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Canceling people’s debt from unpaid medical bills does not lead to improvements in their health or finances, according to a new study. | Getty Images The US leaves millions of people with outstanding medical bills. How do we help them? Four in 10 Americans carry some kind of medical debt, an affliction that is unique to the United States among wealthy nations. The country does not guarantee medical insurance to everyone, and the costs even to people who carry coverage are much higher on average than they are for patients in the rest of the developed world. It’s a fundamental flaw in the design of the US health care system. Those debts weigh on the people who carry them: Research has found that people who incur substantial medical bills (after a cancer diagnosis, for example) report cutting back on everyday spending, depleting their savings, and even downsizing their homes. Medical debt is associated with poorer general health, as well as higher rates of cancer, heart disease, and overall mortality. People end up sicker because they can’t afford their health care. In the absence of politically difficult health care reform, activists and some state and local governments have set up medical debt relief programs, purchasing the debts of people in difficult financial circumstances for much less than face value and wiping them out at no cost to the patient. But a new study of medical debt relief by a group of top economists has called its value into question. Participants who had their debt erased did not see their mental or physical health or their access to credit improve much after debt relief. There was even evidence that some people felt more depressed. “It would be great if we could improve people’s mental health, we could ease their finances, we could get them to go to the doctor more often by buying debt for less than a penny on a dollar,” Francis Wong, a University of Munich economist who co-authored the study, told me. “But it just didn’t work.” The findings stunned the researchers. While it might still be premature to discard medical debt relief based on one study, the research raises important questions about the limits of debt relief, and about how to use finite government and philanthropic resources to alleviate high health care costs. One lesson of the paper may be that relieving debt long after it’s accrued is ultimately a Band-Aid on the structural problems within US health care. Many people with medical debt are contending with other financial problems compounded by their health expenses, which are not easily undone by eliminating hospital bills. Preventing medical debt in the first place may be more effective. “The punchline for me is that you really need to tackle the root cause that created all of these issues in the first place, that created the financial distress and poor mental health,” Wong said. “That’s a matter of addressing the holes in the American health care system.” Medical debt relief didn’t do much to improve people’s finances The research team — including Wong, Harvard’s Raymond Kluender, Stanford’s Neale Mahoney, and UCLA’s Wesley Yin — was commissioned to study a group of 83,400 people who collectively had $169 million in medical debt relieved through the organization RIP Medical Debt (recently renamed Undue Medical Debt). The study analyzed two groups of patients: one had held their debts for seven years on average, the other for a little more than a year. Using surveys and financial data, the experiment tracked most patients for about a year after they received debt relief. Compared to patients who did not have their debt wiped out, the researchers found, the relief had negligible effects on participants’ access to credit and other measures of financial well-being. Credit scores increased by a marginal 3.6 points on average, though for people whose only debt had been medical debt, there was a more sizable 13.4-point increase. The average increase in credit limits was just $342. Participants whose debt was relieved actually became less likely to pay future medical bills, the study found. The results showed no improvements in objective and subjective measures of financial distress. One reason may be that although participants had an average of $2,167 in debt relieved, they had plenty of other, non-medical debt. The group averaged $28,000 in debts including things like credit card balances and car loans. An average of $4,000 in bills had already reached collections. “The most striking thing to me was just how much financial distress that folks with medical debt are experiencing broadly,” Kluender said. “The debt relief that we were able to execute through the experiment was insufficient to address their financial deprivation.” People in medical debt are often pestered by collectors and forced into even more debt to pay their bills and cut their spending on necessities such as food and rent. People did not report feeling happier or healthier after debt relief The study also found that measures of depression, stress, anxiety, subjective feelings of well-being, and general health barely budged after debt was wiped out. One finding is especially telling. Before the experiment began, the authors asked a panel of 45 experts what they expected the study to find. Panelists anticipated on average a 7 percentage point reduction in the number of patients reporting moderate or worse depression. Instead, the study showed a 3.2-percentage point increase in patients reporting that they were depressed. That’s on top of the 45 percent of participants who reported having at least moderate depression before the experiment began. The worst mental health effects were found among the 25 percent of participants with the most medical debt: They experienced a 12.4-percent increase in depression along with “worsening of anxiety, stress, general health, and subjective well-being” after debt relief. “That’s just staggeringly high rates of poor mental health,” Wong said. How can that be? One possibility is that the relief came too late to undo the severe mental health burden of carrying debt for months or years. Such patients have “already been scarred by the collection process,” Mahoney told me, and will continue to struggle with non-medical debts. “That’s the sort of person who on a weekly basis is getting hounded by debt collectors, not just sort of the medical debt collectors that we study, but debt collectors of all sorts,” Wong said. Medical debt relief “really doesn’t do anything to alleviate any of those other conditions, not to mention whatever health condition led them to incur medical debt in the first place.” The researchers identified another plausible theory through a sub-experiment included in the study, which tested the reactions of patients based on how they were informed of their debt relief, either by phone call or by letter. Among the people who received a direct phone call to let them know, the negative mental health effects were greater. Prior research has found that Americans tend to feel shame and stigma when receiving charitable or government aid to pay their bills. Participants had not requested debt relief, the study noted, but rather had it purchased and wiped out by RIP Medical Debt without their prior knowledge (this is often how medical debt relief programs work). It’s possible that the very act of filling out the study’s surveys may have affected how the respondents perceived their own situation. “We’re reminding people of this unpleasant experience that they had,” Kluender told me. “And maybe they were going through some unpleasant negotiations with their insurer or they feel a lot of guilt and shame about being unable to pay the bill.” What do we do with this information? The disappointing findings are especially surprising in light of research on relief programs for other types of debt, like credit card debt and student loan debt, that has found improvements in financial health and job prospects. Medical debt, like those other types of debt, has been associated with worse health and a weaker financial situation. But medical debt has some distinct characteristics. Repayment rates are much lower than they are for student loans or mortgages. Once a medical bill reaches collections, it’s often resolved with a negotiated settlement, which can result in much lower payments than what the patient originally owed. So the study participants, who had carried their debt for more than a year at a minimum, may have already been subconsciously writing off the medical debt by the time relief came, the authors said. That limits the impact they may feel when it’s wiped out. Some experts not involved in the study think the findings may understate the benefits of medical debt relief, especially on people’s finances, based on earlier studies of medical debt relief that had found larger benefits for people’s credit scores and credit access. The effect on credit scores is increasingly a moot point, however. Credit agencies have agreed to stop reporting most medical debt on people’s credit reports, after urging from the Biden administration, a step taken in the midst of the experiment. (The study relied on a subset of people whose debt was relieved prior to that announcement.) Amy Finkelstein, a leading researcher on health care costs at MIT whose nonprofit J-PAL North America helped fund the study, said she was shocked by the results but grateful to have them. Part of the difficult work of policymaking is to soberly assess the results of what you are doing. “Yes, it’s disappointing. But another way of saying it is: This was true whether or not we had done the study,” Finkelstein told me. “So it’s good to know so that we can try to learn from it and move on.” Everybody I spoke to agreed on one thing: Preventing people from accruing medical debt in the first place would likely be more effective in improving their finances and health than relieving debts after the fact. One-time debt relief may not make it any easier or less stressful to access health care in the future, but providing people with health coverage that eliminates the risk of debt does. That hypothesis is supported by existing evidence. The Oregon Health Insurance Experiment, a totemic work in health care research, found that low-income adults who received Medicaid saw a 9 percent reduction in depression. They were also less likely to end up in debt because of a medical bill and less likely to take out loans or skip payments on their other necessities to cover their health care balance. Experts I spoke to named more robust interventions that could lead to less medical debt and better health and financial outcomes, including more generous insurance benefits for people already covered. Covering the 26 million Americans who remain uninsured would be another step. Most states in the Deep South still haven’t expanded Medicaid under the Affordable Care Act (ACA), leaving millions of low-income people without coverage. Other proposals, such as more public insurance options, have gained increasing support among Democrats. “As a consumer advocate, the best solution would be single-payer, Medicare for all,” Chi Chi Wu, an attorney with the National Consumer Law Center, said. But major overhauls are easier said than done. The history of US health care reform is one of a country inching toward universal health coverage: Medicare and Medicaid passed in the 1960s, and the ACA didn’t come along until 2010. Our byzantine insurance system with weak cost controls persists, with a massive health care industry invested in maintaining the status quo. In the meantime, experts said, policymakers could focus on making sure that hospital financial assistance programs are accessible to more people. Many patients are eligible for aid that would significantly reduce what they owe — but they often have no idea it’s available. The New York Times reported in 2022 that some hospitals were making it extremely difficult for eligible patients to find out about and use assistance programs, while aggressively seeking payment even from patients who should qualify for aid. The long-term project of universal health care continues. The debt relief study, disappointing as its results might be, may spur some fresh thinking about how to better help people.

