Kerry Washington’s Memoir Reveals A Major Family Secret

But ‘Thicker than Water’ is more sincere than sensational

BY SABRINA FORD

Nights were tough for a young Kerry Washington. At 7 years old she started having panic attacks. Once, while she was in bed, attempting to fend off an episode, the familiar sound of her parents arguing flowed from the other room. Reaching a breaking point, Washington ran out, faced her parents and yelled at them to stop.

“I can count on one hand the number of times that I have seen my mother cry,” the actress writes in her new memoir, “Thicker Than Water.” “This was the second.”

The next morning, Washington’s mother smiled as she made breakfast, as if nothing had happened. It was a familiar scene for the only child who describes her experience growing up as playing the role of “good girl” for parents intent on projecting a picture-perfect image to their daughter and the outside world.

The family history informing this dynamic is complex and specific to Washington, but Black Gen Xers and millennials — those of us born to parents who came of age during the civil rights era — might find the holding of secrets to protect family from social scrutiny or personal shame particularly relatable. (Anyone raised by one or more Black women of that generation knows there is no greater sin than embarrassing them.)

At the heart of “Thicker Than Water” is the story of a daughter who loved and felt loved by her parents but yearned for genuine connection inside a facade. She didn’t fully understand where that yearning might have come from until she agreed, at age 41, to appear on Henry Louis Gates Jr.’s series “Finding Your Roots.” Only then did her parents admit that she had been conceived using a sperm donor — that her father wasn’t biologically related to her. The news was a shock, but even Washington seems surprised at how well she took it, managing to comfort her parents as they struggled to divulge a secret they had planned to keep forever. “Dad,” Washington recalls saying. “Dad. I knew what he needed to hear: ‘Nothing is going to change between us. This won’t impact our love.’”

But this revelation is a relatively minor part of a memoir that is really the story of an artist leaning into the emotional truths of the characters she built, because she never fully trusted her own.

Maybe that explains her impressive success. Washington, 46, was raised in the Bronx and began acting as a young teen with a local educational theater group. After starring in her breakout film, 2001’s oft-memed teen drama “Save the Last Dance,” she would go on to co-star in Oscar-winning films (“Ray,” “The Last King of Scotland”), headline Broadway plays (David Mamet’s “Race”) and, most famously, embody Olivia Pope on the ABC drama “Scandal.” That series, which aired for seven seasons, was culturally significant not only because it was the first network drama led by a Black woman in four decades but also because Olivia Pope was a messy, flawed Black female protagonist — an anomaly when it premiered in 2012.

“Every day, I would get out of bed and head to set, and it felt like swimming out into a body of water that I could not control. I knew my job was to get on top of the waves and ride them, but I was in the storm that comes with rising fame,” Washington writes of the dizzying early days of “Scandal,” when her celebrity grew and her friend circle shrank. “Rehearsed as I was in the performance of perfection, I tried to keep my struggles mostly private, below the surface of the waves.”

As she looks back at her career, Washington completely avoids the familiar beats of celebrity memoir — the name drops, the gossip, the reveals. Instead, she focuses on the work of acting, which she first viewed as a job when she was a teenager looking for a means to contribute to the high cost of her private-school education. She considers the media frenzy that accompanied “Scandal,” and her ascent to becoming a household name, more of an annoyance than anything else, a consequence of being good at her job. Rather than revel in fame, she relishes a title that her cousin bestowed upon her: “the longshoreman of acting.” That name “has a special resonance for me,” she writes, “because our grandfather was a longshoreman on the docks of Lower Manhattan. He died in 1953 in the middle of a nor’easter. I like to think that I’d go into any storm to get the work done, too.”

At times, reading “Thicker” feels like a tease, as Washington glosses over intriguing episodes without divulging the whole story. For instance, she devotes only a few paragraphs to the wild period in high school when she was staying out all night, hooking up, getting lit on whiskey sours and attending Manhattan parties like the fabled Soul Kitchen. What was it like being a kid roaming free in adult spaces in the 1990s, before cellphones and location tracking were commonplace? Who were the characters she encountered? What was the DJ spinning? Where’s that memoir?

Instead, Washington illuminates a very narrow and specific slice of her life — avoiding the sensational in favor of the sincere — and the result is very affecting. The secrets aired here, revolving around Washington and her family, may not be particularly salacious or earth-shattering, but they are crucial in helping the author make sense of herself, her place in her family and her connection to her craft.

Sabrina Ford is a Los Angeles-based culture writer and researcher.

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U.S.-Israel Visa Deal Could Give Some Palestinians New Freedom Of Movement

Travellers walk toward the departures area of Ben Gurion Airport on March 9. (Ahmad Gharabli/AFP/Getty Images)

BY STEVE HENDRIX

AIN YABROOD, WEST BANK (THE WASHINGTON POST) — Moeen al-Kateeb’s mother lives 21 miles from Israel’s Ben Gurion Airport, about 45 minutes in light traffic. He has visited her dozens of times from his home in the United States but has never gone through that airport.

Instead, he flies to neighboring Jordan to reach the occupied West Bank, adding hundreds of dollars and a day to the trip. Unlike most U.S. citizens, Kateeb and thousands of Palestinian Americans have been barred for decades from flying into Ben Gurion.

“[Israeli officials] don’t see me as an American, just as a Palestinian,” said Kateeb, who grew up north of Atlanta in a family that has been in the United States for three generations. The last time he tried to fly into Tel Aviv, when he was 16, he was kept overnight in a basement holding room and put on a plane out the next morning.

But times are changing. The U.S. government announced Wednesday that Israel will be added to a list of 40 friendly countries whose citizens do not have to apply in advance for a visa to visit the United States.

In return, Israel will have to lift many of the restrictions on Palestinian Americans, potentially softening the profiling, intrusive questioning and delays that have characterized their trips since Israel began tightening rules in the 1970s amid a string of terrorist attacks.

The deal, fulfilling a longtime Israeli goal of easing travel to the United States, will benefit only a sliver of Palestinians: dual citizens who are U.S. passport holders and are also registered by Israel as having family connections to Jerusalem, the West Bank or Gaza.

Between 100,000 and 200,000 people could benefit from the program, including more than 10,000 who live permanently in the Palestinian territories, according to unofficial estimates in Israeli and Arab media.

The new rules are meant to apply to American Palestinians living abroad and to those in the Palestinian territories, potentially offering a new degree of freedom to full-time West Bank residents and more limited mobility to those in Gaza.

“It’s not a full two-state solution, no,” said former U.S. ambassador to Israel Thomas Nides, who negotiated much of the agreement with Israel. “But for the first time in decades, Palestinian Americans are going to be treated like any other American.”

