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The Cancer Gene More Men Should Test For

The Atlantic

www.theatlantic.com › health › archive › 2024 › 11 › brca-breast-cancer-men-prostate-pancreas › 680698

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When Mary-Claire King discovered the first gene linked to hereditary breast cancer in 1990, she also got to decide its name. She settled on the four letters BRCA, which had three distinct meanings. The name paid homage to UC Berkeley, where King worked at the time; more to the point, it was a nod to Paul Broca, the 19th-century French physician whose work established a link between family history and breast cancer. It was also an abbreviation for breast cancer.

A few years after King discovered BRCA1, a second BRCA gene, BRCA2, was identified. Together, they now have more name recognition than probably any other gene, their profile boosted by research that has shown staggering effects on cancer risk. Awareness campaigns followed. A 2013 New York Times op-ed in which Angelina Jolie revealed she’d had a preventive double mastectomy because of her own BRCA mutation drove many women to seek DNA tests themselves. The BRCA genes became inextricably linked with breasts, as much as the pink ribbons that have become an international symbol of breast cancer. And in driving more women to find out if they have BRCA mutations, it’s helped to greatly reduce the risk of hereditary breast cancer.

But in the three decades since the genes were discovered, scientists have learned that BRCA mutations can also lead to cancer in the ovaries, the pancreas, and the prostate. More recently, they have been linked with cancers in other parts of the body, such as the esophagus, stomach, and skin. As many as 60 percent of men with changes in BRCA2 develop prostate cancer, yet men are generally far less aware than women that BRCA mutations can affect them at all.

“It’s a branding problem,” Colin Pritchard, a professor of laboratory medicine and pathology at the University of Washington, told me. Men with family histories of breast cancer may not realize that they should get screened. Physicians, too, lack awareness of which men should get tested, and what steps to take when a mutation is found. Now Pritchard and other researchers are working to rebrand BRCA and the syndrome associated with it so that more men and their doctors consider testing.

Normally, the BRCA genes produce proteins that help repair damaged DNA throughout the body. Most people who carry mutations that impair the gene’s function are diagnosed with hereditary breast and ovarian cancer syndrome. (Having HBOC means a person is at increased risk for cancer, not that they already have an illness.) Most breast-cancer cases have no known hereditary link, but more than 60 percent of women with a harmful BRCA1 or BRCA2 mutation will develop breast cancer, compared with about 13 percent of the wider female population. Men, of course, can get breast cancer too, but it's rare, even among BRCA-mutation carriers.

[Read: Cancer supertests are here]

The full significance of the link between BRCA mutations and pancreatic and prostate cancer has become clear only recently—perhaps in the past decade, said Pritchard. The exact risk these mutations impart to men varies widely in studies. But it’s clearly significant: Not only are men with BRCA mutations more likely to develop prostate cancer, they are also more likely to develop the more aggressive forms of the disease.

Roughly one in 400 people carry a harmful mutation in BRCA1 or BRCA2, and half of them are men. But women are far more likely to have been tested for the mutations—up to 10 times as likely, according to one study. “Beyoncé’s dad was the only man that I had ever heard of who had it,” Christian Anderson, a 46-year-old social-sciences professor in Washington State who carries a BRCA2 mutation, told me. Anderson got tested after his sister was diagnosed with breast cancer, but countless men like him go undetected. Only about half of Americans get an annual physical, and doctors aren’t always aware of BRCA-screening recommendations for men. Many men who do test for a BRCA mutation report doing it for their daughters, and studies have shown that they tend to be confused about their risks of developing cancer themselves.