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Nude images shared without consent can be traumatic, whether they’re real or not. | Getty Images/iStockphoto How do you stop deepfake nudes? There’s a lot of debate about the role of technology in kids’ lives, but sometimes we come across something unequivocally bad. That’s the case with AI “nudification” apps, which teenagers are using to generate and share fake naked photos of their classmates. At Issaquah High School in Washington state, boys used an app to “strip” photos of girls who attended last fall’s homecoming dance, according to the New York Times. At Westfield High School in New Jersey, 10th grade boys created fabricated explicit images of some of their female classmates and shared them around school. Students from California to Illinois have had deepfake nudes shared without their consent, in what experts call a form of “image-based sexual abuse.” Now advocates — including some teens — are backing laws that impose penalties for creating and sharing deepfake nudes. Legislation has passed in Washington, South Dakota, and Louisiana, and is in the works in California and elsewhere. Meanwhile, Rep. Joseph Morelle (D-NY) has reintroduced a bill that would make sharing the images a federal crime. Francesca Mani, a 15-year-old Westfield student whose deepfaked image was shared, started pushing for legislative and policy change after she saw her male classmates making fun of girls over the images. “I got super angry, and, like, enough was enough,” she told Vox in an email sent via her mother. “I stopped crying and decided to stand up for myself.” Supporters say the laws are necessary to keep students safe. But some experts who study technology and sexual abuse argue that they’re likely to be insufficient, since the criminal justice system has been so inefficient at rooting out other sex crimes. “It just feels like it’s going to be a symbolic gesture,” said Amy Hasinoff, a communications professor at the University of Colorado Denver who has studied image-based sexual abuse. She and others recommend tighter regulation of the apps themselves so the tools people use to make deepfake nudes are less accessible in the first place. “I am struggling to imagine a reason why these apps should exist’’ without some form of consent verification, Hasinoff said. Deepfake nudes are a new kind of sexual abuse So-called revenge porn — nude photos or videos shared without consent — has been a problem for years. But with deepfake technology, “anybody can just put a face into this app and get an image of somebody — friends, classmates, coworkers, whomever — completely without clothes,” said Britt Paris, an assistant professor of library and information science at Rutgers who has studied deepfakes. There’s no hard data on how many American high school students have experienced deepfake nude abuse, but one 2021 study conducted in the UK, New Zealand, and Australia found that 14 percent of respondents ages 16 to 64 had been victimized with deepfake imagery. Nude images shared without consent can be traumatic, whether they’re real or not. When she first found out about the deepfakes at her school, “I was in the counselor’s office, emotional and crying,” Mani said. “I couldn’t believe I was one of the victims.” When sexual images of students are shared around school, they can experience “shaming and blaming and stigmatization,” thanks to stereotypes that denigrate girls and women, especially, for being or appearing to be sexually active, Hasinoff said. That’s the case even if the images are fake because other students may not be able to tell the difference. Moreover, fake images can follow people throughout their lives, causing real harm. “These images put these young women at risk of being barred from future employment opportunities and also make them vulnerable to physical violence if they are recognized,” Yeshi Milner, founder of the nonprofit Data for Black Lives, told Vox in an email. Stopping deepfake abuse may require reckoning with AI To combat the problem, at least nine states have passed or updated laws targeting deepfake nude images in some way, and many others are considering them. In Louisiana, for example, anyone who creates or distributes deepfakes of minors can be sentenced to five or more years in prison. Washington’s new law, which takes effect in June, treats a first offense as a misdemeanor. The federal bill, first introduced in 2023, would give victims or parents the ability to sue perpetrators for damages, in addition to imposing criminal penalties. It has not yet received a vote in Congress but has attracted bipartisan support. However, some experts worry that the laws, while potentially helpful as a statement of values, won’t do much to fix the problem. “We don’t have a legal system that can handle sexual abuse,” Hasinoff said, noting that only a small percentage of people who commit sexual violence are ever charged. “There’s no reason to think that this image-based abuse stuff is any different.” Some states have tried to address the problem by updating their existing laws on child sexual abuse images and videos to include deepfakes. While this might not eliminate the images, it would close some loopholes. (In one recent New Jersey lawsuit, lawyers for a male high school student argued he should not be barred from sharing deepfaked photos of a classmate because federal laws were not designed to apply “to computer-generated synthetic images.”) Meanwhile, some lawyers and legal scholars say that the way to really stop deepfake abuse is to target the apps that make it possible. Lawmakers could regulate app stores to bar them from carrying nudification apps without clear consent provisions, Hasinoff said. Apple and Google have already removed several apps that offered deepfake nudes from the App Store and Google Play. However, users don’t need a specific app to make nonconsensual nude images; many AI image generators could potentially be used in this way. Legislators could require developers to put guardrails in place to make it harder for users to generate nonconsensual nude images, Paris said. But that would require challenging the “unchecked ethos” of AI today, in which developers are allowed to release products to the public first and figure out the consequences later, she said. “Until companies can be held accountable for the types of harms they produce,” Paris said, “I don’t see a whole lot changing.” This story appeared originally in Today, Explained, Vox’s flagship daily newsletter. Sign up here for future editions.

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When I was a kid, my best friend’s mother had a habit of singing arias to her houseplants. I did not know this at the time, but she was likely under the influence of The Secret Life of Plants, a 1973 best seller that claimed, among many other things, that plants enjoy classical music more than rock and practice a form of telepathy. Thanks to these nonsense claims, mainstream botany mostly avoided the debate of whether plants can, in any way, be considered intelligent. But recently, some scientists have begun to devise experiments that break down elements of this big, broad question: Can plants be said to hear? Sense touch? Communicate? Make decisions? Recognize kin?In this episode of Radio Atlantic, we talk to staff writer Zoë Schlanger, author of the upcoming The Light Eaters: How the Unseen World of Plant Intelligence Offers a New Understanding of Life on Earth. How could a thing without a brain be considered intelligent? Should we expand our definition of intelligence to include such an alien variety of it? And if we do, how will that change us? Schlanger has spoken with dozens of botanists, from the most renegade to the most cautious, and she reports back on the state of the revolution in thinking.Listen to the conversation here:Subscribe here: Apple Podcasts | Spotify | YouTube | Overcast | Pocket CastsThe following is a transcript of the episode:Hanna Rosin: Okay, so, you have a glowing petunia?Zoë Schlanger: It was very thrilling to me because I got the first full-size petunia ever. I beat the influencers. I got it like three weeks early, organized a little exclusive on the petunia.And the scientist who crafted the technology that made this possible hand delivered it to our offices in New York.And so I just met him on the sidewalk, and I rushed up to our office, to the darkest part of our office, with this plant, which is the podcast recording studio, and turned out all the lights and waited, and then slowly my eyes adjusted.It does take a minute for your eyes to, you know—our eyes are like cameras. The aperture has to sort of open to take in that low level of light. But once it did, you know—stunning experience to suddenly see your first glowing plant outside of a lab.[Music]Rosin: This is staff writer Zoë Schlanger. And what she’s describing is a real plant, the first commercially available houseplant that glows in the dark.Schlanger: It glows in this very subdued, sort of matte way. There’s no other way to describe it. It’s a bit like moonlight. It’s very contained. You really have the sense that it’s glowing from within.Rosin: Which, technically, it is. Scientists, including the one who delivered that plant to Zoë, borrowed a cluster of five genes—some from a bioluminescent fungus—and these genes somehow reroute the plant’s metabolism through a process that emits light.The company that developed the plants sold out of their first run of 50,000 petunias. Probably, many of those will show up on your favorite Instagram feeds any minute. But Zoë wasn’t doing it for the ’Gram. She’s interested because she believes that the glowing petunias offer the first chance at breaking through a deep human bias.Schlanger: I’m really interested in the ways that we, culturally, don’t really perceive plants as having as much vitality, let’s say, as animals.To suddenly have this product available, where if people are clued into the fact that they’re looking at the plant’s metabolism activating when they see that glow, it kind of brings them into this realm of livingness in our minds.You’re really seeing the plant being alive. It’s very much its livingness.[Music]Rosin: I’m Hanna Rosin. This is Radio Atlantic. And I’m here today to tell you that your houseplant is not just alive but thinking—maybe. In her new book, The Light Eaters, Zoë Schlanger documents a revolution in the world of botany. Scientists—and these are respectable, academic scientists—are starting to ask themselves questions like: Can plants hear? Do they talk to each other? Are they intelligent?Now, The Atlantic does not have a full-time plant reporter. Zoë’s actual beat for years has been climate change. But she was getting tired of the doom and gloom.