These aren't love letters, they're classical exercises!

Oh, but had the artisan who made me created me instead – a worthy woman... ...I would say "how lucky am I"

Father in heaven who did miracles for our ancestors with fire and water... ...Who would then transform me from a man to woman? Were I only to have merited this being so graced by goodness...

What shall I say? why cry or be bitter? If my father in heaven has decreed upon me and has maimed me with an immutable deformity then I do not wish to remove it. the sorrow of the impossible is a human pain that nothing will cure and for which no comfort can be found. So, I will bear and suffer until I die and wither in the ground. Since I have learned from our tradition that we bless both, the good and the bitter I will bless in a voice hushed and weak: blessed are you [HaShem] who has not made me a woman.

The fact that we can put fluids into people via IV saves more lives than I can actually communicate. There are so, so many more ways to die when we can't do that. You can go from literally at death's door from an illness you have no other cure for, to Basically Fine, You'll Feel Icky A Bit Longer But You're Otherwise Fine and Your Own Immune System Will Work Now, from sterile saline into a vein.

Or even fucking subcutaneous, under your skin. It still gets into your system faster and bypasses any fuckery going on in your gi-tract.

But you want the other end?

I recently got the answer to a crapload of symptoms of mine and it turned out to be Crohn's. Ileal crohn's.

For most of human history there was literally nothing to do about this but hope and pray that your immune system didn't decide to rip ulcers and lesions in your digestive tract to the point where you bled out, or the point where parts of it died and killed you with sepsis, or enough to build up stricture bands of scar tissue sufficiently to cause impactions or any other really gnarly and unpleasant ways you can die because for some reason your body decides the walls of your digestive tract are the enemy and need to be dismantled cell by cell. (Including a fuckload of cancers caused by the constant damage to the cell wall.)

Even as recently as when most of the younger people reading this were small children, mostly all you could do about it was take corticosteroids when you were in a flare. And that was better than Nothing. But at the same time, corticosteroids have a potential laundry list of side effects and you want to take them as little as possible and for as brief a period as possible. And there wasn't a lot else.

I am on a medication with the proprietary name "Skyrizi" and the generic name risankizumab. It's made from taking antibodies from a non-human source and then modifying their protein sequences to be more similar to human antibodies, after which they modify them further in order to make it so that the literal only thing they do is go into my body and bind to something called "tumour necrosis factor" so that this will stop flagging my own goddamn digestive system walls for destruction by the rest of the immune system.

Please feel free to read that paragraph over again.

There used to be a common, horrific illness that sailors would get, which was mysteriously cured by limes. People know about this one, it's scurvy. But there are other horrible ways to be sick from vitamin deficiency that weren't considered curable at all, and people had no idea what caused them.

Rickets is a disease caused by vitamin D deficiency where your bones get bendy and grow in the wrong shape (it is most apparent in children). It causes permanent deformity and very easy fractures, along with debilitating pain and persistent dental issues. Historically, it was known that milk, and later, cod liver oil, would improve or prevent it, but the reason was not understood until the vitamin was discovered.

Wernicke-Korsakoff syndrome is a complication of alcoholism that leads to psychosis, dementia, and death if left untreated. Severe alcoholics used to just go completely mad before dying, basically. It ultimately results in permanent memory loss (retrograde amnesia), as well as the inability to form new memories (anterograde amnesia). It is caused by the fact that alcohol prevents the absorption of vitamin B1 (thiamine). It is treatable and preventable by giving the patient thiamine shots - if caught early, before permanent brain damage has occurred, it is fully reversible, although the underlying substance abuse issue still needs to be addressed to prevent recurrence.

Pernicious anemia is caused by vitamin B12 deficiency (in turn ultimately caused by an autoimmune issue causing poor absorption). It causes blood cells to be the wrong size and too few in number, resulting in dizziness and fatigue. It also causes neurological symptoms like tingling in the extremities, poor coordination, confusion, and, in late stages, dementia. There was no cure for pernicious anemia in the past. People would simply become anemic and die from it. That's why it's called "pernicious" - that's an old-fashioned way to say "insidious and deadly," named for its slow onset and then-incurable course. Now it is curable with vitamin tablets or periodic injections.

Cretinism, or, less stigmatizingly, congenital hypothyroidism due to iodine deficiency, is a developmental disorder caused by the inability of the thyroid gland to function properly without sufficient iodine. it causes short stature, intellectual disability, infertility, hair loss, and a large lump in the neck known as a goiter (i.e. a hypertrophic thyroid gland). It was historically associated with poor inland populations living far from the ocean (due to the protective effect of consuming seafood, which is naturally high in iodine). We now simply put iodine in table salt, and this disorder is virtually unheard of in regions where this is the case.