BRCA-awareness campaigns have led many women to get tested; in the two weeks after Angelina Jolie’s viral op-ed, researchers found that BRCA-testing rates went up by 65 percent. In that case, more people may gotten tested than needed to, but in general, the rise in cancer screenings and elective surgical interventions have helped reduce the rates of deaths from breast and ovarian cancers. Education about the genes’ links to other cancers could do the same for men. To that end, Pritchard argued in a 2019 Nature commentary that Hereditary Breast and Ovarian Cancer syndrome should be renamed King Syndrome after Mary-Claire King. “We need to really rethink this if we're going to educate the public about the importance of these genes for cancer risk for everyone, not just women,” he told me.

[Read: I’ll tell you the secret of cancer]

As understanding of BRCA’s risks for men has grown, Pritchard’s idea has started to catch on. King, who is now a professor of genome sciences and medicine at the University of Washington, demurred when I asked her whether the syndrome associated with the BRCA genes should be renamed after her, but agreed that awareness campaigns have focused too narrowly on breasts and ovaries. “We need to bring this awareness to men in the same way that we have for 30 years now to women,” she told me.

How exactly Pritchard’s plan might be put into action is unclear. Gene names are overseen by an international committee and rarely changed. That’s part of why Pritchard is suggesting that the name of the syndrome associated with BRCA mutations become King Syndrome—no single governing body oversees that. Recently, ClinGen, an international group of researchers that works to parse the medical significance of genes, recommended that HBOC be rechristened BRCA-related cancer predisposition. (Pritchard told me he thinks that name isn’t quite as “catchy” as King Syndrome.)

Uncoupling the syndrome associated with BRCA mutations from breasts would likely be only the first step in getting more at-risk men screened for cancer. It would also be an important step in understanding the full impact of BRCA mutations on men. Because fewer men than women have been tested for BRCA mutations, scientists still don’t have a complete picture of their risk. For example, Pritchard told me, it’s only as more attention has been drawn to male BRCA risk that researchers have discovered mutations are linked to especially aggressive forms of prostate cancer. Penn Medicine recently launched a program dedicated to men and BRCA in part to continue this sort of research.

[Read: Scientists have been studying cancers in a very strange way for decades]

BRCA’s name is a legacy of a time when scientists thought genetics would offer a simple way to diagnose and treat disease—that one specific mutation would point definitively to one specific cancer. But today, “the idea that a gene would only affect one type of cancer risk is probably outmoded,” Pritchard said. The more scientists explore the human genome, the more complex its connections to health appear. It turns out that when genes don’t work like they should, the possible consequences may very well be infinite.

Get Ready for Higher Food Prices

The Atlantic

www.theatlantic.com › family › archive › 2024 › 11 › food-prices-trump-presidency › 680670

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When Americans went to the polls last week, they wanted cheaper food. Groceries really are more expensive than they used to be, and grocery costs are how many Americans make sense of the state of the economy at large. In September, Pew Research Center reported that three-quarters of Americans were “very concerned” about them. And this month, many of those people voted for Donald Trump, the candidate who touted his distance from the economic policy of the last four years, and who promised repeatedly to lower prices.

But two of Trump’s other big promises—mass deportations of undocumented immigrants and more restrictive trade regulations—would almost certainly raise food prices, economists told me. American-grown staples would get more expensive owing to a domestic labor shortage, and imported foods would too, because they would be subject to double-digit import taxes. This cause-and-effect dynamic “could be my final exam,” Rachel Friedberg, who teaches “Principles of Economics” at Brown University, told me. “It’s just very straightforward principles of economics.”

The main issue is labor. American farming depends on undocumented workers; if the Trump administration were to enact “the largest deportation operation in American history” and deport every undocumented immigrant living in the United States, somewhere between 40 and 50 percent of the people who plant our crops and pick our fruit would leave the domestic workforce. Proponents of immigration enforcement typically say these jobs could be taken by documented or American-born workers. But the farm industry is already in a prolonged labor crisis, and undocumented immigrants tend to be willing to work for less money—that’s why employers hire them, even though it’s illegal. Fewer workers means higher wages means higher prices, straight up.

