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Why Oz Is the Doctor Trump Ordered

The Atlantic

www.theatlantic.com › newsletters › archive › 2024 › 11 › why-oz-is-the-doctor-trump-ordered › 680727

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Donald Trump appears to experience the world through the glow of a television screen. He has long placed a premium on those who look the part in front of the camera. Paging Dr. Mehmet Oz.

Trump has picked Oz to lead the Centers for Medicare and Medicaid Services. CMS, as the agency is known, falls under the Department of Health and Human Services (HHS). Last week, Trump nominated Robert F. Kennedy Jr. to serve as HHS secretary. As you may have guessed, Kennedy and Oz are not only friends but kindred spirits. Oz is a global adviser at iHerb, a for-profit company that offers “Earth’s best-curated selection of health and wellness products at the best possible value.” He and Kennedy, two relative outsiders, are now positioned to enjoy a symbiotic relationship within Trump’s chaotic ecosystem.

Oz was last seen running for a Pennsylvania Senate seat in 2022. He lost to John Fetterman, who, despite dealing with the aftereffects of a stroke, carried the state by five points. Throughout that race, Oz struggled to combat the perception that he was a charlatan and carpetbagger who primarily lived in New Jersey. (Fetterman’s team repeatedly tagged Oz as an out-of-touch elitist, trolling him, for example, when he went grocery shopping for crudités and lamented high prices.) After that electoral defeat, Oz’s political dreams seemed all but dashed. But he wisely remained loyal to Trump—a person who has the ability to change trajectories on a whim.

In the pre-Trump era, it might have been a stretch to describe CMS administrator as an overtly political position. But Oz’s objective under Trump couldn’t be clearer. In a statement, Trump, using his reliably perplexing capitalization, telegraphed that Oz will bring a certain ethos to the job—a little MAGA, a little MAHA. Oz, Trump promised, will “cut waste and fraud within our Country’s most expensive Government Agency, which is a third of our Nation’s Healthcare spend, and a quarter of our entire National Budget.” And, because he’s Trump, he mentioned Oz’s nine daytime Emmy Awards.

Some 150 million Americans currently rely on the agency’s insurance programs, including Medicaid, Medicare, and Obamacare. Oz has been a proponent of Medicare Advantage for All. Though that sounds like the Medicare for All initiative championed by progressives such as Senator Bernie Sanders, the two programs are quite different. At its core, Medicare for All would set the U.S. on a path toward nationalizing health care. Trump would never go for that. But Medicare Advantage already exists within America’s patchwork private/public system, and Oz might push to strengthen it. He could also face budgetary pressure to weaken it. Oz’s own health-care views haven’t remained consistent. Though he once praised the mandatory universal models of Germany and Switzerland, as a Republican politician he threw his support behind privatized Medicare.

When asked about Oz’s nomination, Fetterman, his former opponent, told CNN: “As long as he’s willing to protect and preserve Medicaid and Medicare, I’m voting for the dude.” Some people were pissed. Victoria Perrone, who served as the director of operations on Fetterman’s Senate campaign, called out her old boss on social media: “Dr. Oz broke his pledge to ‘do no harm’ when he said red onions prevent ovarian cancer. My sis died of OC in 6/2022. This is a huge personal betrayal to me. We know he won’t protect the Medicaid that paid for her treatments,” Perrone posted on X. “I feel like I’ve been duped and 2 years of working on your campaign was a waste,” she added.

The above argument is illustrative of another reality Trump acknowledged in announcing his pick: “Make America Healthy Again” keeps growing. Oz, Trump declared, “will work closely with Robert F. Kennedy Jr. to take on the illness industrial complex, and all the horrible chronic diseases left in its wake.” He went a step further, promising that Oz will bring “a strong voice to the key pillars of the MAHA Movement.” Oz holds degrees from Harvard and Penn, and he worked as a professor of surgery at Columbia. In spite of that pedigree, Oz has spent years facing credible accusations of medical quackery for his endorsement of dietary supplements. In 2014, he received a dramatic dressing-down on Capitol Hill. Senator Claire McCaskill read three statements that Oz had made on his eponymous show:

“You may think magic is make-believe, but this little bean has scientists saying they’ve found the magic weight-loss cure for every body type: It’s green coffee extract.”

“I’ve got the No. 1 miracle in a bottle to burn your fat: It’s raspberry ketone.”

“Garcinia cambogia: It may be the simple solution you’ve been looking for to bust your body fat for good.”

Oz’s defense that day was that his job was to be a “cheerleader” for the Dr. Oz audience. “I actually do personally believe in the items I talk about in the show. I passionately study them. I recognize oftentimes they don’t have the scientific muster to present as fact, but nevertheless, I would give my audience the advice I give my family,” he testified.

He emerged from that hearing largely unscathed. Two years later, Oz would go on to read what he claimed were Trump’s medical records on that same show. He famously praised Trump’s testosterone levels and supposed all-around health. Four years after that, once Trump was president, Oz sent emails to White House officials, including Trump’s son-in-law Jared Kushner, pushing them to rush patient trials for hydroxychloroquine, an unproven treatment for COVID.

In the next Trump administration, those are the sorts of exchanges Oz could be having with Kennedy—or with Trump himself. How did we get here? Oz landed this gig because he’s good on TV, yes, but also because, when he entered the political arena, he fully aligned himself with Trump. The 47th president rewards loyalty. If there’s one thing that’s become clear from his administration nominations so far, it’s that.

Some of Trump’s appointments will be less consequential than others. Anything involving the health and well-being of tens of millions of Americans is inarguably serious. Oz’s confirmation is not guaranteed, but his selection has already confirmed that nothing about Trump 2.0 is mere bluster.

Related:

Trump is coming for Obamacare again. (From January) Why is Dr. Oz so bad at Twitter? (From 2022)

Here are three new stories from The Atlantic:

Another theory of the Trump movement What the men of the internet are trying to prove Arash Azizi: The problem with boycotting Israel

Today’s News

Republican members of the House Ethics Committee blocked the release of the investigation into the sexual-misconduct and drug-use allegations against former Representative Matt Gaetz. Jose Ibarra, who was found guilty of killing Laken Riley on the University of Georgia campus, was sentenced to life in prison without possibility of parole. Trump tapped former WWE CEO Linda McMahon, who previously led the U.S. Small Business Administration during Trump’s first term, to be the secretary of education.

Dispatches

The Weekly Planet: Drought is an immigration issue, and Trump’s climate policies are designed to ignore that, Zoë Schlanger writes.

Explore all of our newsletters here.

Evening Read

Video by Joanne Imperio / The Atlantic. Sources: Archive Films / Getty; Internet Archive; Prelinger Associates / Getty.

Put Down the Vacuum

By Annie Lowrey

The other night, a friend came over. A dear friend. A friend who has helped me out when I’ve been sick, and who brought over takeout when I had just given birth. Still, before he arrived, I vacuumed.

I thought about this while reading the Gender Equity Policy Institute’s recent report on gender and domestic labor. The study finds that mothers spend twice as much time as fathers “on the essential and unpaid work” of taking care of kids and the home, and that women spend more time on this than men, regardless of parental and relationship status. “Simply being a woman” is the instrumental variable, the study concludes.

Read the full article.

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Stephanie Bai contributed to this newsletter.

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Is Wokeness One Big Power Grab?

The Atlantic

www.theatlantic.com › ideas › archive › 2024 › 11 › musa-al-gharbi-wokeness-elite › 680347

In his 2023 Netflix comedy special, Selective Outrage, Chris Rock identified one of the core contradictions of the social-justice era: “Everybody’s full of shit,” Rock said, including in the category of “everybody” people who type “woke” tweets “on a phone made by child slaves.”

I was reminded of that acerbic routine while reading Musa al-Gharbi’s new book, We Have Never Been Woke. Al-Gharbi, a 41-year-old sociologist at Stony Brook University, opens with the political disillusionment he experienced when he moved from Arizona to New York. He was immediately struck by the “racialized caste system” that everyone in the big liberal city seems to take “as natural”: “You have disposable servants who will clean your house, watch your kids, walk your dogs, deliver prepared meals to you.” At the push of a button, people—mostly hugely underpaid immigrants and people of color—will do your shopping and drive you wherever you want to go.

He contrasts that with the “podunk” working-class environment he’d left behind, where “the person buying a pair of shoes and the person selling them are likely to be the same race—white—and the socioeconomic gaps between the buyer and the seller are likely to be much smaller.” He continues: “Even the most sexist or bigoted rich white person in many other contexts wouldn’t be able to exploit women and minorities at the level the typical liberal professional in a city like Seattle, San Francisco, or Chicago does in their day-to-day lives. The infrastructure simply isn’t there.” The Americans who take the most advantage of exploited workers, he argues, are the same Democratic-voting professionals in progressive bastions who most “conspicuously lament inequality.”