Neural tube defects are a leading cause of birth defects, infant mortality, and stillbirth. The most common nonlethal forms of neural tube defects include spina bifida, hydranencephaly, and encephalocele. These defects are caused by a failure of the embryonic structure that becomes the spinal canal to close properly during development, leading the central nervous system to have a distorted shape that may impair cerebrospinal fluid drainage and put pressure on the brain. In severe cases, e.g. anencephaly, the brain/spine essentially develop outside of the body, which is not compatible with life (anencephalic and iniencephalic babies typically die within hours or days; fetuses with more severe forms are usually stillborn if they are not terminated). The risk of these defects is drastically reduced by taking supplemental folic acid (vitamin B9).

Vitamin K is perhaps the most amazing one on this list. Newborns often have very low vitamin K levels due to the fact that it does not cross the placental barrier easily and is not found in high levels in breast milk. It is only produced by gut bacteria, which babies do not have when they are born, and it takes time for them to acquire the right flora from their environment. Deficiency impairs blood clotting, and in infants, can lead to brain bleeds and sudden, unexplained death. Tiny babies would simply die of brain hemorrhaging for no good reason at all. But if they're given a quick shot of vitamin K at birth, that doesn't happen.

There's a lot of confusion about different "poxes" in this post (which wasn't my intention, and now I feel bad), so here's a general overview (also, obligatory apology for messiness, this was written at like 1 AM):

Smallpox:

Smallpox, caused by variola virus, was a massive problem historically. It existed in the Western hemisphere for thousands of years (genetic evidence of smallpox has been found in Egyptian mummies from ≈1500 BCE, but it was probably around long before then), and it was introduced to the New World during the Columbian exchange, which had devastating consequences for indigenous populations (which were already suffering from colonialist violence, which made epidemics much worse than they already would've been). Historically, smallpox had a case fatality rate between 30-50%, and survivors were often left disfigured or permanently disabled (you've probably seen pictures of smallpox scars, but smallpox can also cause blindness and other complications). Importantly, smallpox only affects humans—it has no animal hosts—which is why it's one of the few infectious diseases to have been completely eradicated. As of May 8, 1980, it officially no longer exists outside of certain designated American and Russian laboratories. (There are, however, concerns that it could be used as a bioweapon, which is why the government still stockpiles smallpox vaccines and antivirals. I wrote my bioethics term paper on this exact issue, and incidentally, it's one of the major reasons why I believe that STEM majors should take ethics courses!)

There were two strains of variola virus: variola major and variola minor. Variola major was much more dangerous, with a much higher mortality rate; variola minor typically didn't cause severe disease. Fortunately, infection with one strain conferred immunity against the other. Both strains are now eradicated. (People sometimes confuse variola minor with other viruses like cowpox and horsepox, but they're different things.)

There were four clinical forms of smallpox: ordinary (classic smallpox, associated with the rash you usually see in pictures), modified (less severe, often occurred in vaccinated people who got infected anyway), malignant (caused a flat rash instead of the usual pustules, associated with immune dysfunction, almost always fatal), and hemorrhagic (caused severe bleeding, and also near-universally fatal.) All of the non-ordinary forms could be difficult to diagnose because they looked so different from typical smallpox. The less serious "modified" form was often confused with chickenpox, and the hemorrhagic form was sometimes assumed to be a completely different disease. Occasionally, historical sources will refer to hemorrhagic smallpox as "black pox," with or without an understanding that it's caused by the same virus as ordinary smallpox.

Other relevant viruses:

Cowpox, caused by cowpox virus (an orthopoxvirus similar to smallpox) causes mild disease in cows, humans, and several other animals. Infection with cowpox virus confers immunity to variola—Edward Jenner noticed this relationship and used material from cowpox lesions to inoculate people against smallpox.

Vaccinia virus, another orthopoxvirus, is the source of the modern smallpox vaccine. It's closely related to both cowpox and horsepox (weirdly, it's actually closer to horsepox), but it's distinct enough to be its own species. Infection usually causes mild symptoms, and, of course, confers immunity to smallpox.

Chickenpox is an entirely different thing. It's caused by the varicella-zoster virus, which is a herpesvirus, not a poxvirus at all! Infection with varicella-zoster does not confer immunity to smallpox or any other poxvirus—chickenpox is from a totally different family.

So why are the names so weird and confusing? Why is everything about all of this so weird and confusing?

There are multiple reasons for this, so bear with me.