[Music]Schlanger: As anyone who reads climate change news knows, it’s harrowing, and as a reporter, I was just sort of getting numb to this material.Rosin: So Zoë went out looking for something that gave her the opposite of that feeling. And she found her thrill in—Schlanger: Botany journals.Rosin: Botany journals, which were, at this moment in history, so alive with a radical question.Schlanger: Plant scientists were debating openly in journals about whether or not plants could be considered intelligent.Rosin: Like, they were using the word intelligent?Schlanger: Yes. There had been a few kind of rabble-rousing scientists who had formed an alliance to try and push this idea into the fore of their field. And because of that, there was a discussion of whether or not neurobiology could be altered as a field to apply to plants.Rosin: Whoa. Okay. I have a loose sense that in the ’60s, there was a mushy idea that you could play music to your plants or that somehow you could communicate with your plants, and then there was some spirituality. But it wasn’t serious.Schlanger: Totally. You are talking about an era in which a book called The Secret Life of Plants came out. That was more like ’73, but it was sort of bubbling up through the culture up until that point. And this book was full of that sort of a thing. It is one of the reasons people started talking to their plants, and it contained the claim that plants enjoy classical music more than rock and roll.Rosin: Of course. Of course. Like babies. Like, everybody loves Beethoven.Schlanger: Exactly. Makes them smarter. And it included a CIA agent who strapped a lie-detector test to his houseplant and then thought about burning it. And he says that his thoughts made the plant’s lie-detector test kind of go wild, suggesting it was reading his mind.Rosin: Ooh. Okay.Schlanger: This book was so popular. For the first time, botany had a pop-science book that captivated people—perfect for the new-age moment. But the problem was a lot of it was just not true.Rosin: So it probably discredited the whole field of: Are plants intelligent?Schlanger: It did. It made all of the institutions that fund this kind of science kind of clam up and get nervous and stop funding it.Rosin: Uh-huh.Schlanger: But, for sure, in the last 15 years, technology has come up so far that they are able to confirm things they had never previously been able to in the Secret Life of Plants era.Rosin: And what are the kinds of things that are being debated?Schlanger: The main debate is: Are plants behaving intentionally? Are plants behaving at all? Can they be said to behave when something doesn’t have a mind? You get into all these murky discussions of what intelligence really means.If intelligence means responding in a way that has a good future outcome, then there’s probably a good argument for that.But does intelligence mean a sort of more academic awareness of events and this more mushy quality of consciousness? Then you get into stranger territory.And, science is a very conservative institution. Scientists don’t want to be using words that they can’t precisely define.So this caused a lot of fights and is still causing fights. Nobody can quite decide how to refer to plants.Rosin: So now, basically, plants are in this large, maybe post-Biblical-era debate about what else besides us could be said to be intelligent—like primates, dolphins, whales, pigs—that we’re used to. And maybe plants has now entered the legitimate realm of those discussions, rather than the far-out-there realm.Schlanger: Yeah, plants have entered the consciousness chat, for sure.Rosin: Oh my God, the consciousness chat.[Music]Schlanger: It’s very hard to make some of these plant-science findings tangible. The idea that, let’s say, a plant makes decisions or is communicating with airborne chemicals—you can’t see any of that.Rosin: So what’s the first, say, surprising thing that your eyes were opened to once you started to look into it? Like, an ability or a skill or a thing that a plant could do that you didn’t know about before?Schlanger: One of the biggest things was, I didn’t realize that plants could feel me touching them.That was a big one. I, you know, pet my houseplants all the time.Rosin: You do?Schlanger: Yeah, you know, fresh leaves that have just come out—they’re really soft. It’s lovely. But now I think about that twice because I realize that there are sensors.No one’s quite sure of the mechanics of this, but the plant has an ability to sense that touch and treat it like an assault. It might amp up its immune system to respond to that. It might change its growth pattern.Rosin: Uh-huh.Schlanger: From what we now know, many plants will ramp up their defenses when they’re touched too many times. That ultimately might mean a tougher exterior, a more flexible stem, or just an invisible cascade of chemicals to prevent infection.[Music]Rosin: So plants can sense touch, which isn’t intelligence in the same way that, say, writing a great book about plants is intelligence, but it is an element of intelligence—something like using one of your senses to make a decision. So let’s try another sense-related intelligence question: Do plants hear?[Music]Rosin: All right. So let’s get into one of the experiments. We’re going to listen to a sound here. I’m sorry, podcast people. This is a sound that people listening to shows hate, but here we go.[Caterpillar audio]Rosin: I actually think it’s kind of beautiful.Schlanger: Mm-hmm.Rosin: All right. What is that? What are we listening to?Schlanger: You are listening to the delicious noises of a cabbage white caterpillar chewing on a leaf. This recording was taken by these two researchers named Rex Cocroft and Heidi Appel, and they study the world of phytoacoustics, or the way that plants respond to sound.Rosin: Now, mind you, this isn’t an actual caterpillar chewing on an actual leaf. It’s a recording being played back to the plant.Schlanger: So they recorded these caterpillars chewing and clipped little guitar pickups to the same plants. And these pickups vibrate the leaf at the same frequency, amplitude that the caterpillar’s mouth chewing the leaf would. And what they wanted to know was, would a plant respond to just the noise of their predator eating them, even if they weren’t really being eaten?Rosin: Right. So not the smell or not the sensation of the caterpillar there, but just purely the sound.Schlanger: Exactly. Because we already know other plants will detect the saliva of a caterpillar and respond. But they just really want to know, what is the role of sound in a plant’s life?To their shock, honestly, the plants reacted by priming their chemical-defense systems. So when the researchers brought in real caterpillars, they were ready for them. They produced all these pesticides. They made their leaves unappetizing.Rosin: Okay. I want to elaborate on how wild that is, because what do you mean the plant is listening to an acoustic recreation, amplification of a caterpillar? Like, how?Schlanger: It’s astonishing to me too. The “how” of this is that sound is vibration.Rosin: Ah.Schlanger: So vibration is a physical stimulus. It’s a physical thing that the plant is encountering, which is kind of like how the hairs in our ears work. You know, they get hit by sound waves, and the hairs in our ears vibrate. And then that sends a message to our brain, and we perceive that as a sound.Rosin: I can see the philosophical problem now. Because as you first started talking, the plant is vibrating—I’m thinking, Okay, it’s just reflex. Like, once you say that, it seems like no big deal. But then once you explain how we hear, then it doesn’t seem vastly different, except I guess you don’t have the brain to transmit the signal through. So that is different.Schlanger: And that’s the boiling-hot core of the entire plant-science debate: How does the plant respond when there’s no centralized place for all these signals to go? How do you do this without a brain?Rosin: I see. That then leads to the question of: Can you have intelligence, consciousness, decision-making without a brain?Schlanger: Exactly. That gets into questions like: Is network intelligence possible? Do you need the signals to go to a centralized place, or can we accept a sort of more diffuse, whole-body awareness in the way that we think about a computer network?Rosin: Okay. After the break, now that we’ve gotten to the core of it, I make Zoë go through a lightning round of questions.Rosin: Do plants communicate with each other?Do plants recognize their relatives?This one is crazy: Do plants have personalities?Rosin: And then we figure out: What are we supposed to do with all this expanding knowledge about plants? Never walk in a grassy field again? That’s coming up.[Music]Rosin: Okay, this is a lightning round of questions, but I want you to answer at the speed of plants—not necessarily quickly, because they’re big and interesting questions.Do plants communicate with each other?Schlanger: Plants do have ways of communicating with each other. They’re able to synthesize all these incredibly specific chemicals in their bodies to match different conditions. And then they project them out via their pores. And then other plants take them up via these little pores. They have these pores on the backs of their leaves that look like little fish lips. It’s very funny under a microscope. And that contains some information.So if a plant is being eaten by caterpillars, it will synthesize a chemical that then alerts other plants to sort of up their defenses before the caterpillar or pest or whatever even reaches them.And there’s some really interesting research coming out now around regional “dialects” in plants, which blows my mind. These researchers have found that fields of isolated plants can have what they’re calling regional dialects that are specific to that single field that’s a more specific version of the general, more universal language of that species.Rosin: And when you say “dialects,” you mean they’re communicating with slight variations of a chemical, right? It’s not like, you know, they have different French accents or something.Schlanger: Right. It’s a regional variation of how they use chemicals to send signals, although the term dialect is actually how the researchers themselves describe it.Rosin: Okay, another wild question: Do plants recognize their relatives?Schlanger: So kin recognition in plants is a fascinating field. It’s a very muddy field. We have parsed very little of this so far.But we do know that sunflowers, for example—the traditional thinking with sunflowers is that you have to plant them quite far apart because otherwise they compete for resources so much that they try and shade each other out, so you end up with fewer sunflower seeds, which is not what sunflower farmers want. But certain research has found that when you place sunflowers with their genetic siblings, you can actually pack them so tightly because they will angle their stems to avoid shading each other.Rosin: (Gasps.) You mean they don’t steal resources from their relatives? They, like, protect their own?Schlanger: Exactly.Rosin: That’s crazy.Schlanger: And there’s clear evolutionary