[Read: Trump signals that he’s serious about mass deportation]

Some farms might be able to get by shorthanded, at least for a little while. Some might embrace technology more quickly, investing in automated systems that could help fill the labor gap. But that would take time, and as David Anderson, a Texas A&M University agricultural economist, told me, “You gotta get the cows milked and fed every day.” America’s agricultural system relies on hands and feet, arms and legs, day in and day out.

If the Trump administration does, in fact, deport millions of people, produce prices would likely increase the most, Bradley Rickard, an agricultural economist at Cornell University, told me in an email, because “labor represents a significant share of total costs.” Prices would probably go up quickest and most dramatically for the crops that are most labor-intensive to harvest: strawberries, mushrooms, asparagus, cherries. So would those for the foods farmed in California, which grows three-quarters of the fruit and nuts, and a third of the vegetables, produced domestically, and is home to about half of the country’s undocumented agricultural workers.

Mass deportations would also drive up prices for dairy and meat, whose industries have also been in a labor shortage, for at least the past half decade. According to a 2022 analysis from the American Immigration Council, which advocates for immigrants and seeks to shape immigration policy, a scarcity of workers led the median wage in the dairy and meat sectors to increase 33.7 percent from 2019 to 2022, and prices to rise between 4.5 and 7 percent. In 2015, Anderson and some colleagues conducted a survey on behalf of the dairy industry and found that eliminating immigrants from the sector would reduce production, put farms out of business, and cause retail milk prices to increase by about 90 percent.

Anderson’s study is 10 years old, and assumed a total loss of all immigrant labor, documented and undocumented. Last week, he told me that he has no reason to believe the dynamic wouldn’t hold to a lesser degree if a smaller amount of the workforce were deported now. “We wouldn’t be able to produce all the stuff that we do today. Less production means less supplies,” he said, “and less supplies means food prices would go up.”

Immigration policy affects food that is grown domestically. But about 15 percent of the American food supply is imported, including about 60 percent of fresh fruit, 80 percent of seafood, 90 percent of avocados, and 99 percent of coffee. Our reliance on, or taste for, imported goods has ticked up steadily over the past few decades, as we have become accustomed to Italian olive oil and raspberries in winter. On the campaign trail, Trump proposed taxing these—and all—imported goods, in an attempt to raise domestic production and to reduce the deficit. If his plan goes through, Chinese imports—which include large amounts of the fish, seafood, garlic, spices, tea, and apple juice we consume—would be subject to 60 to 100 percent tariffs. All other imports would be subject to 10 to 20 percent tariffs. Those taxes would be passed onto consumers, especially in the short term, as domestic production ramps up (if it can ramp up), and especially if undocumented immigrants are simultaneously leaving the workforce. “There’s no safety valve,” Marcus Noland, the executive vice president and director of studies at the nonpartisan think tank Peterson Institute for International Economics, told me. “If you start deporting people, it’s not like you can import the product and make up for it if you have these tariffs.”

[Read: The immigration-wage myth]

We all need food to live, and all food needs to come from somewhere. The process by which it makes it to our plate is complicated, resource-intensive, and subject to the vagaries of policy, weather, disease, and labor supply. The system does not have a large amount of slack built into it. If sticker-shocked milk fans start gravitating toward other drinks, those prices will also go up. If California’s berry industry is squeezed by a labor shortage, and the market for imported berries is squeezed by tariffs, berries will cost more.

And although farms are the biggest employer of undocumented workers, these workers are also a major part of the mechanism that processes, butchers, cooks, and delivers our food, from the sprawling poultry-processing plants of the South to the local fried-chicken place. The restaurant industry—which employs more than 800,000 undocumented immigrants, according to a Center for American Progress analysis—is already struggling to fill jobs, which is driving higher prices; even a small reduction in the workforce would increase operating costs, which will almost definitely result in either restaurants closing or costs being passed onto eaters.