[Read: The blindness of elites]

Musa sees the reelection of Donald Trump as a reflection of Americans’ resentment toward elites and the “rapid shift in discourse and norms around ‘identity’ issues” that he refers to as the “Great Awokening.” To understand what’s happening to American politics, he told me, we shouldn’t look to the particulars of the election—“say, the attributes of Harris, how she ran her campaign, inflation worries, and so on,” but rather to this broader backlash. All of the signs were there for elites to see if only they’d bothered to look.

One question We Have Never Been Woke sets out to answer is why elites are so very blind, including to their own hypocrisy. The answer al-Gharbi proposes is at once devastatingly simple yet reaffirmed everywhere one turns: Fooled by superficial markers of their own identity differences—racial, sexual, and otherwise—elites fail to see themselves for what they truly are.

“When people say things about elites, they usually focus their attention on cisgender heterosexual white men” who are “able-bodied and neurotypical,” al-Gharbi told me, in one of our conversations this fall. Most elites are white, of course, but far from all. And elites today, he added, also “increasingly identify as something like disabled or neurodivergent, LGBTQ.” If you “exclude all of those people from analysis, then you’re just left with this really tiny and misleading picture of who the elites are, who benefits from the social order, how they benefit.”

Sociologists who have studied nonwhite elites in the past have tended to analyze them mainly in the contexts of the marginalized groups from which they came. E. Franklin Frazier’s 1955 classic, Black Bourgeoisie, for example, spotlighted the hypocrisy and alienation of relatively prosperous Black Americans who found themselves doubly estranged: from the white upper classes they emulated as well as from the Black communities they’d left behind. By analyzing nonwhites and other minorities as elites among their peers, al-Gharbi is doing something different. “Elites from other groups are often passed over in silence or are explicitly exempted from critique (and even celebrated!),” he writes. And yet, “behaviors, lifestyles, and relationships that are exploitative, condescending, or exclusionary do not somehow become morally noble or neutral when performed by members of historically marginalized or disadvantaged groups.”

When al-Gharbi uses the word elite, he is talking about the group to which he belongs: the “symbolic capitalists”—broadly speaking, the various winners of the knowledge economy who do not work with their hands and who produce and manipulate “data, rhetoric, social perceptions and relations, organizational structures and operations, art and entertainment, traditions and innovations.” These are the people who set the country’s norms through their dominance of the “symbolic economy,” which consists of media, academic, cultural, technological, legal, nonprofit, consulting, and financial institutions.  

Although symbolic capitalists are not exactly the same as capitalist capitalists, or the rest of the upper class that does not rely on income, neither are they—as graduate students at Columbia and Yale can be so eager to suggest—“the genuinely marginalized and disadvantaged.” The theorist Richard Florida has written about a group he calls the “creative class,” which represents 30 percent of the total U.S. workforce, and which overlaps significantly with al-Gharbi’s symbolic capitalists. Using survey data from 2017, Florida calculated that members of that creative class earned twice as much over the course of the year as members of the working class—an average of $82,333 versus $41,776, respectively.

Symbolic capitalists aren’t a monolith, but it is no secret that their ruling ideology is the constellation of views and attitudes that have come to be known as “wokeness,” which al-Gharbi defines as beliefs about social justice that “inform how mainstream symbolic capitalists understand and pursue their interests—creating highly novel forms of competition and legitimation.”

Al-Gharbi’s own path is emblematic of the randomness and possibility of membership in this class. The son of military families on both sides, one Black and one white, he attended community college for six years, “taking classes off and on while working,” he told me. There he was lucky to meet a talented professor, who “basically took me under his wing and helped me do something different,” al-Gharbi said. Together, they focused on private lessons in Latin, philosophy, and classics—subjects not always emphasized in community college.

Around that time he was also going on what he calls “this whole religious journey”: “I initially tried to be a Catholic priest, and then I became an atheist for a while, but I had this problem. I rationally convinced myself that religion was bullshit and there is no God, but I couldn’t make myself feel it.” Then he read the Quran and “became convinced that it was a prophetic work. And so I was like, Well, if I believe that Muhammad is a prophet and I believe in God, that’s the two big things. So maybe I am a Muslim.” Soon after, he changed his name. Then, just when he was getting ready to transfer out of community college, his twin brother, Christian, was killed on deployment in Afghanistan. He chose to go somewhere close to his grieving family, the University of Arizona, to finish his degree in Near-Eastern studies and philosophy.

The same dispassionate analysis that he applies to his own life’s progress he brings to bear on America’s trends, especially the Great Awokening. He traces that widespread and sudden movement in attitudes not to the death of Trayvon Martin or Michael Brown, nor to Black Lives Matter or the #MeToo movement, nor to the election of Donald Trump, but to September 2011 and the Occupy Wall Street movement that emerged from the ashes of the financial crisis.

“In reality, Occupy was not class oriented,” he argues. By focusing its critique on the top 1 percent of households, which were overwhelmingly white, and ignoring the immense privilege of the more diverse symbolic capitalists just beneath them, the movement, “if anything, helped obscure important class differences and the actual causes of social stratification.” This paved the way for “elites who hail from historically underrepresented populations … to exempt themselves from responsibility for social problems and try to deflect blame onto others.”

[Read: The 9.9 percent is the new American aristocracy]

Al-Gharbi is neither an adherent of wokeism nor an anti-woke scold. He would like to both stem the progressive excesses of the summer of 2020, a moment when white liberals “tended to perceive much more racism against minorities than most minorities, themselves, reported experiencing,” and see substantive social justice be achieved for everyone, irrespective of whether they hail from a historically disadvantaged identity group or not. The first step, he argues, is to dispel the notion that the Great Awokening was “some kind of unprecedented new thing.”

Awokenings, in al-Gharbi’s telling, are struggles for power and status in which symbolic capitalists, often instinctively and even subconsciously, leverage social-justice discourse not on behalf of the marginalized but in service of their own labor security, political influence, and social prestige. He does not see this as inherently nefarious—indeed, like Tocqueville and many others before him, he recognizes that motivated self-interest can be the most powerful engine for the common good. Al-Gharbi argues that our current Awokening, which peaked in 2021 and is now winding down, is really the fourth such movement in the history of the United States.

The first coincided with the Great Depression, when suddenly “many who had taken for granted a position among the elite, who had felt more or less entitled to a secure, respected, and well-paying professional job, found themselves facing deeply uncertain futures.”

The next would take place in the 1960s, once the radicals of the ’30s were firmly ensconced within the bourgeoisie. “The driver was not the Vietnam War itself,” al-Gharbi stresses. That had been going on for years without protest. Nor was the impetus the civil-rights movement, gay liberation, women’s liberation, or any such cause. “Instead, middle-class students became radical precisely when their plans to leave the fighting to minorities and the poor by enrolling in college and waiting things out began to fall through,” he argues. “It was at that point that college students suddenly embraced anti-war activism, the Black Power movement, feminism, postcolonial struggles, gay rights, and environmentalism in immense numbers,” appropriating those causes for their own gain.

If this sounds familiar, it should. The third Awokening was smaller and shorter than the others, stretching from the late ’80s to the early ’90s, and repurposing and popularizing the Marxist term political correctness. Its main legacy was to set the stage for the fourth—and present—Awokening, which has been fueled by what the scholar Peter Turchin has termed “elite overproduction”: Quite simply, America creates too many highly educated, highly aspirational young people, and not enough high-status, well-paid jobs for them to do. The result, al-Gharbi writes, is that “frustrated symbolic capitalists and elite aspirants [seek] to indict the system that failed them—and also the elites that did manage to flourish—by attempting to align themselves with the genuinely marginalized and disadvantaged.” It is one of the better and more concise descriptions of the so-called cancel culture that has defined and bedeviled the past decade of American institutional life. (As Hannah Arendt observed in The Origins of Totalitarianism, political purges often serve as jobs programs.)  

The book is a necessary corrective to the hackneyed discourse around wealth and privilege that has obtained since 2008. At the same time, al-Gharbi’s focus on symbolic capitalists leaves many levers of power unexamined. Whenever I’m in the company of capitalist capitalists, I’m reminded of the stark limitations of the symbolic variety. Think of how easily Elon Musk purchased and then destroyed that vanity fair of knowledge workers formerly known as Twitter. While some self-important clusters of them disbanded to Threads or Bluesky to post their complaints, Musk helped Trump win the election. His PAC donated $200 million to the campaign, while Musk served as Trump’s hype man at rallies and on X. Trump has since announced that Musk will be part of the administration itself, co-leading the ominously named Department of Government Efficiency.