theory around this for higher animals, but we had not yet considered that for plants.Rosin: So that’s, like, widely accepted?Schlanger: Well, I wouldn’t say widely. (Laughs.) The caveats in this whole field are just unbelievable. But it’s also only been something that people have been considering for about 10 years, so it’s probably going to take another 20 before everyone’s like, Here’s how this works exactly.Rosin: Okay, this one is crazy: Do plants have personalities?Schlanger: So there’s some limited research emerging about variations in plant behavior and whether those variations do amount to a kind of personality.We’re used to scientists studying what you might call personality in animals, where an individual animal is more quote-unquote “shy” or more quote-unquote “bold” than other members of their species. But one researcher has applied that framing to plants and found what he believes are similar variations there.There’s some evidence to say that some plants are something like The Boy who Cried Wolf. They’ll kind of signal wildly at the slightest disturbance. And other plants are more reticent to do that. They’ll kind of wait for the disturbance to be really bad—for the pests to be really bothering them—before they let out their kind of distress call that alerts other plants to there being some kind of pest invasion.Rosin: You know, the way you’re talking about plants—it really sounds like how we talk about people, like how people make decisions. Is it fair to call how some plants interact with the world decision-making?Schlanger: So this is where I’d remind everyone that this is still a very new and very hotly debated area of science, especially when it comes to the language we use. And it’s easy to get into trouble when the language might make it sound like plants are people or plants have minds. They aren’t, and they don’t.But what I will say is that after spending all this time with the research, there’s a lot of plant behavior that looks a lot like decision-making. Often these are very, very simple decisions, like, input: There’s water over there. Output: Let’s grow towards it. But it also shows how much we don’t know. For instance, we know some plants are capable of storing information and then acting based on that information later.Or, you know, in some instances, plants can count and then choose to do an action based on a certain number of things. There’s a classic example that people call the memory of winter—that a plant needs to have a certain number of days of cold for it to then bloom in the spring.Rosin: But why isn’t it just responding to sensations? Like, if we’re talking about the difference between reflex and intention, which is how I’m thinking about it, is it just a reflex? There’s heat, you know. It’s stored a certain amount of sunlight. I’m not sure what the reflex would be in response to, as opposed to the word you used, which was counting.Schlanger: It comes down to a question of how far you need to distance what a plant is doing from what ourselves might be doing. There’s another example of counting plants in a Venus flytrap: They have all of these little hairs in their maw, in the leaves that snap closed, and it’s not enough for a little pebble to fall into that trap. It won’t close on a pebble. It needs multiple of those little hairs, those little trigger hairs touched. So it has to be a squirming animal that falls in there for the plant to bother closing. So it counts to at least five in that case.[Watch ticking sound]Schlanger: And then it counts time elapsed. If 30 seconds pass, and it doesn’t feel more movement, it’ll reset. But if the animal in there keeps moving, then they’re sure that they have a little fly or something, and digestion begins.Rosin: Right.Schlanger: And it tracks all this movement by counting how many hairs are triggered and over what amount of time. So that’s kind of math at another level that requires storage and addition in some ways.Rosin: Okay, so I’m asking you this now straightforwardly: Are plants intelligent?Schlanger: I, at this point, would say that they are, with the caveat that I came to this with a lot of skepticism of that perspective.Rosin: Mm-hmm.Schlanger: I’ve seen enough to feel like all of the hedging that people do around this is maybe a bit overblown. And the most important thing is that they’re not intelligent in the way we expect ourselves to be intelligent.We’re dealing with an alien life form in a lot of ways. You wouldn’t expect aliens to have developed intelligence through the same routes as we did. But if we can expand our brains to sort of eliminate this human, academic version of intelligence, there’s no doubt they’re making choices for themselves.And they’re doing that despite everything coming at them. They’re dealing with a very complicated, continually changing environment, and they’re spontaneously reacting to rise to the occasion.Rosin: But, okay, so what does it matter? Like, we’re having a mini debate here about intelligence and maybe consciousness and decision-making and reflex. Like, it could be just semantics, so we’re arguing over definitions, but if we decide it’s reflexive, then what? And if we decide it’s a decision, then what?Schlanger: If we decide this is all reflexive, then we all continue how the culture has always continued. That just regards plants as quasi-living, not particularly sentient, capable of interesting things, but ultimately closer to a rock an animal—closer to a rock than, like, a whale or something.Rosin: Mm-hmm.Schlanger: But if we decide that there’s some element of subjectivity in a plant, that starts to put them in a different category. I mean, it all is about how human culture responds to them.So, we draw these kind of lines in the sand between animals and plants. And then within animals, we draw lines in the sand between intelligent animals and dumb animals. And, you know, it seems like every year we start admitting new animals into this category of creatures we consider intelligent or conscious—I mean, dogs and dolphins. And, you know, it’s been only a decade or so since we’ve accepted those things as conscious.But in the last couple of years, we’re understanding that bees can, you know, have elaborate communication styles. They have this waggle dance that tells their hive mates where there’s good food sources, or they can actually detect different styles of art if they’re shown enough of the same pictures.So how much farther down that ladder do you look in a way? What’s, like, past insects?Rosin: Mm-hmm.Schlanger: What happens if we include plants in those categories? That opens up a lot of moral considerations. And then you have the potential for something like what we’ve seen with animal-rights movements.It brings up the question of what happens if we have a plant-rights movement, which is actually something that legal experts are writing and thinking about right now. It introduces this interesting idea: What do we do about the fact that we’re animals that need to eat plants? There’s just no way around that.Rosin: This seems like it really upends a lot of things that we just do routinely without thinking about it. Like, I was going to ask you: Do you still stroke your plants? I imagine you think twice about it now. That’s a small question.Then there’s the slightly bigger question of: When you put a plant in a pot in your house, is that the equivalent, or does that have some resonance with keeping an animal in a cage?And then I guess there’s the much bigger questions of, you know, broadly thinking about protecting plants on Earth.Schlanger: Yeah, it’s interesting you bring up the potted houseplant example. I have come to some amount of consternation around this because after I did a lot of research around plant communication and how plants interact with other organisms below ground, how their roots are hooked in with fungi and other microbes, and how there’s all this information being transferred below ground. And then I look over to my many houseplants sitting in their discrete pots.But I am soothed a bit because I’m looking at all these plants in my Brooklyn apartment, and they are all tropical varieties that have been raised in nurseries for probably generations.And when you raise a plant in optimal conditions for several generations, it loses its hardiness. These plants are not going to survive without us at this point, the ones in our houses.Rosin: (Laughs.) This seems like a dubious argument. This is like, this is a pet chinchilla that you bought that was raised in a, you know, from a family in a series of pet stores, and so—Schlanger: I mean, you know, it’s a bit like our dogs and cats. We’ve created these domesticated species, and now they need us. And that’s the situation.So that makes me feel better.Rosin: Okay, that’s good. I can bear it more with dogs and cats. Like, they do have a—well, dogs anyway—they do have a centuries-old mutual dependence.[Music]Rosin: Do you walk around now and see nature just vibrating? Like, how do you see the world differently than you did before you started this?Schlanger: I do walk into the park by my house very differently. I do have this new awareness that there’s all of this drama going on around me.Rosin: I feel like I’m going to have a hard time stepping on grass now.Schlanger: Yeah, they know you’re doing that, and they hate it. (Laughs.)Rosin: No, stop!Schlanger: But, I mean, caveat to the being worried about harming plants thing: We layer all of our human feelings onto this situation and all this new awareness we have about plants. The truth is plants are modular. They’re designed to lose a limb and be fine.You know, you cut grass; it grows right back. That’s not killing the organism. You can’t cut our arm off and it not have any consequences. But plants are designed to have this kind of diffuse, modular capacity to just grow a new arm.Rosin: Mm-hmm.Schlanger: But it does introduce this kind of sense of wonder, that plants are no longer a background decoration in my life. They’re no longer this kind of general wash of green. I’m really aware that there’s all these individuals. There’s all of these distinct species. There’s all of this biological creativity, all this kind of evolutionary nuance that is playing out all around me.You know, it has the effect of unseating us a little bit from this assumption that we’re sitting sort of on the top of the evolutionary heap.Rosin: Mm-hmm.Schlanger: Once you start to realize the incredible evolutionary fine-tuning that goes into plants, it kind shifts the ground beneath humanity to settle us a little more among other species, and it’s a humbling realization that I think our species could use a lot more of.[Music]Rosin: This episode was produced by Kevin Townsend and edited by Claudine Ebeid. It was engineered by Rob Smierciak and fact-checked by Ena Alvarado. Claudine Ebeid is the executive producer of Atlantic audio, and Andrea Valdez is our managing editor. I’m Hanna Rosin. Thank you for listening.