The new rules leave conditions unchanged for most of the 5 million Arabs living in the Palestinian territories, highlighting the disparities of a system in which Palestinians are treated differently by Israel depending on where they live and where they were born.

During a weeks-long trial of the new program, tens of thousands of Palestinian Americans have landed at Ben Gurion, according to U.S. officials. In a first, they were given the same B2 tourist visa as other arriving Americans, allowing them not only to visit family in the West Bank but to travel around Israel for up to 90 days.

Sami Almalfouh, a Gaza-born electrical engineer from California, flew in Saturday simply to test the new system. He passed the flight questioning whether he would get in at all.

“I spent 14 hours wondering if I was just going to have to fly 14 hours back,” he said. “That has happened to a lot of Palestinians.”

At passport control, Almalfouh, who has a PhD from Georgia Tech and has worked in Silicon Valley since 2011, was told to wait for “an hour and five minutes” without explanation while others passed through.

“What was different about me than the guy from Utah who was behind me?” Almalfouh wondered. “They didn’t say.”

But when he was handed a visa and the electric gate swung open: “That was very emotional. I have been waiting for that for many years.”

Almalfouh, who left Gaza when he was 17, joined other Palestinian Americans touring sites that have been off limits to them for years, including al-Aqsa Mosque in Jerusalem and the ancient port cities of Jaffa and Haifa.

A number of American passport holders in the West Bank crossed into Jordan and back just to acquire the new B2 visa. Many have driven into Israel repeatedly to explore; some have seen the Mediterranean for the first time in decades.

“It was nice to be able to say to my friends, ‘Hey guys, let’s go to the beach,’” said al-Kateeb, who was visiting his mother when the trial program began. Most of the crossings have been smooth, he said, but some soldiers blocked him temporarily, seemingly unaware of the new rules.

“Every time I approach a checkpoint, my heart speeds up,” he said.

For those with roots in Gaza, the rules are stricter and harder to navigate.

Almalfouh compiled a dizzying flow chart of the regulations governing a visit to Gaza, which includes more than a dozen variables that affect individual outcomes.

“It’s still very confusing, and the Gazans are getting the shortest end of the stick,” he said.

Maha al-Banna, 49, who moved back to Gaza after 12 years in the United States, hopes the changes will make it easier to visit her children stateside.

She currently has to apply for permission from the Israeli military, then board a bus that is not allowed to stop until it reaches the Jordanian border. An official holds all the passports, and no one is allowed to carry hard bags, wheeled luggage, laptops or toiletries.

“Every time I travel, I have to re-buy everything,” al-Banna said.

Exiting through Ben Gurion would be a huge improvement, but she too finds the new rules baffling and said they have changed more than once during the trial period. They require her to apply for permission from the Israeli army at least 45 days in advance.

“I’m not really optimistic it’s going to work for Gazans,” she said.

Israeli tourists, tech companies and ultra-Orthodox citizens with business and family ties to the United States have long pressed their government to gain access to the visa waiver program. The effort picked up momentum in 2021 under Prime Minister Naftali Bennett and has been a priority for Prime Minister Benjamin Netanyahu.

Israelis were shocked when U.S. negotiators laid out how they expected Israel to treat all arriving Americans the same, even those with Palestinian IDs, according to officials from both countries familiar with the talks.

“At first it was, ‘Are you out of your mind,’ but they really wanted the [agreement] to go through,” Nides said.

The experience could hold lessons for a potential normalization deal with Saudi Arabia, in which Israel would be asked to make concessions to the Palestinians, he said.

“When it’s important to them, the Israelis can make big changes happen,” Nides said.

Not every Israeli official thinks the trade-off is worth it. “This will oblige us to allow the entry of unwanted parties, Palestinians, who will travel in the country,” Tourism Minister Haim Katz, a member of Netanyahu’s Likud party, said to an Israeli broadcaster. “Who needs this?”

Hazem Balousha in Gaza contributed to this report.

Plagiarist Or Master? The Tortured Legacy Of Yambo Ouologuem

BY ELIAN PELTIER

DAKAR, SENEGAL (THE NEW YORK TIMES) - Five decades ago, an award-winning Malian author disappeared from public life after being accused of plagiarism. Now, his ambiguous novel is being released, and evaluated, in new light.

In 1968, a young Malian author living in Paris published his first book to the highest praise: Critics called it a “great African novel,” and awarded it one of France’s most prestigious literary prizes. But soon, his rise gave way to a devastating fall from grace.

The author, Yambo Ouologuem, was accused of plagiarism, but he denied any wrongdoing and refused to explain himself. His publishers in France and the United States withdrew the novel, “Le Devoir de Violence,” or “Bound to Violence.” After a crushing decade, Ouologuem returned to Mali, where he remained resolutely silent on the matter, responding to questions about his aborted literary career with digressions or outbursts of anger, refusing even to speak French.

He died in 2017, forgotten by most, his novel read by few — until recently, when another award-winning novel by a West African author helped bring new attention to Ouologuem and the tormented trajectory of his book. “The Most Secret Memory of Men,” by the Senegalese writer Mohamed Mbougar Sarr, follows a mysterious writer who disappears from public life after being accused of plagiarism in Paris — a loose reference to Ouologuem. It won the Goncourt prize in 2021 and was published in the United States by Other Press this week, in a translation by Lara Vergnaud.

With Sarr’s book, Other Press is also republishing “Bound to Violence,” translated by Ralph Manheim. The reissue comes as fresh consideration of Ouologuem’s work by readers and academics is holding the old accusations up to new light: Should what Ouologuem did really be considered plagiarism? Or had hasty criticism, perhaps tinged with racism, destroyed one of the literary star of his generation?

There is no question that Ouologuem copied, adapted and rewrote phrases, sometimes entire paragraphs, from many sources.

The borrowings likely begin with the novel’s opening sentence, “Our eyes drink the brightness of the sun and, overcome, marvel at their tears.” Critics have found it heavily inspired by another award-winning novel published years earlier, “The Last of the Just,” which begins with, “Our eyes register the light of dead stars.” Dozens of other similarities with “The Last of the Just” fill the pages of “Bound to Violence.”

But what if, academics are asking, those démarquages, as Ouologuem described the borrowings, were an artistic technique — a sort of anthology that poured the canon of Western literature into an African context, or an assemblage or collage, like that used by visuals artists like Georges Braque or Pablo Picasso, but using words?

“It’s not plagiarism, it’s something else,” said Christopher L. Miller, an emeritus professor of African American Studies and French at Yale University, who is working on a compilation of borrowings in the book. “I don’t think we have a word for what he did.”