The immigration and tariff policies, in other words, would affect all the food we eat: snacks, school lunches, lattes, pet food, fast food, fancy restaurant dinners. People will not stop eating if food gets more expensive; they will just spend more of their money on it.

Trump’s team proposed deportations and tariffs as a way to fix America’s inflation-addled economy. But voters are unlikely to be comforted by what they see over the next few years. Toward the end of our call, I asked Friedberg if she could see any scenario under which, if the new administration’s policies are enacted, prices don’t go up. “No,” she said, without pausing. “I am extremely confident that food will get more expensive. Buy those frozen vegetables now.”

Why America Still Doesn’t Have a Female President

The Atlantic

www.theatlantic.com › politics › archive › 2024 › 11 › bias-against-female-president › 680589

In 2016, Hillary Clinton was a former secretary of state and senator running against the politically inexperienced real-estate tycoon Donald Trump. She lost. People would vote for a woman, the thinking went, just not that woman.

In 2024, Kamala Harris was the vice president, a former senator, and a former attorney general also running against Trump, who was by then a convicted felon and sexual abuser. She also lost. People would vote for a woman, once again, just not that woman.

The events of the past eight years might prompt some to wonder: If Clinton wasn’t good enough, and neither was Harris, will a woman ever be good enough to be president? What kind of a woman would it take? According to interviews I conducted with six researchers who study gender and politics, sexism was a small but significant factor that worked against Harris. And it’s going to be a problem for any woman who runs for president. “American voters tend to believe in the abstract that they support the idea of a woman candidate, but when they get the real women in front of them, they find some other reason not to like the candidate,” Karrin Vasby Anderson, a communications professor at Colorado State University, told me. In 2017, she wrote an article about the long odds faced by women running for president. The title? “Every Woman Is the Wrong Woman.”

It’s important not to overstate the role that sexism played in Harris’s loss. She’s the vice president of an unpopular incumbent. Although the U.S. economy writ large is objectively strong, many voters feel pinched by high inflation and interest rates. And after President Joe Biden dropped out of the race in July, Harris had less than four months to make her case to the American public. A very small number of people have ever run for president, and, well, someone has to lose.

[Read: The shadow over Kamala Harris’s campaign]

But some people are biased against female presidential candidates. In 2017, a study found that about 13 percent of Americans were “angry or upset” about the idea of a woman serving as president. In an experiment that same year using hypothetical political candidates, Yoshikuni Ono and Barry Burden, political scientists at the University of Wisconsin at Madison, found that voters punish female candidates running for president by 2.4 percentage points. This means that a hypothetical female candidate would get, say, 47 percent of the vote, rather than 49.4 percent if she were a man. This bias against female presidential candidates, Ono and Burden found, was most pronounced among men and among politically unaffiliated voters—two demographics that Harris struggled with. (Because they don’t feel strongly attached to a party, independents rely on other characteristics of the candidates to make up their mind.)

The obvious counterpoint is that, although they are still underrepresented, women have attained other types of high political offices. We’ve never had a female president, but women make up nearly a third of Congress. Twelve governors are women.

The presidency may be different from other elected positions, though. When researchers ask voters to list the traits that they want in a president, they rate masculine-coded traits, such as strength, as more important than feminine-coded ones, such as compassion. “The prestige and the height of the office contributes to the perception that women are just too big of a risk to take,” Nichole Bauer, a political-communication professor at Louisiana State University, told me.

Masculinity is so important to the presidency that candidates often try to cast their male opponents as feminine: Think of George W. Bush painting John Kerry as effete in 2004, and Marco Rubio’s opponents mocking him for his high-heeled boots in 2016. Female heads of state tend to emerge in countries—including Germany and the United Kingdom—that have parliamentary systems, in which leaders are chosen by political parties, not by voters.