Al-Gharbi’s four Great Awokenings framework can sometimes feel too neat. In a review of We Have Never Been Woke in The Wall Street Journal, Jonathan Marks points out a small error in the book. Al-Gharbi relies on research by Richard Freeman to prove that a bust in the labor market for college graduates ignited the second Awokening. But al-Gharbi gets the date wrong: “Freeman’s comparison isn’t between 1958 and 1974. It’s between 1968 and 1974”—too late, Marks argued, to explain what al-Gharbi wants it to explain. (When I asked al-Gharbi about this, he acknowledged the mistake on the date but insisted the point still held: “The thing that precipitated the massive unrest in the 1960s was the changing of draft laws in 1965,” he said. “A subsequent financial crisis made it tough for elites to get jobs, ramping things up further.” He argued it was all the same crisis: an expanding elite “growing concerned that the lives and livelihoods they’d taken for granted are threatened and may, in fact, be out of reach.”)

Despite such quibbles, al-Gharbi’s framework remains a powerful one. By contrasting these periods, al-Gharbi stressed to me, we can not only understand what is happening now but also get a sense of the shape of wokenesses to come. As he sees it, “the way the conversation often unfolds is just basically saying wokeness is puritanism or religion,” he explained. “They think Puritanism sucks, or religion sucks,” he continued. But just saying that “wokeness is bad” is not “super useful.”

Indeed, one of the primary reasons such anti-woke reactions feel so unsatisfactory is that wokeness, not always but consistently, stems from the basic recognition of large-scale problems that really do exist. Occupy Wall Street addressed the staggering rise of inequality in 21st-century American life; Black Lives Matter emerged in response to a spate of reprehensible police and vigilante killings that rightfully shocked the nation’s conscience; #MeToo articulated an ambient sexism that degraded women’s professional lives and made us consider subtler forms of exploitation and abuse. The self-dealing, overreach, and folly that each of these movements begat does not absolve the injustices they emerged to address. On the contrary, they make it that much more urgent to deal effectively with these ills.

[Musa al-Gharbi: Police punish the ‘good apples’]

Any critique of progressive illiberalism that positions the latter as unprecedented or monocausal—downstream of the Civil Rights Act, as some conservatives like to argue—is bound not only to misdiagnose the problem but to produce ineffective or actively counterproductive solutions to it as well. Wokeness is, for al-Gharbi, simply the way in which a specific substratum of elites “engage in power struggles and struggles for status,” he said. “Repealing the Civil Rights Act or dismantling DEI or rolling back Title IX and all of that will not really eliminate wokeness.”

Neither will insisting that its adherents must necessarily operate from a place of bad faith. In fact, al-Gharbi believes it is the very sincerity of their belief in social justice that keeps symbolic capitalists from understanding their own behavior, and the counterproductive social role they often play. “It’s absolutely possible for someone to sincerely believe something,” al-Gharbi stressed, “but also use it in this instrumental way.”

Having been born into one minority group and converted to another as an adult, al-Gharbi has himself accrued academic pedigree and risen to prominence, in no small part, by critiquing his contemporaries who flourished during the last Great Awokening. He is attempting to outflank them, too, aligning himself even more fully with the have-nots. Yet his work is permeated by a refreshing awareness of these facts. “A core argument of this book is that wokeness has become a key source of cultural capital among contemporary elites—especially among symbolic capitalists,” he concedes. “I am, myself, a symbolic capitalist.”

The educated knowledge workers who populate the Democratic Party need more of this kind of clarity and introspection. Consider recent reports that the Harris campaign declined to appear on Joe Rogan’s podcast in part out of concerns that it would upset progressive staffers, who fussed over language and minuscule infractions while the country lurched toward authoritarianism.

Al-Gharbi’s book’s title is drawn from Bruno Latour’s We Have Never Been Modern, which famously argued for a “symmetrical anthropology” that would allow researchers to turn the lens of inquiry upon themselves, subjecting modern man to the same level of analytical rigor that his “primitive” and premodern counterparts received. What is crucial, al-Gharbi insists, “is not what’s in people’s hearts and minds.” Rather the question must always be: “How is society arranged?” To understand the inequality that plagues us—and then to actually do something about it—we are going to have to factor in ourselves, our allies, and our preferred narratives too. Until that day, as the saying about communism goes, real wokeness has never even been tried.

She Was an Education Superstar. Then She Got Blamed for America’s Reading Crisis.

The Atlantic

www.theatlantic.com › magazine › archive › 2024 › 12 › lucy-calkins-child-literacy-teaching-methodology › 680394

This story seems to be about:

Photographs by Jeff Brown

Until a couple of years ago, Lucy Calkins was, to many American teachers and parents, a minor deity. Thousands of U.S. schools used her curriculum, called Units of Study, to teach children to read and write. Two decades ago, her guiding principles—that children learn best when they love reading, and that teachers should try to inspire that love—became a centerpiece of the curriculum in New York City’s public schools. Her approach spread through an institute she founded at Columbia University’s Teachers College, and traveled further still via teaching materials from her publisher. Many teachers don’t refer to Units of Study by name. They simply say they are “teaching Lucy.”

But now, at the age of 72, Calkins faces the destruction of everything she has worked for. A 2020 report by a nonprofit described Units of Study as “beautifully crafted” but “unlikely to lead to literacy success for all of America’s public schoolchildren.” The criticism became impossible to ignore two years later, when the American Public Media podcast Sold a Story: How Teaching Kids to Read Went So Wrong accused Calkins of being one of the reasons so many American children struggle to read. (The National Assessment of Educational Progress—a test administered by the Department of Education—found in 2022 that roughly one-third of fourth and eighth graders are unable to read at the “basic” level for their age.)

In Sold a Story, the reporter Emily Hanford argued that teachers had fallen for a single, unscientific idea—and that its persistence was holding back American literacy. The idea was that “beginning readers don’t have to sound out words.” That meant teachers were no longer encouraging early learners to use phonics to decode a new word—to say cuh-ah-tuh for “cat,” and so on. Instead, children were expected to figure out the word from the first letter, context clues, or nearby illustrations. But this “cueing” system was not working for large numbers of children, leaving them floundering and frustrated. The result was a reading crisis in America.

The podcast said that “a company and four of its top authors” had sold this “wrong idea” to teachers and politicians. The company was the educational publisher Heinemann, and the authors included the New Zealander Marie Clay, the American duo Irene Fountas and Gay Su Pinnell, and Calkins. The podcast devoted an entire episode, “The Superstar,” to Calkins. In it, Hanford wondered if Calkins was wedded to a “romantic” notion of literacy, where children would fall in love with books and would then somehow, magically, learn to read. Calkins could not see that her system failed poorer children, Hanford argued, because she was “influenced by privilege”; she had written, for instance, that children might learn about the alphabet by picking out letters from their surroundings, such as “the monogram letters on their bath towels.”

In Hanford’s view, it was no surprise if Calkins’s method worked fine for wealthier kids, many of whom arrive at school already starting to read. If they struggled, they could always turn to private tutors, who might give the phonics lessons that their schools were neglecting to provide. But kids without access to private tutors needed to be drilled in phonics, Hanford argued. She backed up her claims by referencing neurological research into how children learn to read—gesturing to a body of evidence known as “the science of reading.” That research demonstrated the importance of regular, explicit phonics instruction, she said, and ran contrary to how American reading teachers were being trained.

Since the podcast aired, “teaching Lucy” has fallen out of fashion. Calkins’s critics say that her refusal to acknowledge the importance of phonics has tainted not just Units of Study—a reading and writing program that stretches up to eighth grade—but her entire educational philosophy, known as “balanced literacy.” Forty states and the District of Columbia have passed laws or implemented policies promoting the science of reading in the past decade, according to Education Week, and publishers are racing to adjust their offerings to embrace that philosophy.

Somehow, the wider debate over how to teach reading has become a referendum on Calkins herself. In September 2023, Teachers College announced that it would dissolve the reading-and-writing-education center that she had founded there. Anti-Lucy sentiment has proliferated, particularly in the city that once championed her methods: Last year, David Banks, then the chancellor of New York City public schools, likened educators who used balanced literacy to lemmings: “We all march right off the side of the mountain,” he said. The New Yorker has described Calkins’s approach as “literacy by vibes,” and in an editorial, the New York Post described her initiative as “a disaster” that had been “imposed on generations of American children.” The headline declared that it had “Ruined Countless Lives.” When the celebrated Harvard cognitive psychologist Steven Pinker shared an article about Calkins on X, he bemoaned “the scandal of ed schools that promote reading quackery.” Queen Lucy has been dethroned.