A sperm donor fathers more than 150 children. A cryobank misleads prospective parents about a donor’s stellar credentials and spotless health record. A cancer survivor’s eggs are stored in a glorified meat locker that malfunctions, ruining her chance at biological motherhood. A doctor implants a dozen embryos in a woman, inviting life-threatening complications. A clinic puts a couple’s embryos into the wrong woman—and the biological parents have no recourse.All of these things have happened in America. There’s no reason they won’t happen again.When the Alabama Supreme Court ruled in February that frozen embryos are children, effectively banning in vitro fertilization, it produced an uproar. In response, the state legislature quickly granted IVF clinics sweeping immunity, regardless of what egregious errors they may make. This is the way the debate over assisted reproduction has typically played out in the United States: A vocal minority asserts that embryos are people and calls for total bans of reproductive technology; meanwhile, the industry goes unregulated, leaving prospective parents with few safeguards and even fewer options when things go wrong. Unconsidered are all the patients who want IVF to be legal and also want it to be regulated like any other medical practice.[Read: The people rooting for the end of IVF]People across the political spectrum should be concerned about how underregulated fertility care is. The stakes are high. An estimated 9 percent of American adults have used some form of assisted reproduction by the end of their childbearing years—including in vitro fertilization, intrauterine insemination, and donor gametes. One out of every 50 babies born in the United States was conceived via IVF. Many of the hundreds of thousands of people who show up at clinics each year are desperate; the tissues that they entrust to these clinics frequently represent their only hope of biological parenthood. In a country that claims to care about families, the dearth of regulation represents a failure that cuts across party lines.Kaitlyn Abdou spent $165,000 on IVF and never had a child. Although she experienced multiple miscarriages using artificial insemination and paid for an insurance plan with full fertility benefits, her insurer denied her coverage because, as a single, queer woman, she didn’t meet Massachusetts’s definition of infertility: a man and a woman who are unable to conceive after one year of trying. Like thousands of other Americans, Abdou fell through the cracks of inconsistent state-by-state mandates. So she sold her house to pay for the treatments.At the clinic, CNY Fertility, Abdou struggled to understand her options, because there were so many different potential add-ons to her treatment, many of which seemed to be backed by shaky science. Without large-scale studies and clinical best practices to consult, Abdou felt, like many patients, that the best medical information came from anecdotes in Facebook groups. After four months of doctor-ordered human-growth-hormone injections—a common tactic to try to improve egg quality, though not FDA-approved—Abdou’s right ovary burst during an egg retrieval. Despite the pain, the clinic sent Abdou home. She woke up in agony and then headed to the emergency room, where she learned that she was bleeding internally. “If I had slept through the night,” she told me, “I probably would have bled out and died.”At times, Abdou wondered if the lab had mishandled her embryos; when several blastocysts that had been developing well were suddenly not viable, Abdou couldn’t tell if the reason was chance or poor protocols. No one warned her that she might continue to lose one pregnancy after another: Over three years, she had five miscarriages before giving up. Her care team cited the importance of “staying positive.” But with each round of treatment, the clinic made more money. Abdou received no guidance about when to stop or information about how likely she was to succeed. (CNY Fertility did not respond to a request for comment.)After hearing horror stories from patients at other clinics, about freezers malfunctioning and doctors withholding basic information on embryo quality and ultrasound results, Abdou feels like her experience could have been far worse. “I was lucky,” she said.The U.S. fertility industry is unique in its lack of rules and oversight, compared with other countries and other fields of medicine. From the field’s inception, lawmakers have declined to regulate it. In the 1980s, anti-abortion conservatives blocked initial efforts at IVF regulation because of discomfort with the creation and destruction of embryos, as well as the perceived threat to morality posed by decoupling sex and reproduction. Although Democrats led the congressional hearings fighting for oversight, liberals also feared that restricting what could be done would limit who could access it, and would end up excluding single people and same-sex couples (who are, in fact, barred from accessing IVF in many other countries, including France, Italy, and China).Dov Fox, a reproductive-law professor at the University of San Diego and the author of Birth Rights and Wrongs, told me that Congress “just threw up their hands and said, ‘We’ll let the private sector sort it out.’”American consumers were left with the barest of federal rules—one law requiring testing donor sperm and eggs for sexually transmitted diseases, another requiring clinics to report their pregnancy and birth rates—with no penalties for noncompliance. Additionally, the FDA will not approve techniques that genetically modify embryos. In this vacuum, a patchwork of state statutes and case law developed, creating “a confusing legal tangle” for patients, according to Margaret Marsh, a professor at Rutgers University and a co-author of The Pursuit of Parenthood. For the most part, the industry is self-regulated by professional bodies that have no enforcement power, besides referring reckless doctors to state medical boards.Ironically, by opting out, the federal government played an enormous role in shaping the fertility industry and causing it to diverge from other medical specialties. In 1995, two Republican members of Congress added an appropriations-bill rider that banned federal funding of embryo research—a provision that still stands. In most medical fields, government grants get new treatments off the ground, which leads to rules, best practices, and data-collection guidelines meant to serve the public interest. In assisted reproduction, this is all absent. Wanda Ronner, a professor of obstetrics and gynecology at the University of Pennsylvania School of Medicine, and the other co-author of The Pursuit of Parenthood, told me, “We don’t even have independent, peer-reviewed research funded by the NIH to say ‘What’s the most effective way to make sure the embryo is okay to transfer?’ or even ‘What temperature to freeze the embryos?’ We don’t even have a lot of information on these fertility drugs and how they impact you.”Basic facts continue to elude researchers. “We do not even know how many frozen embryos we have in this country,” Marsh told me. The last count was performed 20 years ago and found 400,000. Today, “we have no idea.” Unlike new cancer drugs and novel surgeries, which go through multiple rounds of trials before receiving FDA approval, “a lot of innovation in fertility is clinical,” Sonia Suter, a law professor at George Washington University and a co-author of Reproductive Technologies and the Law, told me. Usually performed on small samples of patients, many of these experiments “don’t even require going through the research process.” This means patients like Abdou are left with sparse information about efficacy; instead, they are often test subjects themselves.Because of the federal research-funding ban, Fox told me, “assisted reproduction grew up less as a medical practice or research than as a business activity.”[Yuval Levin and O. Carter Snead: The real lessons of the Alabama IVF ruling]Ordinary safeguards are often absent. Every area of health care has so-called never events: catastrophic failures that are never supposed to happen, such as amputating the wrong limb or forgetting a scalpel inside a patient’s abdomen. The government requires hospitals to report these incidents—but no agency tracks reproductive disasters. Whereas donor blood is usually barcoded and drug storage frequently requires fingerprints to unlock, Fox points to multiple cases of egg and sperm banks labeling tissue with pen and paper.This lack of oversight extends into almost every aspect of assisted reproduction. The U.S. has no federal limits on how many times a man can donate sperm—leading to donors with hundreds of offspring and a rise in accidental incest between donor-conceived half-siblings. No one holds cryobanks responsible for the information that they provide customers. One bank promoted its most popular donor as a genius athlete with a Ph.D. and perfect health. In reality, he was a college dropout with a rap sheet. According to Fox, who produced a podcast about the case, “They know that nothing is going to be checked and that they can make more money if they lie.”Sex selection, banned in almost every other country, is big business in the United States. Genetic tests paired with IVF enable prospective parents to identify and implant either male or female embryos. This is illegal in Canada, Australia, and every European nation besides Cyprus, except in rare cases to avoid passing on X-chromosome-linked diseases. But in 2018, an estimated 75 percent of American clinics offered sex selection for nonmedical reasons, with the majority allowing people to undergo IVF solely to pick a son or a daughter—despite a 1999 condemnation from the professional body overseeing reproductive medicine. (It has since updated its position to a neutral stance.) Jeffrey Steinberg, a pioneer of the procedure who practices in California, estimates that trait selection comprises 5 to 10 percent of the American IVF market, or up to $90 million annually.New polygenic tests—which sequence embryos’ genomes and promise parents the ability to select those at the lowest risk for obesity, bipolar disorder, and other conditions—are attacked by critics as “Eugenics 2.0” yet are completely unregulated by the FDA. Most countries ban these tests, along with their marketing claims. But in the U.S., parents can use raw genetic data to pick embryos based on whatever criteria they want. They can even go online to find dubious advice about how to choose the smartest, tallest, most attractive offspring.Steinberg defended the status quo, telling me that regulation risks “putting the handcuffs on scientists.” He added, “If there’s anything society should have learned, it’s Keep their hands off of people’s reproductive choices.” Like many other fertility specialists, Steinberg uses the rhetoric of choice, borrowed from the abortion debate, to argue for loose regulations—a tactic that might backfire and imperil IVF as abortion restrictions mount across the nation.Despite its shortcomings, the U.S. fertility industry is booming. People travel from all over the world to get care here. Some seek services that are illegal elsewhere, such as sex selection, the purchase of donor gametes, and commercial surrogacy. Others can’t get care in their home country because they are single, queer, older, or ill.When negative outcomes arise, one could argue “that’s a price we’re willing to pay for a medicine of miracles that fills empty cribs and frees families of terrible diseases,” Fox said.No matter how hard clinics try, Steinberg said, mistakes are the cost of doing business. “Embryos are treated with the utmost respect, just like humans,” he told me. “But it’s never to say that a human doesn’t get sucked out of the window of an airplane or that an embryo doesn’t get dropped on the floor. It can happen. ... Life is life. Not everything will be absolutely perfect.”Reproductive technology can bring prospective parents great hope—which makes its failures especially brutal.Georgette Fleischer believes that she was the victim of fertility fraud. Fleischer quickly conceived her first child using donor gametes, but when she came back to give her six-month-old daughter a sibling with remaining gametes, New Hope Fertility Center, in New York, couldn’t produce a single viable embryo. According to a lawsuit Fleischer filed, New Hope denied her access to her medical records multiple times; when she finally got them, she learned that previously healthy sperm were now nearly all immotile or deformed. (The clinic created the embryos anyway, without informing Fleischer.)Eventually, Fleischer found a paper in the prestigious journal Fertility and Sterility published by the chief executive of New Hope, John Zhang, that documented his trials in freeze-drying and reconstituting sperm. The dates overlapped with Fleischer’s treatment, and the consequences resembled what had happened to her sperm, leading Fleischer to believe that Zhang had experimented on her tissue without asking her.