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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.

The political scientist Wilson Carey McWilliams once observed that alienation is not the loss of an old homeland, but the discovery of a new homeland that casts the former in a more dismal light. Today, the country indeed looks alien. The America many of us believed we knew now appears stranger in retrospect: The anger and resentment we may have thought was pitched at a simmer turned out to be at a rollicking boil. And one of liberals’ most cherished shibboleths from 2016—that Trumpism is a movement for aggrieved white men—unraveled in the face of a realignment that saw the GOP appear to give birth to a multiracial working-class movement. A second Trump presidency is the result of this misjudgment.

There is plenty of blame to go around, and much of it will be directed at Kamala Harris. Rightly so. Her campaign strategy was often confounding. Harris gambled on suburban-Republican support, which she tried to juice by touring with Liz Cheney and moving right on the border, a strategy that many warned was questionable. Meanwhile, in her quest to bring these new conservative voters into the Democratic fold, Harris neglected many of the voters the party has long relied on. She took far too long to reach out to Black men—despite a year’s worth of polling that said she was losing their support—and when she finally did, she had little to offer them but slapdash policies and half-baked promises. It was the same story for Hispanic men. Despite polling showing Donald Trump increasing his Hispanic support, Harris largely ignored the problem until a month before Election Day, when she stitched together a condescending last-minute “Hombres con Harris” push. As for Arab American voters, she and her surrogates couldn’t be bothered to do much more than lecture them.

[David A. Graham: What Trump understood, and Harris did not]

The results speak for themselves: Trump won a stunning victory in a heavily Black county in North Carolina and carried the largest Arab-majority city, Dearborn, Michigan. Early exit polls suggest that he doubled his Black support in Wisconsin and won Hispanic men by 1o points. Meanwhile, Harris’s scheme to run up the score in the suburbs plainly failed to bear fruit: She underperformed Biden’s numbers with these voters. Simply put, almost nothing about the Harris game plan worked. But as easy as it is to play Monday-morning (or rather, Wednesday-morning) quarterback—and her dubious campaigning provides plenty of material to work with—the reality is that Harris was probably doomed from the jump.

The reason is that she had an 81-year-old albatross hanging around her neck: Joe Biden. When Biden got into the 2020 presidential race, he said he was motivated to defeat the man who blamed “both sides” for a neo-Nazi rally in Charlottesville, Virginia. Five years later, Biden’s inability to see his own limitations handed that same man the White House once more. Nobody bears more responsibility for Trump’s reascension to the presidency than the current president. This failure lies at his feet.

Biden was supposed to be a one-term candidate. During his 2019 campaign, he heavily signaled that he would not run again if he won. “He is going to be 82 years old in four years and he won’t be running for reelection,” one of his advisers declared. Biden himself promised to be a “transition” candidate, holding off Trump for four years while making room for a fresh Democratic challenger in 2024. “Look, I view myself as a bridge, not anything else,” he said at a Michigan campaign event with Governor Gretchen Whitmer, one of those promising younger Democrats Biden was ostensibly making room for.

Of course, that’s not what happened. Scranton Joe, supposed paragon of aw-shucks decency, ultimately wouldn’t relinquish his power. He decided in the spring of 2023 to run for reelection despite no shortage of warning signs, including a basement-level approval rating, flashing bright red. He also ignored the will of the voters. As early as 2022, an overwhelming percentage of Democratic voters said they preferred a candidate other than Biden, and support for an alternative candidate persisted even as the president threw his hat back in the ring. This past February, one poll found that 86 percent of Americans and 73 percent of Democrats believed Biden was too old to serve another term, and another revealed that only a third of Americans believed that he was mentally fit for four more years.

The idea that Americans would vote for a man who they overwhelmingly thought was too old and cognitively infirm stretched reason to its breaking point. And yet Biden and his enablers in the Democratic Party doubled down on magical thinking. This was a species of madness worthy of King Lear shaking his fist before the encroaching storm. And like Lear, what the current president ultimately raged against was nature itself—that final frailty, aging and decline—as he stubbornly clung to the delusion that he could outrun human biology.

[Adam Serwer: There is no constitutional mandate for fascism]

Nature won, as it always does. After flouting the will of his own voters, after his party did everything in its power to clear the runway for his reelection bid, and after benefiting from an army of commentators and superfans who insisted that mounting video evidence of his mental slips were “cheap fakes,” Biden crashed and burned at the debate in June. He hung on for another month, fueling the flames of scandal and intraparty revolt and robbing his successor of badly needed time to begin campaigning. And yet when he finally did stand down, Biden World immediately spun up the just-so story that the president is an honorable man who stepped aside for the good of the country.

He did not stand down soon enough. The cake was baked. The powers that be decided the hour was too late for a primary or contested convention, so an unpopular president was replaced with an unpopular vice president, who wasted no time in reminding America why her own presidential bid failed just a few years before. The limitations of Harris’s campaign are now laid bare for all to see, but her grave was dug before she ever took the podium at the Democratic National Convention.

Harris could not distance herself from Biden’s unpopular record on inflation and the southern border. She could not distance herself from his unpopular foreign policy in the Middle East. She could not break from him while she simultaneously served as his deputy. And she could not tell an obvious truth—that the sitting U.S. president is not fit for office—when asked by reporters, and so she was forced into Orwellian contortions. If the worst comes to pass, if the next four years are as bad as Biden warned, if the country—teetering before the abyss—stumbles toward that last precipice, it will have been American democracy’s self-styled savior who helped push it, tumbling end over end, into the dark.