Ouologuem was born in 1940, in central Mali, and moved to Paris when he was 20. He entered the prestigious École Normale Supérieure, as the poets and politicians Léopold Sédar Senghor of Senegal and Aimé Césaire of Martinique, both champions of the anticolonial Négritude movement in literature, had done decades earlier.

He wrote at a frenzied pace. At 23, he sent his first manuscript to a publisher, Éditions du Seuil; within little more than a year, he sent two more. All were rejected. “Bound to Violence” was his fourth attempt.

When the book was first published in France, critics heaped praise on Ouologuem, then 28 years old. Released in the United States in 1971, the book was called a “skyscraper” by The New York Times — a work that deserved “many readings.”

The novel, composed of four parts, varies in style, drawing from West African oral tradition, ancient tales, theater and contemporary novels. It is a searing exposé of the centuries of violence that took place in parts of Africa, both before and during European colonization.

From its first pages, “Bound to Violence” is raw and sarcastic: Telling the story of the fictional Saif dynasty, which the reader follows from the 13th through the 20th centuries, would make for poor folklore, the narrator writes. Instead, readers encounter a world where “violence rivals with horror.” Children have their throats slit and pregnant women have their stomachs cut open after they are raped, under the helpless eyes of their husbands, who then kill themselves.

Sarr discovered “Bound to Violence” as a teenager in Senegal, thanks to a professor who lent him an old copy with pages missing. The book “sparkled,” Sarr said, even as it shed a harsh light on the continent, portrayed as rife with slavery, violence and eroticism.

“It’s an epic story of human cruelty set in Africa, just like it could have happened — and did — in the rest of the world,” Sarr said.

Even before accusations of plagiarism surfaced, Ouologuem’s portrayal of Africa caused outrage among African intellectuals. Among them were towering figures like Senghor, who described the novel as “appalling.”

Ouologuem shrugged off the criticism of his peers. “It is unfortunate that African writers have written only about folklore and legend,” he said in a 1971 interview with The Times.

The accusations of plagiarism came shortly after the book’s publication in English. In 1972, an anonymous article in The Times of London’s Literary Supplement pointed to multiple similarities between “Bound to Violence” and a novel by Graham Greene published in 1934, “It’s a Battlefield.”

Researchers and journalists spotted dozens of references and excerpts borrowed, plagiarized, rewritten — the appropriate words to use are still up for debate — from sources as varied as the Bible and The Thousand and One Nights, from James Baldwin to Guy de Maupassant.

“What Ouologuem did was fabulous, but at times he was borderline, and even crossed that red line,” said Jean-Pierre Orban, a Belgian academic and writer who studied Ouologuem’s correspondence with his publisher and interviewed his former Parisian classmates.

“He was infused with literature, quoting writers by heart as if he was making their work his,” Orban said. “He lived between reality and fiction.”

Some of the first revelations of Ouologuem’s borrowing drew pushback from readers. When Eric Sellin, a prominent professor of French and comparative literature, presented similarities between “Bound to Violence” and “The Last of the Just” at a colloquium in Vermont in 1971, a young attendant retorted, “Why are you white people and Europeans always doing this to us? Whenever we come up with something good in Africa, you say that we couldn’t have done it by ourselves.”

Further research by Orban and others found that Ouologuem’s French publishing house, Le Seuil, was aware of those similarities before publication. But the criticism grew as Ouologuem vehemently denied any wrongdoing, claiming for instance that he had sent the original manuscript with quotation marks, an excuse that most find dubious.

“He was hurt because he had been misunderstood, and he had a virulent and rather clumsy attitude toward those attacks,” said Sarr.

Academics and critics wonder if a Western author would have faced similar criticism.

“I don’t think that in France, a European or French author would have faced the same condemnation,” Orban said. Borrowings, pastiches and literary tricks were often considered a literary game, he argued. But it was one that Ouologuem wasn’t allowed to play.

Sarr believes that a white author would have faced a similar backlash, but one that would have been restricted to the literary field — while Ouologuem, he said, was castigated for who he was: an African author plagiarizing Western canons.

Miller, the emeritus professor from Yale, suggests that Ouologuem flouted the rules on purpose, not only attacking the concept of Négritude by offering a radical revision of African history, but also the Parisian literary establishment, in an act of artistic disobedience.

A bitter feud between Le Seuil and Ouologuem ensued, and the writer moved back to Mali in 1978, according to his son. Once flamboyant and talkative, Ouologuem went nearly silent upon his return, dedicating the rest of his life to Islam.

“He was a wounded man, who came back to curl up among his loved ones,” said Ismaila Samba Traoré, a Malian writer and journalist who interviewed Ouologuem in the 1980s.

His son, Ambibé Ouologuem, said that his father had spent time at a psychiatric hospital in France before moving back to Mali. Upon his return, Ouologuem struggled to walk, his son said, and was cured with traditional methods by his own father.

The feud around the book and the bitterness that ensued also deeply impacted the rest of the family: Ambibé Ouologuem said he had to go to school in secret, with the help of his grandmother, because his father wanted him to focus on studying the Quran.

“My father was proud of being African and Malian, and had always refused to apply for French citizenship,” Ouologuem said.

In Mali, Ouologuem’s book is taught in some high schools, but it remains little known beyond intellectual circles even in West Africa. Mali’s government has vowed to create a literary award dedicated to him, but it has yet to be announced. According to his son and those who have studied him, it is likely that the author left unpublished manuscripts in Mali or in France.

To Sarr, the Ouologuem affair is a literary tragedy.

“I would be happy,” he said, “If ‘Bound to Violence’ could be stripped of its maleficent aura, its dark legend. If we could read Ouologuem again and just consider his book for what it is — a great novel.”

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Film Academy Gifts A Replacement Of Hattie McDaniel’s Historic Oscar To Howard University

FILE - Actor Fay Bainter, right, appears with actor Hattie McDaniel the night McDaniel won best supporting actress for her role in the 1939 film “Gone With the Wind” in Los Angeles on Feb. 29, 1940. McDaniel received a plaque, not an Oscar statuette, as was the custom for supporting actor winners of that era. The Academy of Motion Pictures Arts and Sciences has created a replacement of McDaniel’s Academy Award plaque that it is gifting to Howard University. (AP Photo, File)

BY JAKE COYLE

NEW YORK (AP) —Hattie McDaniel’s best supporting actress Oscar in 1939 for “Gone With the Wind” is one of the most important moments in Academy Award history. McDaniel was the first African American to win an Oscar, and it would be half a century before another Black woman again won an acting award. But the whereabouts of her award, itself, has long been unknown.

Now, the Academy of Motion Pictures Arts and Sciences has created a replacement of McDaniel’s legendary Academy Award that it’s gifting to Howard University. Upon her death in 1952, McDaniel bequeathed her Oscar to Howard University where it was displayed at the drama department until the late ’60s.