But women who behave in masculine-seeming ways are also penalized for not being traditionally feminine. “For a woman to be seen as presidential, she would have to be hyper-masculine, but the moment she does that, she is condemned by a swath of the population for violating norms of femininity,” Caroline Heldman, a gender-studies professor at Occidental College, told me. “Sarah Palin tried to straddle the masculine-feminine line really wide, ripping the guts out of a moose, and Hillary Clinton barely stepped on either side of the line with her pearls and her pants. It just doesn’t matter. They all get beaten up in the same sexist ways.”

[From the November 2020 issue: Kamala Harris’s ambition trap]

Members of Congress, meanwhile, aren’t held to this same macho standard. There are more of them, they individually have less power, and they are seen as servants of the people. They’re middle managers to the president’s big boss. And although governors are also chief executives, they don’t command an entire nation’s army. Their families aren’t held up as an ideal American family, with the father in charge. As a female presidential candidate, “you’re upsetting not just our idea of what presidents should be,” Anderson said, “but you’re upsetting a whole bunch of gender norms.”

In their study, Ono and Burden found that the hypothetical female candidates weren’t disadvantaged if they were described as running for Congress rather than for president. Burden told me he suspects this is because there has never been a female president, so voters strain to imagine what a female president would be like.

This creates a maddening situation in which a woman can’t get elected president because there’s never been a woman elected president. Several of the researchers I interviewed were nevertheless doubtful that one would win the presidency anytime soon. “It would be really great to see a woman in the White House in my lifetime, but I’m very pessimistic,” Heldman said. Anderson told me that nominating another woman would be a “strategic risk” for either party.

Essentially, a female candidate would have to overcome her femaleness in order to win a presidential race. She would have to be running with significant tailwinds—as a “change” candidate during a terrible economy, say—so that voters wouldn’t pay too much attention to her gender. This is similar to what happened in 2008: An unpopular Republican was president, the economy was a wreck, and the preternaturally charismatic Barack Obama stepped into the breach. He became the first Black president, and now no one questions whether there could be another. But we’re still holding out for the female Obama. We might be waiting for a while.

The ‘Blue Dot’ That Could Clinch a Harris Victory

The Atlantic

www.theatlantic.com › politics › archive › 2024 › 11 › omaha-nebraska-harris-osborn-blue-dot › 680526

Photographs by Wesaam Al-Badry

It’s the evening rush hour on the Friday before Election Day in Omaha, and about two dozen die-hard Democrats are making a racket. They’re standing on a bridge overpass, cheering, whooping, blowing whistles, holding up little American flags, and waving white signs emblazoned with a blue circle. Even in this Republican area on the outskirts of Nebraska’s biggest city, the cars passing by are honking in approval.

The signs say nothing—it’s just that big blue dot in the middle—but their message is no mystery here. “I don’t think there’s anybody in this city who doesn’t know what the blue dot represents,” Tim Conn, a 70-year-old retiree who has spray-painted a few thousand of the signs in his backyard, told me. More than 13,000 blue dots have popped up on Omaha lawns in the past three months, an expression of political pride in what has become a Democratic stronghold on the eastern edge of a deep-red state.

The blue dots embody a surge of enthusiasm for both Kamala Harris and Omaha’s outsize significance to the national election. Nebraska allocates some of its electoral votes by congressional district, and if Harris defeats Donald Trump in the Rust Belt’s “Blue Wall” states—Pennsylvania, Michigan, and Wisconsin—while losing the battlegrounds to the south, Omaha and its suburbs would likely deliver her the 270th vote that she needs to win the presidency. The district is so important that Trump and his allies repeatedly pressured Republicans in Nebraska’s legislature to change the rules in his favor. (The legislators rebuffed him a final time in September, and Trump has made little effort since to win Omaha the old-fashioned way—by earning more votes.)

Omaha could also determine control of Congress. Democrats view the GOP-held House district as one of their best opportunities to flip a seat and help recapture the majority. And in at least one postelection scenario, an upset victory by the independent Dan Osborn over Senator Deb Fischer—polls show the race is close—would give him the power to choose which party controls the Senate.