“I mean, I can say it—it was a little bit like 9/11,” Calkins told me when we spoke at her home this summer. On that day in 2001, she had been driving into New York City, and “literally, I was on the West Side Highway and I saw the plane crash into the tower. Your mind can’t even comprehend what’s happening.” Two decades later, the suggestion that she had harmed children’s learning felt like the same kind of gut punch.

Calkins now concedes that some of the problems identified in Sold a Story were real. But she says that she had followed the research, and was trying to rectify issues even before the podcast debuted: She released her first dedicated phonics units in 2018, and later published a series of “decodable books”—simplified stories that students can easily sound out. Still, she has not managed to satisfy her critics, and on the third day we spent together, she admitted to feeling despondent. “What surprises me is that I feel as if I’ve done it all,” she told me. (Heinemann, Calkins’s publisher, has claimed that the Sold a Story podcast “radically oversimplifies and misrepresents complex literacy issues.”)

The backlash against Calkins strikes some onlookers, even those who are not paid-up Lucy partisans, as unfair. “She wouldn’t have been my choice for the picture on the ‘wanted’ poster,” James Cunningham, a professor emeritus of literacy studies at the University of North Carolina at Chapel Hill, told me. Indeed, over the course of several days spent with Calkins, and many more hours talking with people on all sides of this debate, I came to see her downfall as part of a larger story about the competing currents in American education and the universal desire for an easy, off-the-shelf solution to the country’s reading problems.

The question now is whether Calkins is so much a part of the problem that she cannot be part of the solution. “I’m going to figure this out,” she remembered thinking. “And I’m going to clarify it or I’m going to write some more or speak or do something or, or—fix it.” But can she? Can anyone?

On the last day of the school year in Oceanside, a well-to-do town on Long Island, everyone was just delighted to see Lucy Calkins. The young Yale-educated principal of Fulton Avenue School 8, Frank Zangari, greeted her warmly, and at the end of one lesson, a teacher asked for a selfie.

The lessons I saw stressed the importance of self-expression and empathy with other viewpoints; a group of sixth graders told me about the books they had read that year, which explored being poor in India and growing up Black in 1960s America. In every class, I watched Calkins speak to children with a mixture of intense attention and straightforward challenge; she got down on the floor with a group learning about orcas and frogs and peppered them with questions about how animals breathe. “Could you talk a minute about the writer’s craft?” she asked the sixth graders studying poetry. “Be more specific. Give examples,” she told a fourth grader struggling to write a memoir.

With her slim frame, brown bob, and no-nonsense affect, she reminded me of Nancy Pelosi. “I can’t retire; I don’t have any hobbies,” I overheard her saying to someone later.

School 8 showed the strengths of Calkins’s approach—which is presumably why she had suggested we visit it together. But it also hinted at the downsides. For generations in American public education, there has been a push and pull between two broad camps—one in which teachers are encouraged to directly impart skills and information, and a more progressive one in which children are thought to learn best through firsthand experience. When it comes to reading, the latter approach dominates universities’ education programs and resonates with many teachers; helping children see themselves as readers and writers feels more emotionally satisfying than drilling them on diphthongs and trigraphs.

This tension between the traditionalists and the progressives runs through decades of wrangling over standardized tests and through most of the major curricular controversies in recent memory. Longtime educators tick off the various flash points like Civil War battlefields: outcome-based education, No Child Left Behind, the Common Core. Every time, the pendulum went one way and then the other. “I started teaching elementary school in 1964,” says P. David Pearson, a former dean at the Berkeley School of Education, in California. “And then I went to grad school in, like, ’67, and there’s been a back-to-the-basics swing about every 10 years in the U.S., consistently.”

The progressives’ primary insight is that lessons focused on repetitive instruction and simplified text extracts can be boring for students and teachers alike, and that many children respond more enthusiastically to discovering their own interests. “We’re talking about an approach that treats kids as competent, intellectual meaning makers, versus kids who just need to learn the code,” Maren Aukerman, a professor at the University of Calgary, told me. But opponents see that approach as nebulous and undirected.

My time at School 8 was clearly intended to demonstrate that Units of Study is not hippie nonsense, but a rigorous curriculum that can succeed with the right teachers. “There’s no question in my mind that the philosophy works, but in order to implement it, it takes a lot of work,” Phyllis Harrington, the district superintendent, told me.

School 8 is a happy school with great results. However, while the school uses Calkins’s writing units for all grades, it uses her reading units only from the third grade on. For first and second grades, the school uses Fundations, which is marketed as “a proven approach to Structured Literacy that is aligned with the science of reading.” In other words, it’s a phonics program.

Calkins’s upbringing was financially comfortable but psychologically tough. Both of her parents were doctors, and her father eventually chaired the department of medicine at the University at Buffalo. Calkins’s mother was “the most important, wonderful person in my life, but really brutal,” she told me. If a bed wasn’t made, her mother ripped off the sheets. If a coat wasn’t hung up, her mother dropped it into the basement. When the young Lucy bit her fingernails, her mother tied dancing gloves onto her hands. When she scratched the mosquito bites on her legs, her mother made her wear thick pantyhose at the height of summer.

The nine Calkins children raised sheep and chickens themselves. Her memories of childhood are of horseback riding in the cold, endless hand-me-downs, and little tolerance for bad behavior.

That is why, Calkins told me, “nothing that Emily Hanford has said grates on me more than the damn monogrammed towels.” But she knows that the charge of being privileged and out of touch has stuck. Her friends had warned her about letting me into her home in Dobbs Ferry, a pretty suburb of New York, and I could see why. Her house is idyllic—at the end of a long private drive, shaded by old trees, with a grand piano in the hallway and a Maine-coon cat patrolling the wooden floors. Calkins has profited handsomely from textbook sales and training fees, and in the eyes of some people, that is suspicious. (“Money is the last thing I ever think about,” she told me.)

She became interested in reading and writing because she babysat for the children of the literacy pioneer Donald Graves, whose philosophy can be summarized by one of his most widely cited phrases: “Children want to write.” Even at a young age, she believed in exhaustively prepared fun. “I would plan a bagful of things I would bring over there; I was the best babysitter you could ever have,” she said. “We would do crafts projects, and drama, you know, and I would keep the kids busy all day.”

When Calkins was 14, Graves sent her to be a counselor at a summer camp in rural Maine. She remembers two kids in particular, Sophie and Charlie. Sophie was “so tough and surly, and a kind of overweight, insecure, tough kid,” but she opened up when Calkins took her horseback riding and then asked her to write about it. Charlie loved airplanes, and so she asked him to write about those. The experience cemented her lifelong belief that children should read and write as a form of self-expression.

After graduating from Williams College in 1973, she enrolled in a program in Connecticut that trained teachers to work in disadvantaged districts. She read everything about teaching methods she could find, and traveled to England, where a progressive education revolution was in full swing.

Calkins returned to America determined to spread this empowering philosophy. She earned a doctorate at NYU, and, in 1986, published a book called The Art of Teaching Writing. Later, she expanded her purview to reading instruction.

At the time, the zeitgeist favored an approach known as “whole language.” This advocated independent reading of full books and suggested that children should identify words from context clues rather than arduously sounding them out. Progressives loved it, because it emphasized playfulness and agency. But in practice, whole language had obvious flaws: Some children do appear to pick up reading easily, but many benefit from focused, direct instruction.

This approach influenced Calkins as she developed her teaching philosophy. “Lucy Calkins sides, in most particulars, with the proponents of ‘whole language,’ ” The New York Times reported in 1997. Her heavyweight 2001 book, The Art of Teaching Reading, has only a single chapter on phonics in primary grades; it does note, however, that “researchers emphasize how important it is for children to develop phonemic awareness in kindergarten.”

The author Natalie Wexler has described Calkins’s resulting approach, balanced literacy, as an attempt to create a “peace treaty” in the reading wars: Phonics, yes, if you must, but also writing workshops and independent reading with commercial children’s books, rather than the stuffier grade-level decodable texts and approved extracts. (Defenders of the former method argue that using full books is more cost-efficient, because they can be bought cheaply and used by multiple students.) “If we make our children believe that reading has more to do with matching letters and sounds than with developing relationships with characters like Babar, Madeline, Charlotte, and Ramona,” Calkins wrote, “we do more harm than good.”