Historically, a "pox" was any disease that caused a bumpy rash of pustles/blisters. Chickenpox, smallpox, and the other "poxes" all cause superficially similar rashes—thus the similar names. (Even though we know now that chickenpox comes from a completely different family, this wouldn't have been apparent before the dawn of modern medicine.)

Smallpox was given that name to differentiate it from syphilis, which was known as the "great pox" when it first appeared in Europe. (Fun[?] microbiology fact: There are debates about the origins of syphilis, but the most common theory holds that it originated in the New World, and Christopher Columbus brought it back to Spain. In that way, it's kind of the inverse of smallpox.) Historically, smallpox was also known by a variety of other names in different European, Asian, and African cultures. Again, this gets murky, because historical physicians sometimes struggled to distinguish between similar-looking-but-different diseases.

Other poxviruses are often named after the animals in which they were first identified. This is not a hard-and-fast rule, though, and it can sometimes be misleading (for example, monkeypox virus was first discovered in laboratory monkeys, but it more often affects rodents and other small mammals. The disease formerly known as "monkeypox" was recently renamed "mpox" because the name wasn't accurate.) Also, some poxviruses aren't named after animals at all! It's a weird and inconsistent system (but a lot of virus names are kinda weird and inconsistent).

Related to the above: We don't even know where the name "chickenpox" comes from. I mean, we know it was called a "pox" because it causes a pox-y rash, but we don't know where the "chicken" part originated. There are multiple theories about this, none of which are definitive. The disease itself has nothing to do with chickens.

Basically, a lot of the weirdness is a result of historical naming practices—people identified and named these diseases before modern virology existed, and those names stuck, so now we have similar names for superficially-similar-but-ultimately-different viruses, and names whose origins have been completely lost to time. Later, virologists muddied the waters further by naming newly-discovered poxviruses after the animals in which they were first seen, even when these animals aren't natural hosts or reservoirs of those viruses. It's a mess! And, again, all of this is complicated by the fact that some of these diseases were very hard to diagnose (or distinguish from one another) before modern medicine existed. Now, we can sequence viral DNA and figure out what's actually going on—which viruses caused which symptoms, whether those viruses were closely related, and whether being infected with one disease conferred immunity to another—but historical doctors and scientists didn't have those tools, so they were doing they best they could with very limited information, and that led to a lot of weirdness in terms of how these viruses were named and classified. Our current system inherited some of that weirdness, so here we are.

TL;DR: Poxvirus names are messy. Smallpox is caused by variola virus, which has two strains: variola major (the more severe one) and variola minor (less severe). Cowpox and vaccinia are different viruses in the same family, and being infected with one of them confers immunity to smallpox. Chickenpox isn't a poxvirus at all, but a herpesvirus—it just happens to cause a pockmark-y rash that looks superficially similar to smallpox pustules (and mild forms of smallpox were historically confused with chickenpox).

(P.S. none of this is super relevant to the average person, so don't feel bad if you didn't know any of it. Unless you are a history major inventing new conspiracies about smallpox, in which case you definitely should feel bad.)

Sources & further reading under the cut!

Old news, but new to me!

Dr Katherine Hall, a Senior Lecturer at the Dunedin School of Medicine and practising clinician, believes the ancient ruler did not die from infection, alcoholism or murder, as others have claimed. Instead, she argues he met his demise thanks to the neurological disorder Guillain-Barré Syndrome (GBS). Dr Hall has had a long standing interest in ancient history and ancient medical history, and over the past five years has been studying part-time for a Bachelor of Arts majoring in Classics (and with a smattering of Ancient Greek). In CLAS241 lecture on Alexander the Great Associate Professor Pat Wheatley outlined what was known about Alexander’s death; drawing on her clinical knowledge and experience of Intensive Care Medicine she was immediately struck with the idea that this could be a case of the neurological disorder Guillain-Barre Syndrome. Six months' research followed, culminating in an article published in The Ancient History Bulletin. In the article she says previous theories around his death in 323BC have not been satisfactory because they have not explained the entire event.

The article appears to be behind a paywall (click to expand volume 32), but it's an extraordinarily rare case of a paywall low enough that it is plausible I might pay it: $2.00 for the article!

In short, Schor’s works is quite shoddy and we shan’t rely on it.