“I was the perfect guinea pig,” Fleischer told me. She believes that she was targeted because she was an older single mother, reliant on both donor eggs and sperm. But even if Fleischer can prove that she was the victim of Zhang’s experimentation, only nine states have laws against experimenting on reproductive material without a patient’s consent. New York isn’t one of them.Fleischer reported Zhang to the FDA and the New York Department of Health, but she may never know the outcome. Her lawsuit laid out 12 claims; the judge dismissed all but medical malpractice and lack of informed consent. She’s appealing, claiming that the damage extends far beyond those narrow categories. But these cases are so hard to win, Fleischer told me, that she couldn’t find a lawyer and has had to represent herself. (In court filings, New Hope Fertility Center and Zhang denied Fleischer’s allegations; neither party responded to multiple requests for comment.)Fleischer exemplifies the vulnerability and desperation that many fertility patients feel, turning to technology when they can’t conceive because of age, cancer, risk of heritable diseases, sexual orientation, or lack of a partner. Clinical failures “leave those people who were already disadvantaged doubly or triply so,” Fox said.Marsh, the historian, told me that under the current system, “infertile people are being robbed.” A lack of clear information means that patients don’t know how to get the best care, scrambling while time runs out. Ronner, at Penn, said she and Marsh believe that reactionary, piecemeal approaches will only make things worse: “We worry that without clear national policies on assisted reproduction, access to IVF and control over embryos could become as difficult in many states as access to abortion already is.” She added that although IVF is available now, “that could change in a minute.”A decade ago, the CDC created an action plan for addressing infertility as a public-health issue; Ronner and Marsh point to its suggestions as a great place to start reform. They also advocate for creating a “distinctly American” version of the United Kingdom’s Human Fertilization and Embryology Authority, an independent body that oversees both research and clinical care.[Read: The calendar of human fertility is changing]Most other industrialized nations provide, subsidize, or mandate insurance coverage of IVF, which gives them a strong incentive to regulate the industry. This could eventually happen in the U.S.; 21 states and the District of Columbia now require insurance to cover some infertility treatment. But even that assistance is uneven: Arkansas, one of the few states to explicitly mandate IVF coverage, restricts that mandate to heterosexual married couples only.Although abortion remains a controversial political issue, the response to the Alabama Supreme Court’s ruling—and the state’s swift passage of a law to protect IVF—shows broad support for family-building technology. According to a recent CBS/YouGov poll, 86 percent of Americans believe that IVF should be legal. Perhaps the uproar in response to the Alabama decision provides an opportunity to protect patients and provide guardrails around the treatments that create much-wanted children, without leaving regulation to the whims of the marketplace or reactionary rulings.America already has a model for regulation: the military. Eight military hospitals provide IVF at about a quarter of the average cost. Security protocols are strict, according to Donald Royster, a retired Air Force colonel and former head of the military IVF center at San Antonio Military Medical Center. Expensive add-ons, including preimplantation genetic testing, are far less common, keeping costs down while dodging thorny ethical questions.Patients also need specific ways to seek relief when things go wrong, according to Fox. Legislation and jurisprudence should recognize the special status of eggs, embryos, and sperm, instead of pretending that they are “lost property or killed persons or a broken contract or even medical malpractice.”Failing to acknowledge this only politicizes and imperils fertility care. Patient safety, accurate advertising, and legal accountability should not be partisan issues.

In 1939, Ernest Hemingway left a large collection of his belongings—the manuscript of his earliest short story, childhood trinkets, memorabilia from his time at war, intimate letters, books, and more—in a storeroom behind Sloppy Joe’s, a bar he frequented in Key West that was owned by some friends of his. When Penn State University’s Toby and Betty Bruce Collection of Ernest Hemingway acquired the items in 2021, it represented the most significant trove of Hemingway memorabilia discovered in generations. But not everything went to Penn State. Some materials found at Sloppy Joe’s instead entered the rare-book marketplace, including 40 books from Hemingway’s personal collection. I know this because I have them.As modernist rare-book collectors, my father and I decided to add these works to our collection when we came across the listing. They include Henry Wadsworth Longfellow’s The Song of Hiawatha, inscribed to Hemingway by his “loving mother” (with whom he had a contentious relationship, according to his letters, and whom he blamed for his father’s suicide); his high-school debate textbook, ornamented with doodles of a tree and a snake; and a war novel holding a pencil-written note to himself—a reminder to compose a story about the “death of Lieut. Taylor with flu in Milan.” These books stretch from Hemingway’s youngest years to 1939, when he turned 40; they not only illuminate Hemingway’s reading habits, but they also date particular books he owned to certain periods of his life.As I fell down a rabbit hole investigating whether Hemingway ultimately wrote a story about a Lieut. Taylor (a mystery I’m still trying to solve), I wondered about which other literary pearls are housed in private collections.Just because a book is a first edition does not always mean it is “rare”—the same goes for the old book on your shelf that was published back in 1857. A book’s demand, condition, publishing history, whether it is signed or inscribed, and even the timing of when a book enters the market are all factors that affect its value. A dust jacket–less first edition of The Great Gatsby is not as rare as a copy wearing the famous dust jacket. The former commands, on average, $4,500 to $8,000 (mostly depending on its condition), while a copy with an unrestored dust jacket is likely to command at least $100,000. Even rarer is an inscribed copy—the most recent of which sold in September for £226,800 at Christie’s, or about $283,000. (This same copy had sold at Bonhams for $191,000 in 2015, demonstrating how its value skyrocketed in less than a decade.) I turn to The Great Gatsby not only because it’s arguably the most famous rare book in terms of 20th-century first editions, but also to illustrate that its value has the capacity to vary, and that a truly one-of-a-kind book involves more than merely being a first edition with a dust jacket. The copy that sold at Christie’s belonged to Charlie Watts, the Rolling Stones drummer, whose fame potentially played into the book’s value. But that value comes primarily from the quality and nature of Fitzgerald’s inscription, which was presented to a friend, Harold Goldman, whom Fitzgerald refers to as “the original ‘Gatsby’” in his note. The cover of a debate book on which Hemingway drew a tree and a snake (Courtesy of the author) [Read: A new way to read Gatsby]In addition to being a collector and an obsessive reader, I’m also an academic—meaning I understand acutely how crucial it is for people to be able to explore literary history through primary documents, and how even the smallest marginalia may carry immense meaning. Does the copy of The Great Gatsby signed to Goldman belong in an institution, such as the New York Public Library or a university’s special collections, where the public can see and access it, whether it be for the pleasure of viewership or for scholarship? (Conversations on the ethics of private ownership permeate the fine-art world too, wherein wealthy individuals—such as Madonna and Jay-Z—own Basquiats, Warhols, and Picassos.) Rare-book dealers will tell you that private collections involve less red tape than institutions—bureaucratic hurdles to access that aren’t in the public interest. For example, in libraries, uncataloged books can lie untouched for months, or even longer, because of a librarian’s other responsibilities or a lack of resources and time. For these reasons, donations or newly purchased books may not be as readily available as one may think. At the same time, Rebecca Romney, a co-founder of the rare-book firm Type Punch Matrix and the rare-books consultant for the TV show Pawn Stars, told me that “it’s not uncommon for collectors to have open invitations for scholars to come to their collection. It’s more the rule than the exception. This is the whole point”—collectors want to share their collections.The dilemma regarding the ethical placement of a rare book isn’t convoluted for Tom Lecky, who was the head of the rare-books and manuscripts department at the auction firm Christie’s for 17 years and now runs Riverrun Books & Manuscripts. When I mentioned the Hemingway manuscript of “The Short Happy Life of Francis Macomber” that sold for $248,000 at Christie’s back in 2000, he pointed out that institutions had had “every bit the opportunity to buy it as a private individual.” Other singular works that have been up for auction are James Joyce’s “Circe” manuscript, Sylvia Plath’s personally annotated Bible, a serial printing of Uncle Tom’s Cabin in the National Era newspaper, and the proofs of that first Great Gatsby dust jacket. In each case, I was captivated by their fate. The National Library of Ireland bought Joyce’s manuscript for $1.5 million and digitized it; Plath’s Bible went to an undisclosed buyer for about $11,000; so did the newspapers, for $126,000. Nobody placed a winning bid for the Gatsby cover art.For Lecky, the ethical question we should be asking isn’t whether institutions should acquire rare books instead of collectors, but what happens when “a private owner owns something that no one knows that they have.” Lecky, like many others in the trade, works to dispel myths about how private collections work. Private collections tend to be temporary and books often jump between hands, but for the time that a collector owns a