Sentences like that are why critics saw balanced literacy as a branding exercise designed to rehabilitate old methods. “It was a strategic rebadging of whole language,” Pamela Snow, a cognitive-psychology professor at La Trobe University, in Australia, told me. Even many of Calkins’s defenders concede that she was too slow to embrace phonics as the evidence for its effectiveness grew. “I think she should have reacted earlier,” Pearson, the former Berkeley dean, told me, but he added: “Once she changed, they were still beating her for what she did eight years ago, not what she was doing last month.”

For the first decades of her career, Calkins was an influential thinker among progressive educators, writing books for teachers. In 2003, though, Joel Klein, then the chancellor of the New York City public schools, suddenly mandated her workshop approach in virtually all of the city’s elementary schools, alongside a separate, much smaller, phonics program. An article in the Times suggested that some saw Klein as “an unwitting captive of the city’s liberal consensus,” but Klein brushed aside the criticisms of balanced literacy. “I don’t believe curriculums are the key to education,” he said. “I believe teachers are.” Now everybody in the city’s public schools would be “teaching Lucy.”

As other districts followed New York’s lead, Units of Study became one of the most popular curricula in the United States. This led, inevitably, to backlash. A philosophy had become a product—an extremely popular and financially successful one. “Once upon a time there was a thoughtful educator who raised some interesting questions about how children were traditionally taught to read and write, and proposed some innovative changes,” the author Barbara Feinberg wrote in 2007. “But as she became famous, critical debate largely ceased: her word became law. Over time, some of her methods became dogmatic and extreme, yet her influence continued to grow.”

You wouldn’t know it from listening to her fiercest detractors, but Calkins has, in fact, continuously updated Units of Study. Unlike Irene Fountas and Gay Su Pinnell, who have stayed quiet during the latest furor and quietly reissued their curriculum with more emphasis on phonics last year, Calkins has even taken on her critics directly. In 2019—the year after she added the dedicated phonics texts to Units of Study—she published an eight-page document called “No One Gets to Own the Term ‘The Science of Reading,’ ” which referred dismissively to “phonics-centric people” and “the new hype about phonics.” This tone drove her opponents mad: Now that Calkins had been forced to adapt, she wanted to decide what the science of reading was?

“Her document is not about the science that I know; it is about Lucy Calkins,” wrote the cognitive neuroscientist Mark Seidenberg, one of the critics interviewed in Sold a Story. “The purpose of the document is to protect her brand, her market share, and her standing among her many followers.”

Talking with Calkins herself, it was hard to nail down to what extent she felt that the criticisms of her earlier work were justified. When I asked her how she was thinking about phonics in the 2000s, she told me: “Every school has a phonics program. And I would always talk about the phonics programs.” She added that she brought phonics specialists to Columbia’s Teachers College several times a year to help train aspiring educators. (James Cunningham, at UNC Chapel Hill, backed this up, telling me, “She was certainly not wearing a sandwich billboard around: DON’T TEACH PHONICS.”)

But still, I asked Calkins, would it be fair to say that phonics wasn’t your bag?

“I felt like phonics was something that you have the phonics experts teach.”

So where does this characterization of you being hostile toward phonics come from?

“Hopefully, you understand I’m not stupid. You would have to be stupid to not teach a 5-year-old phonics.”

But some people didn’t, did they? They were heavily into context and cueing.

“I’ve never heard of a kindergarten teacher who doesn’t teach phonics,” Calkins replied.

Because this is America, the reading debate has become a culture war. When Sold a Story came along in 2022, it resonated with a variety of audiences, including center-left education reformers and parents of children with learning disabilities. But it also galvanized political conservatives. Calkins’s Units of Study was already under attack from the right: In 2021, an article in the Manhattan Institute’s City Journal titled “Units of Indoctrination” had criticized the curriculum, alleging that the way it teaches students to analyze texts “amounts to little more than radical proselytization through literature.”

The podcast was released at an anxious time for American education. During the coronavirus pandemic, many schools—particularly in blue states—were closed for months at a time. Masking in classrooms made it harder for children to lip-read what their teachers were saying. Test scores fell, and have only recently begun to recover.

“Parents had, for a period of time, a front-row seat based on Zoom school,” Annie Ward, a recently retired assistant superintendent in Mamaroneck, New York, told me. She wondered if that fueled a desire for a “back to basics” approach. “If I’m a parent, I want to know the teacher is teaching and my kid is sitting there soaking it up, and I don’t want this loosey-goosey” stuff.

Disgruntled parents quickly gathered online. Moms for Liberty, a right-wing group that started out by opposing school closures and mask mandates, began lobbying state legislators to change school curricula as well. The reading wars began to merge with other controversies, such as how hard schools should push diversity-and-inclusion programs. (The Moms for Liberty website recommends Sold a Story on its resources page.) “We’re failing kids everyday, and Moms for Liberty is calling it out,” a co-founder, Tiffany Justice, told Education Week in October of last year. “The idea that there’s more emphasis placed on diversity in the classroom, rather than teaching kids to read, is alarming at best. That’s criminal.”

Ward’s district was not “teaching Lucy,” but using its own bespoke balanced-literacy curriculum. In the aftermath of the pandemic, Ward told me, the district had several “contentious” meetings, including one in January 2023 where “we had ringers”—attendees who were not parents or community members, but instead seemed to be activists from outside the district. “None of us in the room recognized these people.” That had never happened before.

I had met Ward at a dinner organized by Calkins at her home, which is also the headquarters of Mossflower—the successor to the center that Calkins used to lead at Teachers College. The evening demonstrated that Calkins still has star power. On short notice, she had managed to assemble half a dozen superintendents, assistant superintendents, and principals from New York districts.

“Any kind of disruption like this has you think very carefully about what you’re doing,” Edgar McIntosh, an assistant superintendent in Scarsdale, told me. But he, like several others, was frustrated by the debate. During his time as an elementary-school teacher, he had discovered that some children could decode words—the basic skill developed by phonics—but struggled with their meaning. He worried that parents’ clamor for more phonics might come at the expense of teachers’ attention to fluency and comprehension. Raymond Sanchez, the superintendent of Tarrytown’s school district, said principals should be able to explain how they were adding more phonics or decodable texts to existing programs, rather than having “to throw everything out and find a series that has a sticker that says ‘science of reading’ on it.”

This, to me, is the key to the anti-Lucy puzzle. Hanford’s reporting was thorough and necessary, but its conclusion—that whole language or balanced literacy would be replaced by a shifting, research-based movement—is hard to reconcile with how American education actually works. The science of reading started as a neutral description of a set of principles, but it has now become a brand name, another off-the-shelf solution to America’s educational problems. The answer to those problems might not be to swap out one commercial curriculum package for another—but that’s what the system is set up to enable.

Gail Dahling-Hench, the assistant superintendent in Madison, Connecticut, has experienced this pressure firsthand. Her district’s schools don’t “teach Lucy” but instead follow a bespoke local curriculum that, she says, uses classroom elements associated with balanced literacy, such as the workshop model of students studying together in small groups, while also emphasizing phonics. That didn’t stop them from running afoul of the new science-of-reading laws.

In 2021, Connecticut passed a “Right to Read” law mandating that schools choose a K–3 curriculum from an approved list of options that are considered compliant with the science of reading. Afterward, Dahling-Hench’s district was denied a waiver to keep using its own curriculum. (Eighty-five districts and charter schools in Connecticut applied for a waiver, but only 17 were successful.) “I think they got wrapped around the axle of thinking that programs deliver instruction, and not teachers,” she told me.

Dahling-Hench said the state gave her no useful explanation for its decision—nor has it outlined the penalties for noncompliance. She has decided to stick with the bespoke curriculum, because she thinks it’s working. According to test scores released a few days after our conversation, her district is among the best-performing in the state.

Keeping the current curriculum also avoids the cost of preparing teachers and administrators to use a new one—a transition that would be expensive even for a tiny district like hers, with just five schools. “It can look like $150,000 to $800,000 depending on which program you’re looking at, but that’s a onetime cost,” Dahling-Hench said. Then you need to factor in annual costs, such as new workbooks.

You can’t understand this controversy without appreciating the sums involved. Refreshing a curriculum can cost a state millions of dollars. People on both sides will therefore suggest that their opponents are motivated by money—either saving their favored curriculum to keep the profits flowing, or getting rich through selling school boards an entirely new one. Talking with teachers and researchers, I heard widespread frustration with America’s commercial approach to literacy education. Politicians and bureaucrats tend to love the idea of a packaged solution—Buy this and make all your problems go away!—but the perfect curriculum does not exist.