[David A. Graham: How is it this close?]

All this has made a region that’s hundreds of miles from the nearest swing state a potential tipping point for the balance of federal power. “Nebraska is literally in the middle of everything,” Jane Kleeb, the Democratic state party chair, told me. “They try to say that we’re a flyover state, but ha-ha, joke’s on them.”

Nebraska began splitting up its electoral votes more than three decades ago, but only twice since then has Omaha’s vote in the Second Congressional District gone to a Democrat; Barack Obama won it by a single point in 2008, and Joe Biden beat Trump by six points in 2020.

This year, however, Harris is poised to carry the district by more than either of them. The area is filled with the white, college-educated voters who have largely recoiled from Trump since 2016, and a New York Times/Siena poll last week found the vice president leading by 12 points. Neither Harris nor Trump, nor their running mates, are campaigning in Omaha in the closing days of the election—a sign that both candidates see the district going to Harris.

Still, the Harris campaign and allied groups have spent more than $4 million in the area, which has also imperiled Omaha’s Republican representative, Don Bacon. Trump has spent only around $130,000. “That’s the biggest undertow for us,” Bacon told me on Saturday before a GOP get-out-the-vote rally in a more conservative part of the district. Public polls have shown Bacon’s opponent, the Democratic state senator and former middle-school science teacher Tony Vargas, ahead by a few points. Last week, the Cook Political Report, a leading congressional prognosticator, shifted its rating of the race as a “toss-up” to one that Vargas is slightly favored to win.

Public polls show Tony Vargas, right, narrowly leading his opponent, Republican Representative Don Bacon.  (Wesaam Al-Badry for The Atlantic)

A retired Air Force general serving his fourth term in Congress, Bacon outran Trump in 2020, winning reelection by 4.5 points. He defeated Vargas by a slimmer margin two years ago, and Vargas is running again—this time with more money and more backing from prominent members of his party.

Bacon has positioned himself as a moderate—he’s a member of the bipartisan Problem Solvers Caucus—and frequently criticized the conservative hard-liners who ousted Speaker Kevin McCarthy. But Bacon has been reluctant to cross Trump, and he lost some supporters by backing the former president’s late push to award all of Nebraska’s electoral votes to the statewide winner, which would have effectively stripped power from many of his own constituents. “They’re so mad about that,” Vargas told me on Saturday, noting that Bacon received an endorsement from Trump soon after he signed a letter supporting the change. “Now we know what Don Bacon actually is. He’ll sell out Nebraskans if it means holding on to his seat of power.” At an Osborn event the next day, I met a former Republican and Bacon voter, Paul Anderson, who told me that he wrote in a friend’s name on his ballot rather than support Bacon again. “He’s afraid of Donald J. Trump,” Anderson said.

Vargas’s previous campaign and his plentiful TV ads have made him a recognizable face in the district. When one elderly woman answered her door on Saturday and saw him standing on her stoop, her eyes widened as if he were Ed McMahon about to hand her a giant check. She assured Vargas that both she and her daughter would vote for him. “I’ll remember, don’t worry,” she said. As we walked away, Vargas showed me the canvassing app on his phone: The woman was a registered Republican.

For Nebraska Democrats, the most pleasant Election Night surprise would involve a race in which they haven’t even fielded a candidate. Osborn, a Navy veteran and local union leader, rejected the party’s endorsement and elected to campaign instead as an independent, and he’s stunned Republicans and Democrats alike by running nearly even with Fischer, a two-term incumbent who won both her previous races by more than 15 points.