Now part of the complication there is that for the European Middle Ages, across so much area, what we see is a lot of confusing evidence – statutory minimums, required labor on a lord’s land and so on – which may or may not represent a full working year. What we don’t typically get is someone just telling us how many work days were in the agricultural calendar. But as you may recall, we’re anchoring this discussion in the Roman world and in a rare instance where the ancient evidence is better, Roman agricultural writers just straight up tell us how many working days there were in a year on the Roman agricultural calendar: 290 (Columella 2.12.8-9). He allows 45 days for holidays as well as inclement weather and another 30 days for rest immediately after the crop is sown, to recover from the difficult labor of the final plowing.

The medieval work calendar is not meaningfully different. As noted above, Both Clark and Kenyon end up with similar working-day estimates from the medieval evidence as Columella’s figure. The medieval number is probably slightly lower: the medieval religious calendar might have around 45 feast days but workers might also be expected to spend Sundays in religious observance, which might pull the work-year down to around 270 total working days, plus or minus.

By all evidence, those working days were both less rigid but also longer than modern working hours. On the one hand, peasant farmers are essentially self-employed entrepreneurs, making their own hours. They can arrive in the field a bit late, sometimes leave a bit early. It was certainly common in warmer climates for workers to take a midday break (a siesta) to avoid exhausting themselves in the hottest part of the day. I will say, anyone who has done functionally any outside work in a warm climate will recognize that a midday break can allow you to work more than just pushing straight through the heat of the day because you tire more slowly.

So on the one hand the work hours are somewhat flexible. On the other hand as functionally anyone who has ever worked on a farm or spoken with someone who has will tell you, the working day in absolute terms is long, essentially starting at sunrise and running to sunset. And this is certainly the implication we get from our sources. Because of atmospheric refraction, there are actually slightly more than 12 sunlight hours per day on average (it’s around ~12.3 or so, depending on latitude), though this of course varies seasonally. The bad news for our farmers, of course, is that the shortest days are in the winter when the labor demands are lower. While festival calendars feature events throughout the year, it is not an accident that major festivals in a lot of pre-modern agrarian cultures are concentrated in late Fall, winter and early Spring. For the Christian calendar, that includes things like All Saints Day (Nov 1), Martinmas (Nov 11), the regular slew of December holidays as as the holidays of the Eastertide in early spring. For the Romans, you have major festivals like the Parentalia and Lupercalia in February, the Liberalia in March, the Cerialia in April and the Saturnalia in December.

So in practice the average maximum working day might actually be a bit longer than 12 hours, but we should account for breaks and general schedule flexibility. We might assume, for comparison, something like a ten hour work day. By that measure, our peasants probably put in somewhere between 2,500 and 3,000 working hours per year. By contrast, your average ‘overworked American’ has 260 working days a year, at eight hours a day for just 2,080 hours.

So to answer the question: no, you do not work more than a medieval (or ancient) peasant (despite your labor buying a much higher standard of living).

They are not addressed in the quoted post, but yes they are counted as work! This post is part of a series on peasant farming households. Elsewhere in the series there are posts detailing family structures (including deliberate spacing of pregnancies), setting up some example families to see how different gender and age groupings struggle to reach enough labour in different ways, and the impact of exploitative landlords, then later in the series there are two posts (IVd, IVe) about women's labour and labour hours specifically. It is broken down into a lot more tasks than just "agriculture" (although it also includes hundreds of hours of agricultural work - at certain times of year everyone was needed in the fields), some extracts from IVd below:

Compared to agriculture we almost immediately run into significant source difficulties when discussing the labor of women in peasant households or really any households. Our sources for the pre-modern period are mostly written by men; our sources for antiquity are nearly all written by men and that is reflected by their concerns. [...] As a result, whereas we can model farming from historical data contained in ancient or medieval texts, the evidence to do this for the tasks generally done by women in peasant households simply doesn’t exist. Instead, we will have to estimate from modern practitioners, often with quite a bit of required inference.

[...]

But the upshot of all of that is that while a peasant mother is nursing, she can never be very far from her children and “while she is nursing” – as we noted before – probably represents upwards of 40% of the reproductive period of her life (the c. 25-30 years from her mid-to-late teens to her late-30s/early-40s), which of course also coincides with the period where she would be most physically able to do heavier labor (like agriculture) in any case. Of course children do not become ‘labor-free’ just because they’re eating solids – ask the parent of any toddler – but the realities of nursing have effectively already determined who is going to be in a position to be primary caregiver, since the wife of the house (who is still having more children) must already be in situations where she can watch, feed and care for young children while the husband, almost by process of elimination, has to be in the field (keeping in mind that ‘the field’ may be quite distant from ‘the house’ because, remember, these peasants tend to own lots of little strips of land spread all over).

[...]