“If you gave me any curriculum, I could find ways to improve it,” Aukerman, at the University of Calgary, told me. She thinks that when a teaching method falls out of fashion, its champions are often personally vilified, regardless of their good faith or expertise. In the case of Lucy Calkins and balanced literacy, Aukerman said, “If it weren’t her, it would be someone else.”

Jeff Brown for The Atlantic

One obvious question about the science of reading is, well … what is it? The evidence for some kind of explicit phonics instruction is compelling, and states such as Mississippi, which has adopted early screening to identify children who struggle to read—and which holds back third graders if necessary—appear to be improving their test scores. Beyond that, though, things get messy.

Dig into this subject, and you can find frontline teachers and credentialed professors who contest every part of the consensus. And I mean every part: Some academics don’t even think there’s a reading crisis at all.

American schools might be ditching Units of Study, but balanced literacy still has its defenders. A 2022 analysis in England, which mandates phonics, found that systematic reviews “do not support a synthetic phonics orientation to the teaching of reading; they suggest that a balanced-instruction approach is most likely to be successful.”

The data on the effects of specific methods can be conflicting and confusing, which is not unusual for education studies, or psychological research more generally. I feel sorry for any well-intentioned superintendent or state legislator trying to make sense of it all. One of the classrooms at Oceanside School 8 had a wall display devoted to “growth mindset,” a fashionable intervention that encourages children to believe that instead of their intelligence and ability being fixed, they can learn and evolve. Hoping to improve test scores, many schools have spent thousands of dollars each implementing “growth mindset” lessons, which proponents once argued should be a “national education priority.” (Some proponents also hoped, earnestly, that the approach could help bring peace to the Middle East.) But in the two decades since growth mindset first became ubiquitous, the lofty claims made about its promise have come down to earth.

Keeping up with all of this is more than any teacher—more than any school board, even—can reasonably be expected to do. After I got in touch with her, Emily Hanford sent me seven emails with links to studies and background reading; I left Calkins’s house loaded down with units of her curricula for younger students. More followed in the mail.

Even the most modest pronouncements about what’s happening in American schools are difficult to verify, because of the sheer number of districts, teachers, and pupils involved. In Sold a Story, Hanford suggested that some schools were succeeding with Units of Study only because parents hired personal tutors for their children. But corroborating this with data is impossible. “I haven’t figured out a way to quantify it, except in a very strong anecdotal way,” Hanford told me.

Some teachers love “teaching Lucy,” and others hate it. Is one group delusional? And if so, which one? Jenna and Christina, who have both taught kindergarten in New York using Units of Study, told me that the curriculum was too invested in the idea of children as “readers” and “writers” without giving them the basic skills needed to read and write. (They asked to be identified only by their first names in case of professional reprisals.) “It’s a piece of shit,” Christina said. She added: “We’re expecting them to apply skills that we haven’t taught them and that they aren’t coming to school with. I’ve been trying to express that there’s a problem and I get called negative.” Jenna had resorted to a covert strategy, secretly teaching phonics for up to 90 minutes a day instead of the brief lessons she was instructed to provide.

But for every Jenna or Christina, there’s a Latasha Holt. After a decade as a third- and fourth-grade teacher in Arkansas, Holt is now an associate professor of elementary literacy at the University of Louisiana at Lafayette, where she has watched from the sidelines as the tide turned against Calkins. “The dismantling of this thing, it got to me, because I had taught under Units of Study,” she told me. “I’ve used it, and I knew how good it was. I had lived it; I’ve seen it work; I knew it was good for kids.”

Aubrey Kinat is a third-grade teacher in Texas who recently left her position at a public school because it decided to drop Units of Study. (The school now uses another curriculum, which was deemed to align better with the science of reading.) Suddenly, she was pushed away from full novels and toward approved excerpts, and her lessons became much more heavily scripted. “I felt like I was talking so much,” she told me. “It took the joy out of it.”

For many school boards facing newly politicized parents who came out of the pandemic with strong opinions, ditching Lucy has had the happy side effect of giving adults much more control over what children read. Calkins and some of her dinner guests had suggested that this might be the true reason for the animus around independent reading. “I do start to wonder if this really is about wanting to move everybody towards textbooks,” Calkins said.

Eighteen months after her series launched, Hanford returned in April 2024 with two follow-up episodes of Sold a Story, which took a less polemical tone. Unsurprisingly so: Calkins had lost, and she had won.

The science of reading is the new consensus in education, and its advocates are the new establishment. It is now on the hook for the curriculum changes that it prompted—and for America’s reading performance more generally. That is an uncomfortable position for those who care more about research than about winning political fights.

Some of the neuroscience underpinning Sold a Story was provided by Seidenberg, a professor emeritus at the University of Wisconsin at Madison. (He did not respond to an interview request.) Since the series aired, he has welcomed the move away from Units of Study, but he has also warned that “none of the other major commercial curricula that are currently available were based on the relevant science from the ground up.”

Because the usefulness of phonics is one of the few science-of-reading conclusions that is immediately comprehensible to laypeople, “phonics” has come to stand in for the whole philosophy. In a blog post last year, Seidenberg lamented that, on a recent Zoom call, a teacher had asked if they needed to keep teaching phonemic awareness once children were good readers. (The answer is no: Sounding out letters is what you do until the process becomes automatic.) Seidenberg now worried that the science of reading is “at risk of turning into a new pedagogical dogma.”

Hanford has also expressed ambivalence about the effects of Sold a Story. She compared the situation to the aftermath of No Child Left Behind, a George W. Bush–era federal education initiative that heavily promoted a literacy program called Reading First. “It became focused on products and programs,” Hanford told me, adding that the ethos turned into “get rid of whole language and buy something else.” However, she is glad that the importance of phonics—and the research backing it—is now more widely understood, because she thinks this can break the cycle of revolution and counterrevolution. She added that whenever she talks with lawmakers, she stresses the importance of continuing to listen to teachers.

What about her portrait of Calkins as rich, privileged, oblivious? Forget the monogrammed towels, I told Hanford; there is a more benign explanation for Calkins’s worldview: Everywhere she goes, she meets people, like the teachers and children in Oceanside, who are overjoyed to see her, and keen to tell her how much they love Units of Study.

But Hanford told me that she’d included the towels line because “the vast majority of teachers, especially elementary-school teachers, in America are white, middle-class women.” Many of these women, she thought, had enjoyed school themselves and didn’t intuitively know what it was like to struggle with learning to read and write.

Reporting this story, I was reminded again and again that education is both a mass phenomenon and a deeply personal one. People I spoke with would say things like Well, he’s never done any classroom research. She’s never been a teacher. They don’t understand things the way I do. The education professors would complain that the cognitive scientists didn’t understand the history of the reading wars, while the scientists would complain that the education professors didn’t understand the latest peer-reviewed research. Meanwhile, a teacher must command a class that includes students with dyslexia as well as those who find reading a breeze, and kids whose parents read to them every night alongside children who don’t speak English at home. At the same time, school boards and state legislators, faced with angry parents and a welter of conflicting testimony, must answer a simple question: Should we be “teaching Lucy,” or not?

No matter how painful the past few years have been, though, Calkins is determined to keep fighting for her legacy. At 72, she has both the energy to start over again at Mossflower and the pragmatism to have promised her estate to further the cause once she’s gone. She still has a “ferocious” drive, she told me, and a deep conviction in her methods, even as they evolve. She does not want “to pretend it’s a brand-new approach,” she said, “when in fact we’ve just been learning; we’re just incorporating more things that we’ve learned.”

But now that balanced literacy is as unfashionable as whole language, Calkins is trying to come up with a new name for her program. She thought she might try “comprehensive literacy”—or maybe “rebalancing literacy.” Whatever it takes for America to once again feel confident about “teaching Lucy.”

This article appears in the December 2024 print edition with the headline “Teaching Lucy.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

Richard Price’s Radical, Retrograde Novel

The Atlantic

www.theatlantic.com › magazine › archive › 2024 › 12 › lazarus-man-richard-price-book-review › 680397

In his tenth novel, Lazarus Man, Richard Price is, to borrow one of his own lines, on a “hunt for moments”—snapshots in time, chance encounters, fleeting interactions that reveal someone or something in a startling new light. “I’ve got like X-ray eyes for the little gestures that go right by everybody,” he explained in a profile timed to the publication of his 1992 novel, Clockers. “I don’t go for the big picture so much as a lot of little big pictures.” Mary Roe, a detective and one of the characters in his new book, shares that instinct. At the scene of a “larger horror,” what hits her most forcefully is not the dead bodies but a crushed USPS mail cart, “an everyday object so violently deformed.” It beckons her toward “an unasked-for comprehension of the whole.”