Osborn has caught on with a cross-partisan, populist campaign that mixes support for abortion rights, labor unions, and campaign-finance reform with a hawkish, Trump-like stance on border security. Republicans in the state have accused him of being a Democrat in disguise, but he’s appealed to voters in Nebraska’s conservative rural west by backing so-called Right to Repair laws—popular with farmers. He has also hammered Fischer’s opposition to rail-safety measures and her vote that delayed the provision of benefits to military veterans injured by toxic burn pits. In one commercial, Osborn, a longtime mechanic, takes a blowtorch to a TV showing one of Fischer’s attack ads.

Mostly, though, he seems to be winning support by criticizing both parties, and his success is validating his decision to spurn the Democrats. “This wouldn’t be close if he were running as the Democratic candidate,” says Lee Drutman, a political scientist who has written about the “two-party doom loop,” a term Osborn has used during the campaign. Osborn has vowed to stay independent and said that he would refuse to align with the GOP or the Democratic Party as a senator (unlike the four independents currently serving in the Senate, who all caucus with the Democrats).

[Lee Drutman: America is now the divided republic the Framers feared]

Osborn’s pledge has its doubters, including fans such as Drutman. If either party has a clear majority, Osborn might be able to stay independent. But if both Osborn and Harris win, and Republicans wind up with exactly 50 Senate seats, his refusal to caucus with either party would hand the GOP a majority—and with it the ability to block Harris’s agenda and potentially her nominees to the Supreme Court. “There’s going to be so much pressure on him,” Drutman told me, “and he’s going to have to build a pretty strong infrastructure around him to manage that.”

Osborn has insisted that he wouldn’t budge. “I want to challenge the system, because the system needs to be challenged,” he told me. Osborn acknowledged that leaders in both parties “are gonna come knocking on my door, and then that’s going to allow me to use leverage to make deals for Nebraska.” Yet he gave other indications that he’d want to empower Democrats. He told me, for instance, that he supported filibuster reform and would back the Democrats’ push to remove the Senate’s 60-vote threshold to pass a law restoring abortion rights—a move the party might be able to make only if he helped them assemble a majority.

Republicans are confident that, come Wednesday morning, the question of Osborn’s party alliance will be moot. The national GOP has sent money and reinforcements to rescue Fischer’s bid—Senator Tom Cotton of Arkansas was stumping for her on Saturday—and her campaign has released polls showing her ahead of Osborn by several points. Independent candidates have threatened Republican incumbents a few times in recent years, only to fall short when GOP voters rallied around their party’s candidate in elections’ final weeks; in Kansas in 2014, the independent Greg Orman was polling close to Senator Pat Roberts for much of the campaign, but he lost by more than 10 points.

Left: Veterans protest at Republican Senator Deb Fischer’s rally on Saturday. Center: Senator Tom Cotton stumps for Fischer. Right: Dan Osborn, Fischer’s challenger, has run nearly even with her in polling. (Wesaam Al-Badry for The Atlantic)

Fischer has kept a low profile as a senator, and Republicans privately say she initially did not take Osborn seriously enough as a challenger. She’s embraced Trump in the apparent hope that his coattails will carry her to victory. When I asked Fischer why the race was so close, she pointed at me and the other national reporters who had come to one of her final rallies. “I explain his success to you folks in large part,” she said, “because I think you wanted to see a race here and you believed a lot of his polls that he put out early. We are going to win this race, and we are going to have a strong, strong showing.”

For his part, Osborn is courting Trump voters aggressively, recognizing that he cannot win with Democrats and independents alone. He has refused to say whether he’s voting for Trump or Harris. “As soon as I say who I’m voting for, I become that,” he told me. But Osborn’s closing ads leave the distinct impression that he’s backing Trump. “I’m where President Trump is on corruption, China, the border,” he says in one. “If Trump needs help building the wall, well, I’m pretty handy.”