The film academy, along with the Academy Museum of Motion Pictures, announced Tuesday that the replacement award will reside at the university’s Chadwick A. Boseman College of Fine Arts. The Oscar will be presented in a ceremony titled “Hattie’s Come Home” on Oct. 1 on the Washington D.C. university campus.

“Hattie McDaniel was a groundbreaking artist who changed the course of cinema and impacted generations of performers who followed her. We are thrilled to present a replacement of Hattie McDaniel’s Academy Award to Howard University,” said Jacqueline Stewart, Academy Museum president, and Bill Kramer, chief executive of the academy, in a joint statement. “This momentous occasion will celebrate Hattie McDaniel’s remarkable craft and historic win.”

McDaniel’s award was a plaque, not a statuette, as all supporting acting winners received from 1936 to 1942. During the 12th Academy Awards, McDaniel was seated at a segregated table on the far side of the room at the Ambassador Hotel.

“I sincerely hope I shall always be a credit to my race and to the motion picture industry,” McDaniel said accepting the award. “My heart is too full to tell you just how I feel, and may I say thank you and God bless you.”

McDaniel died in 1952 of breast cancer at the age of 59.

California Man Who Spent 28 Years In Prison Is Found Innocent Of 1995 Rape, Robbery And Kidnapping

In this photo provided by The Innocence Center and the California Innocence Project, Gerardo Cabanillas waves from outside the Hall of Justice in downtown Los Angeles after his release on Tuesday, Sept. 26, 2023. Cabanillas, who spent nearly 30 years in prison for kidnapping, robbery and rape, has been declared innocent and freed, Los Angeles County prosecutors announced Tuesday. DNA testing helped exonerate Cabanillas of the 1995 attack on two couples sitting in parked cars in South Gate, the county district attorney’s office said in a statement. (Laurence Colletti/Legal Talk Network via AP)

LOS ANGELES (AP) — A man who spent nearly 30 years in prison for kidnapping, robbery and rape has been declared innocent and freed, Los Angeles County prosecutors announced Tuesday.

DNA testing helped exonerate Gerardo Cabanillas in a 1995 attack on a couple sitting in a parked car in the city of South Gate, the county district attorney’s office said in a statement.

Cabanillas’ case was reexamined by the Conviction Integrity Unit of the DA’s office, and last week a judge reversed his conviction, found him factually innocent and ordered his permanent release.

“I extend my deepest apologies to Mr. Cabanillas for the miscarriage of justice and the failure of our criminal legal system,” District Attorney George Gascón said in a statement.

Cabanillas was convicted in 1996 and spent 28 years in prison. He confessed to being one of two armed men who approached the couple, forced the man out and drove the woman to an abandoned house where both raped her.

Another couple in a car in the same area were robbed two days later, authorities said.

Victims of the attacks were told of his confession and identified Cabanillas from photo lineups. But they later expressed doubts in court and said they were pressured into identifying him, according to the California Innocence Project at the California Western School of Law, which represented Cabanillas.

DNA testing on the rape kit showed that two other people committed the assault, the group said in a statement.

No other suspects were ever arrested, although one man later confessed to committing one of the crimes, the Innocence Project said.

“False confessions are one of the leading causes of wrongful convictions in the United States,” interim director Alissa Bjerkhoel said in a statement. “Police are permitted to lie to suspects, including promises of leniency if the person confesses. That is exactly what happened here and, if it was not for the DNA evidence, Gerardo would have spent the rest of his life in prison.”

“We are thrilled for Gerardo and his family that the truth has finally set him free,” she said.

Mandela’s Granddaughter Zoleka Dies At 43. Her Life Was Full Of Tragedy But She Embraced His Legacy

Author Zoleka Mandela, right, granddaughter of former president Nelson Mandela and Winnie Madi kizela-Mandela, left, attent the launch of Zoleka's book "When Hope Whispers," in Johannesburg Tuesday, November 12, 2013. (AP Photo/Denis Farrell, File)

BY GERALD IMRAY

CAPE TOWN, SOUTH AFRICA (AP) — Zoleka Mandela, a granddaughter of Nelson Mandela whose life was tangled up in addiction, a suicide attempt, a battle with cancer and the tragedy of losing two young children before she came back from the shadows to embrace his legacy, has died. She was 43.

Her death on Monday was announced by the Mandela family in a statement on Tuesday. The breast cancer she had fought for years had been in remission. But she was later diagnosed with cancer in her liver and lungs and it had metastasized and spread, her family said.

The Nelson Mandela Foundation, which promotes the legacy of the South African statesman who died in 2013, said it mourned Zoleka Mandela’s death and offered its condolences to her family. It said she was a “beloved grandchild” to Nelson Mandela and praised her work raising awareness of cancer and her role as an inspiration to those affected by the disease and to those who had lost children.

She set up foundations to help people in both spheres.

Mandela’s early story was a series of struggles and tragedies that were almost too much for one person. They were set against her self-confessed attempt and initial failure to live up to the example of her grandfather, a Nobel Peace Prize winner, the leader of the anti-apartheid movement, the first Black president of South Africa and a powerful force for good recognized and admired across the globe.



Mandela suffered sexual abuse as a child and battled drug and alcohol addiction from her teenage years. Her 13-year-old daughter, Zenani, was killed in a car crash in 2010 on the way back from a concert that marked the opening of the soccer World Cup in South Africa. It was caused by a drunk driver and came when Zoleka, herself, was deep in her drug and alcohol addiction and in a hospital having attempted suicide.

“I hadn’t seen my daughter for 10 days before her passing, and I hadn’t because I chose to use drugs,” Mandela said in an interview with The Associated Press in 2013. “That’s obviously a reminder that I chose my addiction over my kids and I have to live with that for the rest of my life.”

The horror and guilt jarred her into seeking help and going into rehab for the good of her other child at the time, son Zwelami, and the memory of her daughter Zenani, she said. Zenani’s death brought a frail-looking Nelson Mandela out to a church for his great-granddaughter’s funeral and one of his last public appearances.

Mandela was diagnosed with breast cancer barely a year after her daughter’s death, leading to a double mastectomy and grueling chemotherapy. Her second son was born prematurely in 2011 while she was being treated for cancer and died days later. She had four surviving children at the time of her death.

She released an autobiography titled “When Hope Whispers” in 2013. It delved into what she called some of the “unbearable circumstances” of her life and how an abnormal childhood played its part. In the book, she recounted the realities of being a Mandela when South Africa was in some of its most violent throes under the apartheid system of racial segregation in the 1980s and her grandfather was in jail for leading the anti-apartheid movement.