book, in my view, they should make efforts to share it. “Most collectors don’t think of it as possession but caretaking,” Lecky said. “They’re a piece of the chain in the provenance, not the end of it.”Historically, private collectors have formed the foundations of institutions. “There are entire libraries and museums that were created by collectors,” Barbara Heritage, the director of collections, exhibitions, and scholarly initiatives at the University of Virginia’s Rare Book School, told me—the Morgan Library & Museum; the Getty Research Institute; the Folger Shakespeare Library; and the Huntington Library, Art Museum, and Botanical Gardens, to name a few.Many rare books, manuscripts, and items in the collections at these institutions are donated by or purchased from private collectors. In other cases, a donor supplies the funds for an institution to make general or specific acquisitions. If you’ve visited the permanent “Polonsky Exhibition of the New York Public Library’s Treasures,” you might have seen one-of-a-kind items on rotation, such as an early manuscript draft of Oscar Wilde’s The Importance of Being Earnest, a lock of Mary Shelley’s hair, and a page from the manuscript of an unpublished chapter of The Autobiography of Malcolm X. These pieces were “acquired through the generosity of” a donor or were donated by a collector.Collectors tend to donate or sell their collections to institutions if they don’t put them back into the marketplace via auction houses or rare-book sellers. “Collecting isn’t mere shopping,” Heritage said. “The best collecting requires vision, passion, knowledge, and creativity—and, above all, persistence.” Collecting, for Heritage, has the capacity to be a form of advocacy through the creation of knowledge and the ability to tie together strands of knowledge that otherwise couldn’t be done unless one has a lifelong devotion to a particular subject. Some collectors have honed niche collections that have since been deposited in libraries (either wholly or partially). Walter O. Evans collected Black artwork and literature that now constitute mainstay collections—such as the Walter O. Evans Collection of Frederick Douglass and Douglass Family Papers and the Walter O. Evans collection of James Baldwin—at Yale’s Beinecke Rare Book & Manuscript Library. The Douglass papers in Evans’s collection have been digitized so that scholars, students, and the public can access them.[Read: The way we write history has changed]Or consider the archives created from the collections of Lisa Unger Baskin, who sold her trove of women-related ephemera—including thousands of books dating from 1240 to the late 20th century—to Duke University. Unger Baskin’s political activism is reflected in her collection of materials created by women. She told me how, for example, she priced herself out of the market because she participated in the creation of a market that values women’s work. With a sharp eye, she bought many materials that others didn’t pay attention to, such as Charlotte Brontë’s needlework, which she scooped up in London for £60. Before selling to Duke, Unger Baskin considered four other universities. Their financial offers were obviously salient, but she liked that Duke promised to make her assemblage a teaching collection, so she accepted its proposal and sold everything to the school, including a desk that was designed and used by Virginia Woolf. Because Unger Baskin continues to collect, she has a contract with Duke stipulating that the rest of her collection will also go there.Sammy Jay, a senior literature specialist at Peter Harrington Rare Books, told me that collectors are “scholars in a hybrid sense.” For Stuart A. Rose—the namesake of the Stuart A. Rose Manuscript, Archives, and Rare Book Library at Emory University—amassing materials is synonymous with sharing them with the public. He chose to donate much of his collection to his alma mater rather than put it back into the marketplace. (Like Unger Baskin, he’s still collecting. Unlike her, he has yet to make up his mind about what he’ll do with the materials he continues to acquire.) Today, he opens his home to classes at Ohio State University and says he has never turned down a scholar who wants to reference a book in his collection, which includes a copy of The Great Gatsby inscribed by Fitzgerald, one of the first 100 copies of Ulysses signed by Joyce, and what he claims is the most extensive private collection of Jane Austen’s corpus.Though all private collections are at risk of theft, flooding, and fire, collectors argue that these threats are no different from those that institutions face. Private collections tend to have less traffic and less handling, and this limited exposure can help with preservation. Yet preservation may be vulnerable when selling publicly. As Lecky pointed out, “A collection can be formed over 50 years and then suddenly it goes to auction and there are five days of auction exhibit, and in those five days, those books are handled more than they’ve been in the last 50 years.” When rare books are in institutions, Rose believes they should be on view, so that the public can see “what makes a book great.”Rose’s exhibition will be the first on view at one of the two new exhibition halls at the Folger Shakespeare Library, in Washington, D.C., set to be unveiled in June. Other private collectors have taken a less traditional approach to presenting their collections. The artistic director Kim Jones made Woolf’s Orlando a central theme in Fendi’s spring/summer women’s collection in 2021, and used Jack Kerouac’s On the Road as the basis for Dior’s men’s fall 2022 fashion show. Both fashion shows were complemented by exhibits featuring the books that were cornerstones of the collections.If one believes that literary relics should be held only in public environments, then trying to define the ideal private collector is a contradiction in terms. But in practice, access can be complicated. Consider again the inscribed copy of The Great Gatsby, signed by Fitzgerald to his “original Gatsby.” As part of the auction, Christie’s included pictures of the book and its inscription in the listing, along with a detailed description. Though private collecting may rob someone of an unmediated experience with that book, the sale leaves a trail of photos, making it arguably more accessible than it would be in either a private or public collection. Perhaps book enthusiasts should focus less on ownership and more on establishing a broad cultural responsibility to share unique books and manuscripts, be it in the form of a public exhibition, digitization, or appointment-only home visits.At the same time, the rare-books market is evolving as the medium itself changes, which is seen in the popularity of audiobooks and ebooks. Have we, or are we about to, hit a civilizational point in which all writers from today onward will not compose handwritten manuscripts and letters? Will the only manuscripts and letters that circulate the marketplace be pre-2020? Are visible drafts—which allow us to trace an author’s structuring and even restructuring of a novel—a thing of the past, as the errors in our online documents are constantly replaced by spell-check and are saved over and over again, erasing the history of a truly original document? One can project that the marketplace will begin to include technological objects, which will come at exorbitant costs. If bundles of Joan Didion’s empty notebooks sold for $11,000 apiece and her Celine faux-tortoiseshell sunglasses were purchased for $27,000 in 2022, what price tag will be put on an author’s cellphone or laptop, if they choose to sell them? Salman Rushdie, for example, sold his personal archive to Emory, including a Mac desktop, three Mac laptops, and an external hard drive.The ceaseless evolution of technology, the proliferation of cheaply produced paperbacks, and a change in what we consider to be literary objects will undoubtedly affect the future of the trade and the contents of our archives. Will time reveal a pushback in adopting technology in the writing process, or will note-taking software, email, and SMS expand our understanding and the breadth of a personal archive? Lately I have been thinking about how and when I will have to rehome my own collection of rare books and how I see my career unfolding in the rare-book world. As I contemplate these questions, I know that my guiding principle will be accessibility. And in the meantime, I plan to accept an invitation to bring my Hemingways to Penn State University to be digitized.

Anne Hathaway as Solène and Nicholas Galitzine as Hayes in The Idea of You. | Courtesy of Prime From The Idea of You to viral essays, the discourse is rarely about the people inside the relationships. There’s something about age gaps right now. They’re all over the place. The Idea of You, out on Amazon Prime this week, features Anne Hathaway as a 39-year-old mom falling in love with a 24-year-old boy band star, only to be haunted by tabloid covers calling her a cougar. It’s based on a novel of the same title by Robinne Lee, dubbed by Vogue “the sleeper hit of the pandemic.” Meanwhile, over the past few months, the Cut has twice gone viral with articles about age gaps. In December, it published a reported article by Lila Shapiro interviewing multiple couples with significant age gaps. In March came a personal essay by Grazie Sophia Christie about her relationship with her husband, who’s 10 years older. On social media, Shapiro’s report was largely met with fascination and Christie’s with recriminations; both were widely distributed and discussed. In her new memoir Consent, writer Jill Ciment revisits her celebrated memoir of 20 years ago, Half a Life, about her marriage to the man she met when she was 17 and he was her 47-year-old art professor. “Should I refer to him in the language of today — sexual offender, transgressor, abuser of power?” Ciment asks, referring to her late husband, as she describes their first kiss. “Or do I refer to him in the language of 1970, at the apex of the sexual revolution, when the kiss took place — Casanova, silver fox?” The ways we talk about age-gap relationships have changed so completely so fast. They’ve come to be a stand-in for the way the Me Too movement changed our whole erotic vocabulary: Before, titillating; after, abusive. When Taylor Swift first releases “All Too Well” in 2012, it’s received as a tragic breakup song about Swift’s relationship with Jake Gyllenhaal, who she dated when she was 20 and he was 29. When she rereleases it in 2021, it’s received as an account of predatory behavior. Age-gap relationships in the abstract have become a place of talking through our newly heightened societal awareness of power dynamics and the potential therein for abuse — especially when the standard gender roles flip. Frequently, the discourse has almost nothing to do with the people actually in the relationships in question. Historically, men were expected to be older than their wives. The reasons why are as gross as you think. “Haven’t you ever heard that the girl is supposed to be half the man’s age, plus seven?” asks Patty O’Neill in the 1951 play turned 1953 film The Moon Is Blue. Patty, 22, is wooing a 30-year-old man at the time, and she is delighted to find that the math “just works out.” Today, the rule “half your age plus seven years” is popularly held to tell you the youngest possible person you can date without being creepy. A 30-year-old, the idea is, can just about get away with dating a 22-year-old of any gender, but get down to 21 and things start to feel weird. Historically, however, the equation was supposed to dictate the ideal age gap between a man and a woman. It seems to have been fairly common around the midcentury. In 2014, the New