The currency that Lazarus Man—a patchwork of scenes from urban working-class life, set in the spring of 2008—trades in is the micro-epiphany. Price’s four interlaced East Harlem protagonists are big-souled people navigating narrow, “negotiated life.” What they want for themselves—someone to lie beside, a little more money, work that doesn’t involve selling something—rarely outpaces what is possible. They do not ask for much more of the world, or New York City, than it is ready to give. Each one of them is decent.

Felix Pearl is a 20-something photographer with a gig taking video footage of a playground and basketball courts for the parks department (to monitor safety protocols) and a habit of getting bamboozled by a pretty junkie. Mary, a respected member of the police department, is also the daughter of a prizefighter tormented by a mistake he made as a young man. Anthony Carter, a middle-aged divorcé, is a former salesman, former teacher, and former cokehead hoping to stumble onto a metaphysical truth that will mend the broken parts of his life. Royal Davis, a failed NBA hopeful, runs a funeral home and wishes he didn’t. When a tenement building collapses in Harlem, their paths become entangled and they reexamine their lives.

This disaster, which leaves six dead, is ostensibly the big event that sets the novel in motion, but it also feels almost beside the point. No one, including Price, shows much curiosity about what caused the collapse. In fact, Lazarus Man seems deeply uninterested in the idea of cause at all. The characters we encounter live a challenging existence; they are not quite on the cliff’s edge, but they are close enough to peer into the canyon without craning their neck. The novel has all the trappings of fiction as gritty urban social portraiture—the kind of enterprise that Price is associated with as the author of the drug-trade-steeped novel Clockers and a writer for HBO’s The Wire. Yet it isn’t.

[From the September 2024 issue: A satire of America’s obsession with identity]

Nor has Price written a gentrification novel about a changing Harlem, even as its Harlem is changing. Or a novel of proletarian discontent, though it is about discontented proletarians. Lazarus Man isn’t about structural racism either, despite being populated with minorities down on their luck and harangued by the police. What Price has given us is a retrograde novel. It is animated by unreconstructed, unembarrassed humanism.

His pages offer no fictional repackaging of uplift or pessimism or low-wattage Marxist theory. They depict no working-class heroes or Dickensian scoundrels. The characters are not pawns in some philosophical or political or cultural proxy war for which the novel is simply a vehicle. You would be forgiven for overlooking that the story is set amid the heat of Barack Obama’s historic presidential campaign, because this never comes up. Price’s characters are strapped but not completely stuck, battered by social structures but not paralyzed by them.

In his 1945 lecture “Existentialism Is a Humanism,” Jean-Paul Sartre observed that European existentialism had developed an undeserved reputation for being “gloomy,” denigrated as a philosophical movement obsessed with death, absurdity, anxiety, and the like. Sartre rejected this appraisal: Existentialism turned on the conviction that people can—in the face of history’s sweep, dehumanizing societal institutions, and unrestrained economic and technological development—choose how to live. Speaking before a sizable crowd at Paris’s Club Maintenant, Sartre addressed his critics. “Their excessive protests make me suspect that what is annoying them is not so much our pessimism,” the philosopher wryly observed, “but, much more likely, our optimism. For at bottom, what is alarming in the doctrine that I am about to try to explain to you is—is it not?—that it confronts man with a possibility of choice.”

Lazarus Man’s protagonists, confronted with exceptional circumstances they had no hand in generating, must nonetheless contend with the discomfiting reality of their own agency. This leaves Price walking a tightrope. His novel at once invites and undercuts the polarized attitudes toward social crisis that have recently become familiar—either fatalistic acceptance or righteous denunciation. Lazarus Man is about a traumatic event that defies a reflexive victim-culture response, as well as the lazy buck-up bromides favored by that culture’s critics.

Put a different way, it is a trauma novel without a trauma plot—pushing back against the formulaic storyline, so thoroughly skewered by The New Yorker’s Parul Sehgal, that reduces characters to predictable symptoms after some fateful event. The book’s author, too, isn’t readily fazed: Price, a white novelist writing yet again about Black urban life, betrays no signs of racial anxiety. “Northern white writers sometimes see black people as another species,” he noted in 2006. “I think the white writer sometimes says, ‘No, no, that’s a hornet’s nest.’ ” He’s still poking it.

The possibility that Price might have adopted the identitarian conventions of the previous decade or so—the last novel he wrote under his own name was Lush Life (2008), which unfolds on New York City’s Lower East Side—is swiftly ruled out by Anthony, the novel’s anchoring character. A half-Black, half–Italian Irish Ivy League screwup—years ago, he lost a full ride to Columbia for dealing drugs—he has been on a downward trajectory ever since. In his sober and unemployed middle age, he has been living in his dead parents’ tenement apartment and resists any attempt to frame himself as a victim. “A therapist suggested that as a Black student he might have subconsciously felt pressure to act out the role expected of him by the white students,” he reflects. Then he adds, “But that was bullshit.”

When Anthony is pulled out of the soot-gray rubble a third of the way through the novel—the reborn Lazarus of the book’s title—he is a changed man. Or, more accurately, he is a man desperately trying to play the part of a changed man. It is never quite clear, even as Lazarus Man rushes toward its devastating denouement, whom exactly Anthony is trying to convince of his redemption: the audiences who eventually come to hear him speak at community events, enchanted by the wisdom he has wrung from brute survival, or the man he sees in the mirror. To the extent that Price’s novel has a message, it is that epiphanies are a kind of theater we perform for ourselves. Faced with disaster or a momentous encounter, we are not gripped by revelation or metamorphosed in the fire of circumstance. Events do not transform us against our will. We decide, always retroactively, that some unexpected joy or undeserved blow is the stuff out of which a new life is made.

This idea, that we choose our own epiphanies, appears again and again. Mary, the worn-down detective, is especially epiphany-haunted, surrounded by people who have undergone sudden shifts of self. Her father, disturbed by his capacity for cruelty after a boxing opponent ended up permanently disabled, abruptly gave up the sweet science. Her husband is a reformed violent drunk whom Mary finds boring in his new meditative sobriety. And Mary herself lives in the long shadow of a halfway epiphany, restless in marriage and motherhood after a freak elevator accident two years earlier nearly killed her, leaving her searching for—and failing to find—new moorings. Mary spends much of the novel playing the role of dutiful detective, looking for a resident of the imploded building who hasn’t been seen since the day it crumbled. She tenuously connects the search to absolution for herself—guilt-ridden about being a distant mother—and for her father, convinced that discovering the missing man, dead or alive, will somehow land her on terra firma.

Lazarus Man possesses the same kind of telegenic quality that made Clockers an inspiration for The Wire. Some vignettes read like hilarious set pieces. When the tenement dissolves into a haze of white smog and rubble, Royal is dozing in one of his unsold coffins. Awoken by the noise, he pushes open the lid of his pine box and sits bolt upright, scaring witless the group of film-school students to whom he’s rented out his struggling funeral home so they can shoot a bad zombie movie. This slapstick gives way to something darker as Royal, knowing that the rumbling boom means bodies—and thus business—instructs his son to put on his best black suit and go hawk their services. Other moments give way to a gentle melancholy.

And as Anthony is slowly transformed into a minor New York celebrity—first thanks to a local-news appearance, and then through a series of speeches he is coaxed into giving—his ordeal gels into an earnest if squishy doctrine, one part self-help and one part call to duty. He proclaims again and again that his only goal is to “be of service.” His lectures are full of clichés and pseudo-profundities—“The street can be a brutal sculptor”—but his overwrought aphorisms also land, the kinds of phrases that audience members scribble down and later recite around the dinner table. Anthony’s underlying theme is always that change is possible, that the worst that comes to pass will end up being “the best thing that could possibly happen to you.” Personal catastrophe, Anthony preaches, is a gift. A sheep in wolf’s clothing.

[From the May 1976 issue: A review of Richard Price’s second novel, Bloodbrothers]

But in the end, Lazarus Man rejects its own Lazarus. Or at least Price subverts his post-traumatic gospel. When a woman approaches Anthony after one of his appearances, interrogating him about his mantra—“Whatever befalls you no matter how heartbreaking or onerous will turn out to be the best thing”—he finds himself, for the first time, at a loss for words. She tells him about a husband of two decades, newly dead. Three young kids at home and an ailing mother. An apartment slipping through her grasp. Plainly, no alchemy is forthcoming: The fragments of her life will not turn to gold if she just hopes hard enough. After Anthony mumbles something about God, she lets him have it.