All of that said the ‘modular’ nature of these tasks – able to fit in the spaces that peasant women could afford to give them while managing such a heavy workload (and as we’ll see, it is a heavy workload) – makes it even harder to model out the labor demands fully, because we’re not dealing with one big task (agriculture) with a rigid schedule but a host of small tasks with variable schedules, which are no less essential.

[bigger snip about textile production hours and economic stuff - the below is offtopic for this tumblr post but i thought it was still worth sharing]

Yet even then, wool-working commands even worse wages than unspecialized male labor and it is hard not to see the structures of gender and power at work here. It certainly isn’t that fabric was cheap in these societies, but that it was easier to press down the wages of women, who had less power and fewer opportunities to acquire capital or engage in more remunerative wage labor. This is sometimes quite vividly portrayed, particular in the context of medieval male commercial weavers, who command higher wages than the female spinners providing all of their thread (on this, see J.S. Lee, op. cit.).

From IVe, after a lot of granular maths on different tasks and different households:

We should also note that these women work an enormous amount. We estimated, you will recall, working hours for our male peasants on the order of 2,500 to 3,500 working hours per year, massively more than modern full-time employment (40 hours per week is ~2000, typically around 1,750 hours after sick time, vacation, holidays and such). By contrast our peasant women are working in this model 3,760 hours per year, significantly more than their fathers, husbands and brothers and wildly more than modern workers. Now of course that figure is in theory something of a maximum, but that’s what our model is for: it demonstrates that they can’t really be working much less, since their margin over minimum subsistence is so narrow even working those many hours. Indeed, we might instead imagine many peasant women might be working more, eating a little into the dark hours cooking or spinning (as Lucretia famously does in Livy, 1.57.9-10, leading the women of her (aristocratic) household in wool-working by lamp-light) or into the time we’ve given her ‘off’ on those festival days, just to keep up with all of the tasks that need doing.

[...]

So I do sort of scratch my head about this and wonder whether "they weren't any stupider than modern people" is wholly accurate, but I think to get a good picture of it I'd need some statistical analysis of malnutrition and its impact on cognition. But it would be a matter of more than just whether people had enough food, because malnutrition includes e.g. iron deficiency, iodine deficiency, etc. There are parasite burdens, lead exposures, times of famine ... very complicated to get a handle on in any kind of scientifically rigorous way.

"To address the extensive facial injuries sustained by soldiers in World War I, Dr. Gilles was a key contributor to developing the technique using pedicled and tubed flaps to restore facial form and function. This facilitated the integration of injured soldiers back into their communities but also set the foundation for more complex reconstructive techniques that became the standard surgical techniques used in gender-affirming procedures, head and neck reconstruction, and breast surgery." [x]

1) John Adams

John Adams was a tireless advocate for the revolution (i.e. topping from the bottom) and he once described himself as "obnoxious, suspected, and unpopular" - "he was known for his bluntness, impatience, and tendency to be easily frustrated with those who disagreed with him." As a brat in Congress, his personality was repulsive, but everyone listened to him and they all still wanted him. They wanted him so bad they made him president. Kind of makes you think.

His match:

Adams needs someone with a strong personality to challenge his - someone who's not afraid to repel the mainstream in order to realize their vision. Gaga has it, and he needs it. "Bad Romance" in many way encompasses Adams' struggles through the 1776 Continental Congress. They could teach each other much.

2) Theodore Roosevelt

A man dedicated to the preservation of natural parks and ecological wonders - and for what? To run through the trees under the full moon as his pheromones wafted through the air? We know.

His match:

Grimes once described herself as becoming "way less gay" after she became pregnant, which is 1) weird, and 2) the reason I'm sticking her with Teddy. I don't think that he could fix her completely, but she seems the type to maintain no moral compass of her own, simply adopting the political ideology of whomever she's with, so maybe there's hope. Maybe Grimes could introduce Teddy to shrooms, and Teddy could take her out on trips in the forest. And then we can find out if Grimes getting a man pregnant makes her more or less gay.

3) Richard Nixon

Best known for his one legendary debate with the handsome JFK, wherein he became a stuttering, sweating mess, unable to focus or say what he meant. Interesting!

His match:

Bisexual icon Taylor Swift is also struggling to appease both sides of the political aisle. They could share their woes and their love of good ol' fashioned Americana, and then Taylor could tie him to the wall and make him bark like a dog. The pregnancy would be difficult on both of them with Taylor's extremely busy schedule, and Nixon would regrettably terminate it in the second trimester, causing a rift in the relationship that would never be mended. The resulting laments that Taylor composed about Nixon's abortion would of course be dissected and attributed to a secret relationship with a woman - Nixon's wife.