regard,” she said. “He was a pretty remarkable man.” She admired him for coming up with his ivermectin regimen and then sharing it with other people, and for the broader anti-establishment worldview he represented. “It’s a belief system I’ve now adopted,” she said.

By the time Lemoi started his Telegram group, in November 2021, ivermectin and its rapid politicization had become inseparable from the pandemic. In April 2020, when an early lab test had seemed to indicate that ivermectin could be used as a possible COVID-19 treatment, the FDA had warned Americans not to self-administer versions of the drug “intended for animals.” Later that year, Republican Senator Ron Johnson of Wisconsin had invited a pro-ivermectin doctor to a Senate hearing, where that doctor referred to the drug as a “miracle.” (Johnson has since emerged as a vocal anti-vaxxer.) Clinical trials never found good evidence that human formulations of ivermectin were useful for treating COVID-19, and experts have continued to warn that formulations created for animals are dangerous to people. Some high-profile Republican lawmakers went to bat for the medication despite clear and consistent warnings from physicians, and many state-level legislators pushed for new laws that would protect doctors who prescribed it from censure or liability. Since then, semi-infamous groups of renegade doctors and nurses have continued pushing it. As reported by The Washington Post, a group of doctors who call themselves the Frontline COVID-19 Critical Care Alliance has recently started recommending ivermectin to treat the flu and RSV as well.

[Read: A major clue to COVID’s origins is just out of reach ]

The members of Lemoi’s group are not solely focused on the coronavirus. Many—as Lemoi did—use horse-grade ivermectin in a misguided attempt to treat the symptoms of Lyme disease, cancer, anxiety, depression, and other maladies. Some, like Barry, take it preventively in hopes of strengthening their immune system and avoiding brushes with the “evil” pharmaceutical industry. The chat is also not only about ivermectin. It has an anti-vaccine, right-wing bent—a quick scroll brings up homophobic memes; a graphic, Photoshopped image mocking Nancy Pelosi; and a post explaining how unvaccinated people could inadvertently “contaminate” their blood by having sex with a vaccinated person. But the (incorrect) idea that unites the group is that most diseases are caused by parasites, and that members can prevent almost all illness by following the regimen that Lemoi created.

Though Lemoi’s experience with ivermectin originally had nothing to do with COVID-related conspiracy theories, it seems to have steered him in that direction over time. In the last episode of his podcast, posted on February 26, he spoke about “the biggest red pill the world is ever going to swallow.” He was convinced that the pharmaceutical industry wants to keep people in poor health, and that ivermectin use was considered fringe only because the powers that be want to keep people full of parasites.

At this late stage in the pandemic, ivermectin is still attracting new attention through social platforms. Recently, in a YouTube video with 1.7 million views, the mega-popular podcaster Joe Rogan talked about using it and feeling frustrated that the media keep referring to it as “horse dewormer” (though it literally is one). Tracking the extent of its use is also getting harder. Some of the biggest and most unruly Facebook groups promoting ivermectin have been removed, but many groups remain that are smaller, private, more careful about avoiding automated content moderation, and more selective about who they admit. (My request to join one of them was immediately denied.) The conversation has moved out of mainstream spaces and into more specialized communities that were originally organized around other shared attitudes or experiences. On Reddit, ivermectin discussion mainly appears in the infamous, openly paranoid forum r/conspiracy, or in the newer forum r/covidlonghaulers, populated by people dealing with long-term COVID symptoms and experimenting with whatever treatments sound like they could possibly help. Like the #DiedSuddenly conspiracy theory, ivermectin also has a big presence in the alt-tech ecosystem—Gab, the far-right platform, runs ads for the drug in its main feed.

The continued misuse of Ivermectin reminds us that a dangerous idea doesn’t go away when it’s removed from the center of attention on major social-media platforms. In fact, as some researchers have argued, it may become more concentrated—a greater source of identity and of in-group self-definition. “Shared experience that is not acknowledged or appreciated by mainstream communities is a very powerful source of community-building,” Drew Margolin, an associate professor at Cornell who studies online communication and alternative health groups, told me. And though much pressure has been put on social-media companies to prevent the proliferation of medical misinformation in the past three years, a platform like Telegram, which is not end-to-end encrypted by default but does present itself as a place for private, unmoderated messaging, offers an easy alternative.

Robert Aronowitz, a professor of history and the sociology of science at the University of Pennsylvania who has studied the controversy around Lyme disease, has been following the tension between medical authority and anti-authority medical activist groups since the 1970s. A lot of these groups involved improvisational home remedies, influencers who became icons, and a strong sense of community. “Many of us journalists, doctors, blame social media for inciting distrust in medical authority and allowing communities of people to form,” he told me. “I’m not saying social media doesn’t have a role, but in terms of ultimate cause or origins, it has very little to do with it.”

If anything, the internet may have helped different existing groups find one another and comingle. When Aronowitz was studying Lyme disease, he said, there was no overlap between that community and the anti-vaccine movement—“there weren’t obvious alliances or even sympathies.” (The alliance now is not total—many Lyme activists also promote COVID-19 vaccination.) Nor was there a hint of polarized “left-right politics.” Today, the anti-vaccine movement has made so much progress at co-opting other alternative health movements, and has been so thoroughly claimed by the political right, that this is hard to imagine.

It’s even harder to imagine anti-vaxxers engaging productively with a faction of the pro-vaccine mainstream that has begun to build a morally superior identity around its acceptance of science. Just look through the self-satisfied tweets about Lemoi’s death: “I just want to thank Danny Lemoi for his hard work in the extremely competitive field of ‘Natural Selection,’” a typical post reads. Another person wrote: “Here lies Danny Lemoi, who fucked around and found out.”