When the novel at last gives up its final secret—who our Lazarus Man is, really—the big reveal does not hand over any certainty as to what lies in Anthony’s heart. The question that haunts the second half of the book is whether he is a con artist or a genuine street prophet. The answer ends up being neither. Or both. The simple truth is that one bad decision led to worse decisions, then to better ones. The same could be said of each character. As to the question of whether that building collapse truly made a new man, no one (including Anthony) is sure.

The genius of Price’s novel is that it rejects all mechanistic accounts of human existence—tragic or utopian, religious or otherwise—without downplaying the social forces that shape lives of labor. Price isn’t peddling a bootstraps humanism. Anthony, Felix, Royal, and Mary cannot pull themselves up into a more comfortable middle-class existence through sheer will, or by the thaumaturgic power of some hoped-for epiphany. They cannot be exactly who they want to be. But Price holds them accountable for who they are, and the choices they make within the world as it is given to them. Lazarus Man leaves us with four people still lurching toward an uncertain transformation. “I’m thinking a few things,” Royal muses. “All I know for sure is that I have to make a life that I can live with.”

This article appears in the December 2024 print edition with the headline “Richard Price’s Radical, Retrograde Novel.”

‘We Never Dared to Think About the Cure’

The Atlantic

www.theatlantic.com › health › archive › 2024 › 11 › lupus-car-t-immune-reset-autoimmune-disease › 680521

Lupus, doctors like to say, affects no two patients the same. The disease causes the immune system to go rogue in a way that can strike virtually any organ in the body, but when and where is maddeningly elusive. One patient might have lesions on the face, likened to wolf bites by the 13th-century physician who gave lupus its name. Another patient might have kidney failure. Another, fluid around the lungs. What doctors can say to every patient, though, is that they will have lupus for the rest of their life. The origins of autoimmune diseases like it are often mysterious, and an immune system that sees the body it inhabits as an enemy will never completely relax. Lupus cannot be cured. No autoimmune disease can be cured.

Two years ago, however, a study came out of Germany that rocked all of these assumptions. Five patients with uncontrolled lupus went into complete remission after undergoing a repurposed cancer treatment called CAR-T-cell therapy, which largely wiped out their rogue immune cells. The first treated patient has had no symptoms for almost four years now. “We never dared to think about the cure for our disease,” says Anca Askanase, a rheumatologist at Columbia University’s medical center who specializes in lupus. But these stunning results—remission in every patient—have fueled a new wave of optimism. More than 40 people with lupus worldwide have now undergone CAR-T-cell therapy, and most have gone into drug-free remission. It is too early to declare any of these patients cured for life, but that now seems within the realm of possibility.

Beyond lupus, doctors hope CAR-T portends a bigger breakthrough against autoimmune diseases, whose prevalence has been on a troubling rise. CAR-T has already been used experimentally to treat patients with other autoimmune diseases, including multiple sclerosis, myositis, and myasthenia gravis. And the success of CAR-T has inspired researchers to borrow other—cheaper and simpler—strategies from cancer therapy to kill immune cells gone awry. Not all of these ideas will pan out, but if any do, the next few years could bring an inflection point in treating some of the most frustrating and intractable diseases of our modern era.

CAR-T-cell therapy was originally developed as a way to kill malignant cells in blood cancer. It could, scientists later reasoned, also be used to kill specific white blood cells, called B cells, that go haywire with certain autoimmune diseases. One group tried a CAR-T-like therapy against an autoimmune disease called pemphigus vulgaris, and another CAR-T against lupus. It worked—but these experiments were only in mice.

This was the sum total of available scientific evidence when a 20-year-old woman came to her doctors in Erlangen, Germany, asking to try anything for her severe and uncontrolled lupus. None of the long-term medications typically used to manage lupus were working. Her kidneys, heart, and lungs were all failing, and she could walk only 30 feet by herself. CAR-T was risky, her doctor agreed, but lupus was killing her.

CAR-T-cell therapy could essentially turn her immune system against itself. First, doctors extracted from her blood a class of immune cells, called T cells, which they then engineered into chimeric antigen receptor T (CAR-T) cells that could recognize and destroy the B cells driving her lupus. CAR-T cells can cause dangerous and overwhelming inflammatory responses in cancer patients, and her doctors did worry that CAR-T could do the same for someone with autoimmune disease, whose immune system is already in overdrive. “We take the T cells out, activate them like crazy, and then shoot those massively overactivated T cells in an activated autoimmune disease. So if you think about it, that's kind of crazy to do that, right?” says Fabian Müller, a hematologist-oncologist at the University Hospital of Erlangen and one of the doctors on the German team that pioneered the treatment. But fortunately, the woman with lupus did not have any serious side effects, nor did any of the other patients the German group has since dosed. They are all living their everyday lives, free of lupus symptoms and medications. The woman who could walk a mere 30 feet now runs five times a week, Müller told me. She’s gone back to school and is considering studying for a master’s in immunology.

Müller and his colleagues believe that CAR-T-cell therapy works by wiping out enough B cells to trigger a “deep reset” of the immune system. CAR-T cells are dogged little assassins; they are able to find and destroy even the B cells hiding deep in the body’s tissues. A patient’s B-cell count eventually recovers, but the new ones no longer erroneously attack the body itself. Cancer patients are sometimes considered “cured” after five years of remission, and the first lupus patient to receive CAR-T is not so far off from that milestone. But the therapy cannot erase the genetic predisposition many patients have for the disease, says Donald Thomas, a rheumatologist in Maryland. Whether remission is actually durable enough to be a “cure” will take time to find out.

Still, these extraordinary results have set off a gold rush among biotech companies eager to solve autoimmune diseases. CAR-T start-ups founded to treat cancer are pivoting to target autoimmune diseases. And large pharmaceutical companies such as Bristol Myers Squibb, AstraZeneca, and Novartis are developing their own therapies. Columbia’s Askanase is now an investigator on five separate trials, all using CAR-T or a similar cellular therapy, and she hears from more companies all the time. There’s so much interest, she told me, “I don’t even know there are enough patients” to test new treatments. About 1.5 million Americans have lupus, but only a minority of them—those sick enough to justify experimental treatment but not so sick that they’ve suffered too much irreversible organ damage—are eligible for trials.

For now, CAR-T for lupus and other autoimmune diseases is pretty much only accessible in the U.S. through clinical trials—which, in effect, means it’s inaccessible to almost all lupus patients. Jonathan Greer, a rheumatologist in Florida, works in a seven-doctor practice that treats hundreds of people with lupus; not a single one has received CAR-T. He doesn’t know of a single center in Florida that is up and running to do these studies, so interested patients would have to travel out of state.

Even if it becomes FDA approved for autoimmune diseases, CAR-T is a long and expensive process. Because each patient’s own cells are reengineered, it cannot be easily scaled up. The cost of CAR-T for cancer runs about $500,000. Patients also need chemotherapy to kill existing T cells to make room for CAR-T, which adds risk, and in lupus, they usually need to taper off any medications keeping their disease in check, which can cause flare-ups. All these complications make the current iteration of CAR-T suitable only for lupus patients with severe disease, who have run out of other options.

The practical limitations of CAR-T have dogged the cancer field for a long time now, and researchers have already come up with ideas to get around it. A number of simpler strategies for killing B cells are now making their way from blood cancer to autoimmune disease. They include using donor T cells, a different type of immune cell called natural killer cells, or a molecule that binds a T cell to the B cell it’s meant to destroy. Those molecules, called bispecific T-cell engagers, or BiTEs, are “cheap, fast, uncomplicated,” Müller said, but they may not penetrate as deeply into the tissues where B cells reside. Nevertheless, in September, The New England Journal of Medicine published two successful case reports describing successful treatment in a handful of autoimmune diseases, including lupus, with a BiTE called teclistamab. Similar BiTES on the market could be repurposed for autoimmune disease too.

These simpler therapies may ultimately be “good enough,” Askanase said. And their ease of use could ultimately beat out custom CAR-T therapy, which is unlikely to reach all of the millions of people with lupus worldwide. It’s simply too expensive and too cumbersome, a problem that has held back other cutting-edge therapies that were approved to much initial fanfare. Even if CAR-T itself is never widely adopted for autoimmune diseases, it has opened the door to new ideas that could one day revolutionize their treatment.