Mandela was smuggled into a high-security prison on an island off Cape Town at the age of 1 so her grandfather could meet her for the first time, she said in her book. As a child, she hid a grenade in her schoolbag so her grandmother, who was part of the armed resistance to apartheid, wouldn’t be arrested by the regime.

The opening line of her autobiography set the stage for her early childhood: “By the time I was born ... my mother knew how to strip and assemble an AK-47 in exactly thirty-eight seconds,” she wrote.

She was abusing alcohol by the time she was 9, and later doing lines of cocaine daily, the start of an addiction that led her, years later, away from her own children and toward the greatest of her regrets when she was an absent parent at the time her daughter was killed.

But her life changed and her story ultimately closed with a different chapter. She became a renowned campaigner, both for cancer awareness and also for road safety, winning praise and admiration for her work in both fields, and for her courage in the latter stages of her terminal cancer.

The foundation that bears her grandfather’s name recognized her as a “tireless activist,” possibly the most fitting tribute given that as daunted as she was by the legacy of Nelson Mandela, she was ultimately inspired by it, and by him. She once said that, above all, she hoped he approved.

“I just hope where he is with my daughter he is looking down and thinking she has gotten it right, finally,” she told the BBC in 2016.
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Carley Petesch, a former AP correspondent in South Africa, contributed to this story from Chicago.
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AP Africa news: https://apnews.com/hub/africa

Many Powerful Leaders Skipped The UN This Year. That Created Space For Emerging Voices To Rise

Tiles depicting the United Nations' Sustainable Development Goals are displayed outside the U.N. General Assembly Hall at the United Nations, Saturday, 23, 2023. (AP Photo/Ted Anthony)

BY TED ANTHONY

UNITED NATIONS (AP) — Togo’s foreign minister wasn’t having any of it. He talked of an accelerating “African awakening,” of a resolve to “fight our own battles,” of a refusal to be banished to the children’s table while the musclebound great powers of the 20th century moved chess pieces around the board.

“Nobody is at the center of the world,” Robert Dussey said in French, his voice emphatic. “We don’t want to be relegated to the background as the world develops.”

Africa was Dussey’s subject. But he might have been one of any number of leaders speaking at the United Nations this past week — the voices of smaller nations that typically command less attention. They come, they air grievances and concerns, and then the oxygen is gobbled up by others — often the five permanent members of the U.N. Security Council.

This year, though, Volydymyr Zelenskyy’s high-profile presence notwithstanding, things felt different. Top leaders of four of the five permanent member nations didn’t attend. Climate change helped amplify the concerns of smaller nations — not coincidentally, those most affected by it. And speech by speech, speaker by speaker, it became clear: On the international stage, other voices are beginning to rise — and to be heard.

“The voice of the Global South is growing louder,” said Terrance Michael Drew, prime minister of the Caribbean island nation of Saint Kitts and Nevis. “The voices and experiences of the Pacific matter,” said Australian Foreign Minister Penny Wong. “Our appetite for transformative change has never been higher,” said Xavier Espot, prime minister of the small European country of Andorra.

“The General Assembly is always the biggest platform for countries that don’t get a spotlight,” says Anjali Dayal, an associate professor of international politics at Fordham University and an expert on the United Nations and other international organizations.

“But I think this year, we saw that more leaders were paying attention to the biggest constituency of U.N. countries — countries that are not big powers but that suffer the biggest consequences and very seldom get to cast the decisive vote,” she said.

Where is the momentum coming from? As with so many matters of import these days, there’s no single answer.

This year, one development helped clear space for some of the voices: the shallow attendance of major nations’ leaders. Of the U.N. Security Council’s five permanent members, only the United States, in the personage of President Joe Biden, spoke. The others — Russia, China, France and Britain — chose to send underlings, as did India and Canada.

U.N. Deputy Secretary-General Amina Mohammed called that “disappointing.” But it did mean that smaller nations and coalitions had more oxygen. They used some of it to advocate for a broader-based permanent membership of Security Council, the only U.N. body with the power to take military action and impose sanctions. Only its permanent members can veto resolutions, and frustration about that runs long and deep.

“The global governance architecture has not delivered the equity and inclusion that is required,” said Tandi Dorji, foreign minister of the Asian nation of Bhutan. He insisted representation on the council — which lacks a permanent member from Africa or Latin America — be broadened. “The increasing fragmentation, polarization, and growing inequity we witness in the world today only serve as an urgent cry for strengthening multilateralism.”

The structure of the United Nations, most countries agree, doesn’t fit the current global configuration. An organization built in the postwar mid-20th century to, in essence, prevent the nations who could destroy the world from doing so is not equipped to tackle the fragmentation afoot as the mid-21st century steams toward us with a rapidly evolving global power structure, speaker after speaker said.

Other factors, too, are helping softer voices grow louder. Exhibit A: climate change, which has hit the world’s poorest countries hardest — in particular, island nations whose very existence is threatened by rising waters. When the president of the island nation of Kirabati, Taneti Maamau, says his country is “experiencing intensifying severe drought and coastal inundation,” it’s not a secondhand account — and people are starting to listen.

“They’re banding together and saying, ‘We are the front line of world’s biggest problems, and the only way we get attention is if we band together.’ That has been remarkably effective in terms of voice,” Dayal said. “They’re saying, ‘Today it’s us. Tomorrow it’s going to be you.’”

The pandemic and the gradual recognition — finally — of Secretary-General Antonio Guterres’ yearslong insistence that a multilateral planet is the only way forward also are helping matters.

Much like climate change, the vaccine inequity that the pandemic produced is a pressing topic; smaller nations, as the most affected constituencies, have natural roles driving that as well. “As we rebuild from the pandemic, we must do so with an unwavering commitment to inclusivity,” said Seychelles President Wavel Ramkalawan.

And coalitions are strengthening beyond usual suspects like the G20 and the European Union. There is the Global South in general, with its malleable membership but its commitment to developing countries with unique common needs. There is SIDS, or small island developing states, which tell firsthand stories about climate change. And Africa’s voice is stronger than ever as it pushes for equity, buoyed by a new permanent G20 seat for the African Union.

Then there’s sheer population. Africa’s alone is expected to double from its current 1.3 billion by 2050 and make up a quarter of the planet’s people. This year, India surpassed China to become the world’s most populous nation; its leader, Narendra Modi, may have skipped the U.N. meeting, but he hosted the G20 two weeks ago and used it as a forum to trumpet India’s suitability as a leader of the Global South.

China, too, used the General Assembly last week to cast itself as a member of the Global South and the community of developing nations. While that’s a matter of some debate — China also wants to be perceived as a key global power — its oomph carries along other less-heard nations’ priorities in its wake, while bigger nations are distracted with other things.