Republic found the idea turning up in sources as disparate as The Moon Is Blue (1951) and quotes from Elijah Muhammad in The Autobiography of Malcolm X (1965). American newspapers of the 1930s ascribed the rule to Maurice Chevalier, or, more vaguely, to the French. The ideology that considers this age-gap ideal is profoundly misogynistic. Part of the reason the husband is supposed to be the older figure (twice his wife’s age minus seven years) is to increase his status. Wiser than his wife, the husband could have his own established source of income and his own established adult life before he entered into marriage. The wife would rely on her husband for all of the above. In exchange, the wife would grant her husband her youthful beauty, and the common wisdom held that this exchange was equal. The tricky thing, though, was that the wife’s youth is by its nature fleeting, while the husband’s wealth would with any luck only increase with time. The wife had a ticking clock placed on her social value, and it was up to her to make a good marriage before the clock struck midnight and her social value disappeared. This is a worldview in which a woman’s access to adulthood depends upon her erotic value. Her beauty is all she has to trade to the world in order to be granted the status of full personhood — and even that personhood is contingent, because the wife can only ever access it through her husband. In Christie’s Cut essay, she positions her own marriage as being part of this very legacy. Christie consciously set out to choose an older husband, she writes, because she wanted to benefit from the financial security of an older and wealthier partner, and she thought her best bet was to use the currency of her youth and beauty before they became devalued by age. “I had, like all women, a calculator in my head,” she writes. “I thought it silly to ignore its answers when they pointed to an unfairness for which we [Christie and her fellow female classmates at Harvard] really ought to have been preparing.” The asymmetry in power between Christie and her husband, she writes, benefits her so much that she feels no real need to right it. “Who is in charge, the man who drives or the woman who put him there so she could enjoy herself?” she asks rhetorically. “I sit in the car, in the painting it would have taken me a corporate job and 20 years to paint alone, and my concern over who has the upper hand becomes as distant as the horizon, the one he and I made so wide for me.” It’s only fair to take Christie at her word that she’s happy in her marriage. Yet the exchange she describes sits oddly in the modern era, particularly in the post-Me Too era’s heightened awareness of sexual power dynamics. You run across the same dilemma in all the age-gap think pieces. “It’s perfectly possible for two consenting adults to have a healthy and equitable relationship despite a significant age gap,” mused a Guardian article from 2020 on Leonardo DiCaprio’s habit of dating only 25-year-olds. However, the article continued, “​It feels like a major flag if a man consistently dates women half his age. One suspects that person isn’t actually looking for a partner, but an admirer.” In her Cut article, Shapiro outlines the basic problem. The anti-age-gap discourse, she writes, emerged from the Me Too movement’s “concern with power differentials and with coercion and consent.” On the other hand: “It also sits at odds with Me Too’s core ethos — ‘Believe women’ — by raising an outcry on behalf of women who, by all available public accounts, have no complaints about their relationships. Even if they say they are happy, the age-gap critics don’t believe them.” In the wake of the new discourse, even the people involved in the relationships can’t always believe themselves or the things they say. Much of the tension of Consent comes from Ciment’s anguished and untrusting analysis of her old memoir, the one where she told the story of her marriage as a straight love story. In her first memoir, 1996’s Half a Life, Ciment consistently describes herself as the sexual aggressor in her early encounters with her future husband, Arnold. Yet looking back over the manuscript 25 years later in Consent, she feels her old account cannot be trusted. “Am I as delusional as Humbert Humbert when he narrates (Lolita is twelve at the time), ‘It was she who seduced me’?” Ciment writes. “When I wrote this, was I protecting Arnold? The statute of limitations had long ago passed. Was I protecting my marriage? We had just celebrated our twenty-seventh anniversary.” Ciment and Arnold were married until Arnold’s death in 2016, and according to Ciment, their marriage was a happy one. Still, she keeps interrogating herself. “Had Arnold experienced the sea change of the MeToo era, would he have come to believe that he crossed a line when he first kissed me?” she writes. “Does a story’s ending excuse its beginning? … Can a love that starts with such an asymmetrical balance of power ever right itself?” Things get even more complicated when we reverse the gender roles. Is there a gender swap exception? Discussions about age-gap relationships in which the woman is older than the man tend, on average, to be less about whether or not the woman is a predator and more about whether or not she should be humiliated for dating a younger man. Her detractors might dismiss her as a desperate cougar; her supporters might frame her dating decisions as a feminist triumph. That’s the tension at the heart of The Idea of You, both the Hathaway film and the novel it’s based on by Robinne Lee. The story centers around Solène, a 39-year-old whose ex-husband is dating a younger woman. Solène grits her teeth at his choices, but she’s not surprised by them: “Because that’s what divorced men in their forties did,” she narrates. “His stock was still rising. His power still intact. Daniel had become more desirable, and I somehow less so. As if time were paced differently for each of us.” Shortly thereafter, Solène finds herself entangled in a love affair with the much younger Hayes Campbell, lead singer of her daughter’s favorite boy band. In the book, Hayes is 20. In the movie, he’s 24. Either way, he’s a lot younger than Solène. When she suggests that the age gap might become a problem, however, Hayes scoffs. “If our ages were reversed, no one would bat an eyelash. Am I right?” says Hayes in Lee’s novel. “So now it’s just some sexist, patriarchal crap, and you don’t strike me as the kind of woman who’s going to let that dictate her happiness. All right? Next issue.” Part of the fantasy of The Idea of You is the idea of a woman whose social currency increases as she ages in the same way that her husband’s does. Solène’s beauty and sophistication are so potent that she does not need to be young to be a catch. Her social value is confirmed by her attractiveness to a man who is not only youthful and beautiful himself but also bears the traditional markers of male power: Young Hayes is richer than Solène’s middle-aged ex-husband will ever be, so that he can fulfill both sides of the old age-gap bargain at once. The fantasy here is not a world in which women’s social power doesn’t depend on their sexual currency. The fantasy here is that a woman’s sexual currency might not depreciate over the course of her 30s — particularly if the woman in question is played by Anne Hathaway, long celebrated for her eternal youthfulness. The result is a sort of mirrorverse version of Christie’s worldview: These are the rules, so let’s maximize our power within them. For some readers, this fantasy is intensely potent and affirming. “It teaches that women remain desirable, strong, and sexually viable as they age: there is no end date,” wrote one reader on Goodreads. “It calls out gender-based double standards. It empowers women to block out all the patriarchal noise and build the life they want. When we change our thoughts, we change our world. This. This is what I needed.” For other readers, the fact of Solène’s gender doesn’t change what they see as the fundamental problem with an age-gap romance: the age part. “idk who lied to this woman,” wrote another Goodreads reviewer, “but f*cking some kid 20 years younger than you is not the feminist slay you think it is.” What happens in the end? There is a question neither The Idea of You nor Christie engages with, which is: What happens as time and age come for all of us? The problem of aging rarely appears in the stories about age-gap relationships, but it is central to the people living in those relationships. “It’s only when the two people actually love each other and want to build a life together that the age gap, as an age gap, not as a gap that stands in for various inequities, actually matters,” says the writer B.D. McClay in an essay on Substack responding to Shapiro’s Cut piece. “If you want to get married and have kids, then you have to deal with what I think of as the sad math: how long the older partner is likely to see your mutual children get to become. Any parent can die, but what makes this different is that the absolute best case scenario might involve, for some, not seeing your kids ever graduate from college.” The problem of aging fills the final pages of Consent, which sees Ciment caring for Arnold toward the end of his life. These scenes are not, she feels, literary. “Who would believe a scene in which Lolita takes Humbert Humbert for cataract surgery?” she writes. “Or worries about his prostate? How would I compose the scene where Lolita arranges hospice care for the man who supposedly stole her childhood? Wouldn’t I have to include the day Lolita is at Humbert Humbert’s bedside when he dies? Isn’t that what happily ever after means? A love that lasts long enough that one lover is there to close the other lover’s eyelids?” Ciment is able to come to a resolution of sorts on her questions in her description of the day of Arnold’s death. She sees him lying in their bed, in “the same position he was in when I went to seduce him forty-five years before,” she writes. As she goes to kiss him, she knows that for all her fretful wondering about their first kiss and what it signifies, “there could be none about our last.” Their final kiss is for the pair of them alone, as individuals and as a couple, and what it signifies is them and their long marriage. It is separate from the asymmetry of power from which they began. The fantasy of The Idea of You, however, cannot quite stand up to such realism. It cringes away from the idea of a Solène who might be past middle age and into old age, who might require caregiving or who might even look significantly older than her boyfriend when they’re lounging by a European poolside together. In Lee’s novel, Hayes and Solène split up at the end of the book and don’t reunite, with Solène explaining that the public scrutiny of their relationship is too difficult for her 12-year-old daughter. The film mostly preserves this ending while tacking on a brief epilogue that suggests Hayes and Solène might reunite after her daughter is off at college. In either case, the relationship presented to the audience is preserved in amber, crystallized at the moment in which the age gap is sexy and not potentially tragic. That age-gap fiction and discourse tends to avoid those tragedies is one of the tells that that age-gap discourse is never about individual people, or even individual couples. It is about the whole history of misogynistic ideology from which our age-gap expectations emerge, and how drastically the way we think about sex and power changed in the space of a few years. The age-gap discourse is a metaphor for the way Me Too changed the world — even if the people in age-gap relationships would rather that it weren’t.

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