Osborn’s rightward turn has made it awkward for Democrats like Kleeb, the state party chair, who is clearly rooting for him even if she can’t say so publicly. “Yeah, it’s complicated!” she said when I asked about Osborn, letting out a big laugh. Kleeb told me she’s frustrated that Osborn has backed Trump on border policy and even more so that he assails both Republicans and Democrats as corrupt. “It’s unfair to criticize us as the same,” she said. Still, Kleeb continued, it’s obvious that on most issues, Osborn is preferable to Fischer, a down-the-line Republican: “We’ve told all of our Democratic voters—you need to weigh the issues that you deeply care about and who is closest to you. That’s who we suggest you vote for.”

To most Democrats in Omaha, the choice is easy. When I visited Jason Brown and Ruth Huebner-Brown, I found an Osborn sign on a front lawn festooned with campaign placards. None were bigger, however, than the one Jason created: the blue dot.

The Browns have been Harris enthusiasts since 2019, when she was their first choice in the crowded field of Democratic primary contenders then campaigning over the Iowa state line a few miles away. Inspired by the Democratic National Convention’s exhortation to “do something,” Jason began tinkering in their garage. He cut off the top of a bucket, used it to outline a circle, and spray-painted over a sign for a local lawn service. He showed it to Ruth and asked if he should add any writing, like Vote or Kamala. “No,” she replied. “It makes you stop and think for a second. Just leave it plain.”

Attendees pray at a Fischer rally (left), and the Browns make blue-dot signs (right). (Wesaam Al-Badry for The Atlantic)

They put the sign up in their yard in August, and soon after, neighbors started asking where they had gotten it and whether they could get one too. Before long, the Browns were ordering blank white signs from Amazon, first by the tens, and then by the hundreds. Jason made the first couple thousand by hand in their backyard, and then they enlisted the help of another neighbor, Conn, who had better equipment. After they had distributed 5,000 blue dots, the Browns finally gave up and started having them mass-produced by a political-sign company.

Jason and Ruth were telling me the story as we sat at their dining-room table, where they resembled the kind of superfans you might see satirized in a Christopher Guest movie. Both wore blue-dot T-shirts over blue jeans and blue long-sleeved shirts. Jason, 53, had a Kamala hat and blue shoes—he also has blue-shaded sunglasses—while Ruth, 58, wore blue-dot–shaped earrings. As we were speaking, the doorbell rang: A pair of young men were there to pick up more signs. (They give them out for free, though most people make donations that cover their costs.) The Browns have taken a leave of absence from their consulting business through the election; earlier this fall, they postponed a long-planned cruise.

At first, they told me, they saw the signs as part of an education campaign, because they found that many Omaha voters did not appreciate the city’s importance in the presidential election. Although the Second District has had its own electoral vote since the 1990s, the reapportionment following the 2020 census has made it more important for Harris than it was for past Democratic candidates—a result of shrinking blue states losing electoral votes to growing red ones. (In 2020, Biden wouldn’t have needed the district’s vote to reach 270, so long as he carried the Blue Wall states; he ultimately won 306 electoral votes.)

[Ronald Brownstein: The Democratic theory of winning with less]

As the blue dots took off, the Browns said they came to represent a sense of local pride, as well as inspiration to Democrats who feel isolated and powerless in red states. Ruth has tried to keep the vibe positive—she calls the signs “happy blue dots”—but she told me that the anxiety Democrats feel about the election has also played a part in the movement’s popularity. “I think there’s more enthusiasm because people are more scared this time,” she said.

I mentioned that I had spoken with one Democrat who worried that if Omaha delivered the election to Harris, Trump would make another attempt to lean on Republicans in the legislature to hand him all of Nebraska’s votes before the Electoral College meets in December. The Second District’s vote was saved in September by a GOP holdout, Mike McDonnell, who resisted pressure from other Republicans. Would he hold firm if he was all that stood in the way of Trump’s election?

Jason told me he’s sure that Republicans would come for the blue dot again, and he’s prepared for one more fight. If Omaha is responsible for electing Harris, “we’ll be running up and down that street, waving flags, tears of joy,” he said, “followed by, Oh, shit.”