“It seems that the Global North, under the U.S leadership, is busy resisting China’s growing power and weakening Putin’s Russia,” Zhiqun Zhu, a professor of political science and international relations at Bucknell University, said in an email. “No wonder China is seeking support in the developing world.”

Even Biden focused his U.N. speech not on the big powers whose leaders didn’t show, but on leaders in the room. “The United States is working across the board to make global institutions more effective and more inclusive,” he said, adding that in the 21st century, “21st-century results are badly needed.”

That, like so many other remarks that followed in coming days, was an acknowledgment of something crucial: Both the community of nations and the U.N. itself need to address a world that might not have been recognizable to the architects of the post-World War II order and the global organization that rose from its ashes.

Which brings us back to Togo. Dussey surely voiced the concerns of myriad smaller nations when he said, flatly, that it is time to be heard and listened to — individually or as a group, but in a way that befits a 21st-century civilization where some of the most difficult circumstances are visited upon those with the least resources to cope.

“We are wearied by paternalism,” Dussey said. “We are weary at your condescension. We are weary of your arrogance. We are weary. We are weary. We are weary.”

Ted Anthony, the director of new storytelling and newsroom innovation at The Associated Press, has been writing about international affairs since 1995 and covering the U.N. General Assembly’s leaders meetings since 2018. Find him at http://twitter.com/anthonyted

This Christian Text You’ve Never Heard Of, The Shepherd of Hermas, Barely Mentions Jesus - But it Was A Favorite Of Early Christians Far And Wide

BY CHANCE BONAR

POST DOCTORAL FELLOW,

CENTER FOR THE HUMANITIES

TUFTS UNIVERSITY

People usually think about the Bible as a book with a fixed number of texts within its pages: 24 books in the Jewish version of the Bible; 66 for Protestants; 73 for Catholics; 81 if you’re Ethiopian Orthodox.

Writings that didn’t make it into the Bible, on the other hand, are often called “apocrypha,” a Greek term that refers to hidden or secret things. There are hundreds of apocryphal Jewish and Christian texts that, for one reason or another, were not included in different versions of the Bible. Some simply fell out of use. Some caused theological headaches for later Jews or Christians, and some were rejected because of their author – for supposedly not having really been written by an apostle, for instance. (When used with a capital “A,” Apocrypha refers to a handful of books included in the Catholic and Orthodox versions of the Old Testament, but not most Protestant ones.)

Just because a text was deemed apocryphal, however, does not mean that it was unpopular or lacked influence. Many texts that are treated as unimportant or unbiblical today were considered central at one time. As a scholar of early Christianity, some of my research centers on what was once an extremely well-read text, but one that most people today have never heard of: The Shepherd of Hermas.

Enslaved to God

The Shepherd of Hermas was written sometime between 70–140 C.E. and takes place on the road between Rome and Naples. Hermas, who is presented as the text’s author and narrator, has various encounters with two divine figures called the Church and the Shepherd, who give him commandments and visions that he is instructed to share with other believers.

The Shepherd is a sizable text – 114 chapters long – and substantial portions describe a vision of a tower under construction. The tower represents the church itself, in the sense of all Jesus’ followers, built out of stones that represent different types of believers. Some fit right in, others must be reshaped or recolored, and some are rejected altogether. For example, stones representing rich people or businessmen are urged to repent, while hospitable people are portrayed as properly shaped.

Other parts of the text are focused on how believers should manage their emotions, how to act ethically in the world and how to obey God’s will. The Shepherd urges self-control and fear of God, trying to instill obedience and avoid allowing emotions like fear or doubt to overcome believers.

My own research on the Shepherd focuses on how the text depicts believers as enslaved to God, as is true of some other early Christian literature as well. The writer imagines that God’s holy spirit is able to enter loyal believers’ bodies and possess them, urging them to do what God wills.

Notably, figures like Jesus and the apostles are virtually absent from the Shepherd. Instead, readers find a story about an otherwise unknown enslaved man named Hermas experiencing visions and talking with divine beings in the Italian countryside. Hermas is portrayed as a believer who doubts his own ability to accomplish what these two divine figures, the Church and Shepherd, expect of him, lamenting throughout how difficult it is to follow God’s commandments.

‘Useful for the soul’

Given that the Shepherd is a long, rambling text that doesn’t explicitly mention Jesus, you might assume that it was only read by a small number of early Christian theologians. This, however, isn’t the case.

The Shepherd became one of the most popular texts among Christians for the first five centuries C.E. Even today, there are more surviving manuscripts of the Shepherd from antiquity than of any New Testament text except for the Gospels of Matthew and John.

The visions were translated from Greek into Latin, Coptic, Ethiopic, Arabic and Georgian. Eventually, the text spread as far west as Ireland and as far east as China.

The Shepherd is even included in what scholars consider one of the oldest and most complete Bibles in the world. Canonical Christian Bibles today end with Revelation, a dramatic book of apocalyptic visions. The Codex Sinaiticus, however, a fourth- or fifth-century manuscript now held at the British Library, ends with the Shepherd. The text’s inclusion in such an expensive, deluxe codex highlights how important the text was to many Christians, even as the contents of the New Testament were being solidified.

Many significant Christian writers from the fourth and fifth centuries comment on how the Shepherd is important instruction for new Christians, regardless of whether it was considered part of the formal Bible.

Even figures who did not include the Shepherd among New Testament texts thought it was too important to be discarded. The book was too important to ignore, but too odd to be considered biblical: part of a halfway category that biblical scholar François Bovon called “useful for the soul.”

An open Bible

As the Shepherd helps demonstrate, whether a religious text is included or excluded from the Bible is not necessarily an indicator of its popularity or significance.

While scholars often lament that the Shepherd is boring, pedantic or too long, its style likely made it ideal teaching material for early Christians. Esoteric texts that required deeper philosophical knowledge, like the Gospel of Truth or Gospel of Judas, may have been ideal for some Christians who had access to more education. But texts that make bite-sized claims – like “don’t think about another man’s wife” (Shepherd 29:1), “rid yourself of grief” (Shepherd 40:1), or “believe that God is one” (Shepherd 26:1) – are easier for readers to carry with them and apply to everyday decisions in their lives.

The word “canon,” referring to texts that get a seal of approval from authorities, comes from a Greek word for a measuring stick: which books “measure up”? In religious communities, the idea of “canonical texts” can be especially limiting, determining what believers can or can’t read or believe.

Apocryphal literature, however, allows us to see how that wasn’t always the case: Ancient Christians didn’t think they were bound to the same specific set of stories that churches focus on today. The long history of reading apocrypha shows how some Christians have always been interested in reading the “Bible with the back cover torn off” – continually exploring religious ideas.

Why Separating Fact From Fiction Is Critical In Teaching US Slavery

THE CONVERSATION

A Black actor playing a slave walks past a farmhouse in Colonial Williamsburg in 1995. Nik Wheeler/Corbis via Getty Images

BY ERIC GABLE AND RICHARD HANDLER

Of all the debate over teaching U.S. slavery, it is one sentence of Florida’s revised academic standards that has provoked particular ire: “Instruction includes how slaves developed skills which, in some instances, could be applied for their personal benefit.”

Does this sentence constitute “propaganda,” as Vice President Kamala Harris proclaimed, “an attempt to gaslight us?”

Or is it a reasonable claim in a discussion of a difficult topic?

Whatever it is, the sentence is of a sort not unique to the teaching of enslavement in Florida. It is, instead, an example of how some Americans transform the racist history of this country into an uplifting – and sanitized – moral lesson.

In our view as cultural anthropologists, the disputed sentence is true as historians define facts – tiny nuggets of truth one can find in archives, artifacts and diaries.

It is a fact that small numbers of the enslaved acquired skills that allowed them to earn money, to save it and to buy their freedom and the freedom of family members.

It is also a fact that freed Black people in the antebellum era helped other Black people to also acquire skills and became part of a segregated Black middle class in many Southern cities.

One might argue that such a sentence, because it is true, should not give rise to protest. But as scholars who have studied how history is taught in America, we learned that this particular nugget is neither trivial nor insignificant.

Instead, the one sentence in Florida’s new standards allows Americans to transform a story about what we today call structural racism into an apocryphal story about Horatio Alger and America’s rags-to-riches melting pot.

As this line of thinking goes, enslaved ancestors of contemporary African Americans labored just as most contemporary Americans’ ancestors labored: at the bottom, but able to climb up the social ladder with hard work and discipline.

And this is the problem: To portray enslaved people as laborers like free laborers is exactly how not to teach about slavery.

But it is a commonly used method that is called a “switching mechanism.” In this example, the story about the horrors of the slave system is transformed into a story about opportunity, success and the American dream.

Switching the story at Colonial Williamsburg

Thirty years ago, when we conducted anthropological research at Colonial Williamsburg, we encountered the same narrative switching mechanism that is occurring now in Florida.

At that time, the world-famous Virginia outdoor history museum depicting a genteel, colonial America was trying to present the public with a truer picture of the past by incorporating the history of what they called “the Other Half” – the enslaved people who had been all but absent from the museum’s past portrayals.

But it was difficult, we found, for the museum to sustain a narrative about the evils of the slave system. That’s because much of its paying audience of white middle-class tourists did not want to dwell on such tales, and second, its “interpreters,” or guides, found ways to switch the narrative.

Starting from a story about the enslaved being someone else’s property, they would transition to one suggesting the enslaved were working for their own advancement.

We heard stories during our research like this:

• Don’t imagine that 18th century Williamsburg was like mid-19th century Mississippi cotton plantations, with families torn apart by avaricious masters, whippings, shackles and rape. Instead, in Williamsburg, slaves were valuable property.

• Consider that your average white yeoman farmer of the time had an annual income of about 20 pounds. Now consider that a highly trained slave cook was worth 500 pounds. Would your average owner be likely to abuse such a valuable piece of property? No! They’d treat that slave like an NFL quarterback!

Such stories conflated an enslaved laborer’s monetary value to his owner and the income of a white laborer. And that is how many visitors we listened to interpreted what they were hearing.

In other instances, we found conflicting messages.

In a skit that took us to the basement of an elite white Williamsburg household during Christmas, we witnessed Black interpreters portraying enslaved houseboys, maids and cooks complaining that they had to work harder than ever to create the festive atmosphere their owners desired. Meanwhile, upstairs, white interpreters portraying gentlemen conversing waxed philosophical about the evils of slavery coupled with the impossibility of getting rid of it.

At the conclusion of the story, we talked to two members of the audience who, it turns out, had learned different lessons.

One concluded that she had witnessed a universal story because workers everywhere grumble about their bosses. The other pointed out that if she disliked her boss, she could quit her job – something the enslaved couldn’t do.

Still, both were relieved to hear that slavery did not sit easy on the consciences of the white elite.

Structural inequality or Horatio Alger?

Switching mechanisms such as these are hard to dislodge. They remake the worst parts of the American story into a story consonant with the American Dream.

Today, not much has changed in Williamsburg. In Florida and many other states, switching allows designers of history curricula to avoid discussions on the lasting effects of racialized slave labor. They avoid discussing what that has meant to millions of people who did not, will not and cannot start on the same rung of the ladder of upward mobility that is available to other Americans who do not share a history of enslavement.

In our view, that is not a story that many Americans want to tell, teach or hear.

And so they switch to a different one, in which equal opportunity has been achieved, every one of us is capable of overcoming seemingly insurmountable odds, and failure to rise must be a result of individual weakness and vice.

Best Ways To Prevent Type 2 Diabetes

10. Optimize Vitamin D Levels

One of the best ways to prevent type 2 diabetes is to optimize the vitamin D levels in the body. Studies show that maintaining adequate levels of Vitamin D helps in blood sugar management, which subsequently aids patients with prediabetic orientations. Thus, doctors are now suggesting patients increase their intake of vitamin D to prevent type 2 diabetes. Vitamin D intake can be carried out not only through food sources, like fatty fish and cod liver oil, but also via sun exposure and supplements prescribed by a doctor.

9. Increase Water Intake

To prevent type 2 diabetes, it is advisable to substitute sugary and sweetened drinks with water. One study conducted by the National Institutes of Health found that consumption of one serving of a sugary drink may increase the chances of developing type 2 diabetes by 18%. On the other hand, water intake helps with blood sugar management and maintaining insulin levels. A recent study by the CDC showed that overweight people who followed a comprehensive diet plan and replaced sweetened drinks with water experienced decreased levels of insulin resistance and fasting blood sugar.

8. Quit Smoking

Smoking can not only contribute to diseases like heart disease or lung cancer, but is also linked as a precursor to type 2 diabetes. People who smoke have a higher chance of experiencing insulin resistance. In fact, people who smoke more are increasingly prone to type 2 diabetes, as compared to those who smoke less. In a study conducted by Harvard, it was found that the risk of diabetes in smokers decreases over time after they quit smoking.

7. Reduce Sedentary Behaviour

Reducing sedentary behavior can significantly reduce the risk of type 2 diabetes. One study suggests that those who have 10 hours of sedentary time per day are twice as likely to develop type 2 diabetes, as compared to those who have a nominal 8.3 hours of sedentary time. Sedentary behavior can be changed with minor adjustments, like standing up for a while or taking short walks. According to Harvard, it is important to set achievable goals in order to cut sedentary behavior.
6. Reduce Alcohol Consumption
Alcohol consumption is often linked with a high risk of developing type 2 diabetes. Alcoholic drinks contain exorbitantly large amounts of calories, which can not only lead to obesity but eventually lead to diabetes as well. Additionally, heavy drinking may also increase insulin resistance, which exacerbates chances of developing late onset diabetes. Thus, many studies suggest that reducing alcohol consumption can reduce the risk of developing type 2 diabetes to a great extent. Reducing alcohol consumption ranks number 6 on our list of the 10 Best Ways to Prevent Type 2 Diabetes.

5. Follow a High Fiber Diet

Including fiber in one’s diet can aid with intestinal health, weight management and can in turn help prevent diabetes. People with prediabetic conditions or women with obesity tend to experience increased levels of insulin by adding fiber in their diet. Soluble fiber, which absorbs water, forms a gel in one’s digestive system and slows down food absorption, all the while maintaining blood sugar and insulin levels. Many studies suggest intake of fiber through fiber supplements; however, food rich in fiber may also help.

4. Reduce Total Carb Intake

Carbohydrate intake causes sugar molecules to be absorbed in one’s bloodstream. To maintain high levels of blood sugar, the pancreas secrete insulin. Having high levels of blood sugar and insulin consistently can eventually turn into diabetes. To prevent this, one should include carbs that are high in fiber in one’s diet, including fish, whole fruit, mushrooms, etc. Examples of foods and drinks that are high in added sugars include soda, candy, and other forms of dessert.

3. Regular Exercise

Engaging in regular exercise has been linked with preventing type 2 diabetes. Exercise increases insulin resistance, which means that your body needs less insulin in order to maintain regular blood sugar levels. Exercises, like aerobic exercises and strength training, have been associated with reducing the risk of late onset diabetes. One study showed that high intensity interval training helped in maintaining blood sugar levels.

2. Minimize Intake of Highly Processed Foods

Foods that are highly processed, including chips, pizza, and candies, include added sugars, unhealthy fats, and preservatives, which simply increases the risk of developing type 2 diabetes. To prevent diabetes, one should cut back on these products and instead intake foods that do not go through high levels of processing, like yogurt or frozen vegetables. One study showed that people whose diet included highly processed food were 30% more likely to develop type 2 diabetes.

1. Lose Excess Weight

Having excess weight around one’s abdominal area increases the chance of developing type 2 diabetes, since excess weight is associated with insulin resistance. Losing weight by even 5% to 7% can have drastic effects on one’s overall health and can also substantially reduce the risk of late onset diabetes. People who used to be at a high risk of developing type 2 diabetes were able to reduce the risk by a staggering 40% to 47% by adopting a healthier lifestyle through consistent exercise and diet.

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Implants Like Pacemakers And Insulin Pumps Often Fail Because Of Immune Attacks − stoping Them Could Make Medical Devicesv Safer And Longer-Lasting

BY KELLEN CHEN

Biomedical implants – such as pacemakers, breast implants and orthopedic hardware like screws and plates to replace broken bones – have improved patient outcomes across a wide range of diseases. However, many implants fail because the body rejects them, and they need to be removed because they no longer function and can cause pain or discomfort.

An immune reaction called the foreign body response – where the body encapsulates the implant in sometimes painful scar tissue – is a key driver of implant rejection. Developing treatments that target the mechanisms driving foreign body responses could improve the design and safety of biomedical implants.

I am a biomedical engineer who studies why the body forms scar tissue around medical devices. Along with my colleagues Dharshan Sivaraj, Jagan Padmanabhan and Geoffrey Gurtner, we wanted to learn more about what causes foreign body responses. In our research, recently published in the journal Nature Biomedical Engineering, we identified a gene that appears to drive this reaction because of the increased stress implants put on the tissues surrounding them.

Mechanics of implant rejection

Researchers hypothesize that foreign body responses are triggered by the chemical and material composition of the implant. Just as a person can tell the difference between touching something soft like a pillow versus something hard like a table, cells can tell when there are changes to the softness or stiffness of the tissues surrounding them as a result of an implant.

The increased mechanical stress on those cells sends a signal to the immune system that there is a foreign body present. Immune cells activated by mechanical pressure respond by building a capsule made of scar tissue around the implant in an attempt to shield it off. The more severe the immune reaction, the thicker the capsule. This protects the body from getting an infection from injuries like a splinter in your finger.

All biomedical implants cause some level of foreign body response and are surrounded by at least a small capsule. Some people have very strong reactions that result in a large, thick capsule that constricts around the implant, impeding its function and causing pain. Between 10% to 30% of implants need to be removed because of this scar tissue. For example, a neurostimulator could trigger the formation of a dense capsule of scar tissue that inhibits electrical stimulation from properly reaching the nervous system.

To understand why the immune systems of some people build thick capsules around implants while others do not, we gathered capsule samples from 20 patients whose breast implants were removed – 10 who had severe reactions, and 10 who had mild reactions. By genetically analyzing the samples, we found that a gene called RAC2 was highly expressed in samples taken from patients with severe reactions but not in those with mild reactions. This gene is found only in immune cells, and it codes for a member of a family of proteins involved in cell growth and structure.

Because this protein seemed to be linked to a lot of the downstream reactions that lead to foreign body responses, we decided to explore how RAC2 affects the formation of capsules. We found that immune cells activate RAC2 along with other proteins in response to mechanical stress from implants. These proteins summon additional immune cells to the area that combine into a massive clump to attack a large invader. These combined cells spit out fibrous proteins like collagen that form scar tissue.

To confirm RAC2’s role in foreign body responses, we artificially stimulated the mechanical signaling proteins surrounding silicone implants surgically placed in mice. This stimulation produced a severe and humanlike foreign body response in the mice. In contrast, blocking RAC2 resulted in an up to threefold reduction in foreign body responses.

These findings suggest that activating mechanical stress pathways triggers immune cells with RAC2 to generate severe foreign body responses. Blocking RAC2 in immune cells may significantly reduce this reaction.

Developing new treatments

Implant failure is conventionally treated by using biocompatible materials that the body can better tolerate, such as certain polymers. These don’t completely remove the risk of foreign body reactions, however.

My colleagues and I believe that treatments that target the pathways associated with RAC2 could potentially mitigate or prevent free body responses. Heading off this reaction would help improve the effectiveness and safety of medical implants.

Because only immune cells express RAC2, a drug designed to block only that gene would theoretically target only immune cells without affecting other cells in the body. Such a drug could also be administered via injection or even coated onto an implant to minimize side effects.

A complete understanding of the molecular mechanisms driving foreign body responses would be the final frontier in developing truly bio-integrative medical devices that could integrate with the body with no problems for the recipient’s entire life span.

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