I'm Allergic to Your Nuts
But I Accomplished So Much Last Week
By now we’ve all heard that Elon Musk demanded everyone on the federal payroll justify their existence in the form of five(ish) bullet points explaining what they accomplished last week or else. The demand came in an email while the threat of termination came via state-sponsored social media. According to Musk—who the Trump administration itself says has no real federal authority—a lack of response by 11:59 pm Monday was tantamount to a letter of resignation. Employees were told that they should cc their supervisors on their email and were reminded not to include any classified information.
As reported by the F**king News (a favorite Substack of mine) while some federal workers scrambled to explain what they did last week, others were told by their boss or their boss’s boss’s boss not to reply. The State Department, the Pentagon, and the FBI all told their employees to ignore the directive with each department essentially saying, “we review our own.”
My favorite, though, was the apparent advice from management at the Secret Service which suggested replies such as “I did 100% of tasks and duties required of me by my position description,” and “I submitted 100% of work product that my manger and I have agreed on.” The suggested last bullet read, “I exceeded expectations in the delivery of all of the above.” We always knew those guys were snarky AF.
Trump is surprisingly not ready to throw Elon under the bus. (I really thought it would happen as soon as the Time Magazine cover with Musk behind the resolute desk was published.) Instead, he said that the five-bullet plan was “ingenious” and denied any pushback. It was just Kash being worried about classified materials getting out. Silly Kash, that only happens at Mar-a-Lago.
No one asked for my five accomplishments last week, but here they are anyhow:
I updated a chart on birth control and questioned why we still include diaphragms and cervical caps.
I didn’t fight with anti-vaxxers on social media, even though they were wrong.
I wrote a new page on the difference between sex and gender for a client’s website. I think it’s clear and informative, and I admit that writing it now felt a little subversive (in a good way).
I figured out how to get my washing machine fixed using the protection plan, which meant I had to remember where I’d bought the damn thing.
I signed a new contract for a project combatting misinformation.
I walked into the laundry room and remembered exactly why I was there (twice!).
That was more bullets than Elon asked for, but for once I’m wondering if he’s onto something. I start most weeks lamenting what I didn’t do the week before, but thanks to the Monday accomplishment deadline, I started this week feeling just a little proud.
Don’t worry, I’m not going over to the ketamine-fueled dark side. In fact, another one of my accomplishments last week was giving the finger to a Tesla dealership from across a crowded highway.
The Trump Administration Pretends to Defend Women and Children
Last week womenshealth.gov, a website run by the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services, added a new page titled “Protecting Women and Children.” The page boasts about how the administration is “defending women” from a world in which biological sex is not firmly rooted in sperm and eggs and protecting children from “chemical and surgical mutilation.”
An expanded definition of biological sex takes center stage on the page. Click the link and you’ll learn that there are only two sexes because there are only two gametes. Someone in the administration must have read the criticism of their original definition because this one gets a wee bit defensive, “Rare disorders of sexual development do not constitute a third sex because these disorders do not lead to the production of a third gamete. That is, the reproductive system of a person with such a disorder does not produce gametes other than eggs or sperm.”
No one said it did, a**holes. What we said was that the existence of people who do not fit your definition because they do not belong entirely to either “the sex characterized by a reproductive system with the biological function of producing eggs (ova)” or “the sex characterized by a reproductive system with the biological function of producing sperm” proves that your definition is dumb. (The fact that no medical organization or textbook published after 1483 uses a similar definition should also be a clue about its inanity.)
The new webpage dedicates quite a bit of real estate to the most pressing problem of our generation: “keeping men out of women’s sports.” The centerpiece of this argument is a video of Riley Page, a swimmer and conservative political activist who commands $10-20,000 per speaking engagement to spew anti-trans rhetoric. I only made it through the first 39 seconds of this piece of bulls**t propaganda but essentially, she genuflects before President Trump thanking him for sending a clear message to girls and women “that we matter” by recognizing the differences between biological sexes.
Oh Riley, we do not matter.
If we mattered, the administration would not have closed the Pregnancy Risk Assessment Monitoring System (PRAMS), a federal data collection system that was meant to measure progress toward the goals of improving the health of mothers and infants. The system was created in 1988 and has run continuously (through multiple Democratic and Republican administrations). It collects information on pregnancy outcomes for women, newborn health, and issues like postpartum depression. But, hey, why would we want to know how women are doing now. (Not great, Riley. We’re not doing great.)
If we mattered, Texas lawmakers would be horrified to learn that sepsis among pregnant women is climbing in their state as a result of their draconian abortion law. Pro-publica first brought sepsis to our attention when they told the stories of Josie Barnica and Neveah Crain who were forced to wait hours (or days) to receive treatment for miscarriage and infection because their fetuses continued to have “heartbeats.” (It’s not a heartbeat, but I’m too tired to fight that battle today.) Both women wanted to be pregnant and have the baby. Both women died.
Sepsis occurs when your body overreacts to an infection and your immune system starts to attack healthy tissue. It is a medical emergency. Without urgent treatment, sepsis can lead to organ failure, brain damage, and death. But the Texas abortion law frowns on any treatment—urgent or not—that looks like an abortion. While there is a medical emergency clause in the Texas law, there is no agreement on when it kicks in.
When a patient is miscarrying in the second trimester, the standard of care is to empty the uterus as soon as possible to prevent the risk of infection which could lead to sepsis. This risk of both is even greater if the woman’s cervix has opened or her water has broken. Some doctors in Texas, however, report that their hospitals don’t allow them to offer this standard care until the fetal heartbeat stops or they can document that the woman is in imminent danger of dying.
ProPublica further investigated sepsis deaths among pregnant women in Texas by analyzing hospital discharge data from 2017 to 2024. Working with maternal health experts, researchers identified all hospitalizations that included miscarriages, terminations, and births from the beginning of the second trimester up to 22 weeks’ gestation. First trimester miscarriages were not included because these rarely require hospitalization, and pregnancy complications after fetal viability were not included because they bring up another set of options/issues.
In 2021 (when the law merely threatened doctors with civil liability), 67 patients who lost a pregnancy in the second trimester were diagnosed with sepsis. In 2022 (after Dobbs, when the current law threatening them with prison went into effect), that number jumped to 90. In 2023 it climbed to 99.
Further analysis found that the greatest jump in mortality was among women whose fetus still had a “heartbeat” when they were hospitalized. Dr. Kristina Adams Waldorf, professor of obstetrics and gynecology at University of Washington Medicine and an expert in pregnancy complications, told ProPublica, “What this says to me is that once a fetal death is diagnosed, doctors can appropriately take care of someone to prevent sepsis, but if the fetus still has a heartbeat, then they aren’t able to act and the risk for maternal sepsis goes way up.”
In total 120 pregnant women in Texas died in 2022 and 2023 which is up from 79 in 2018 and 2019. The state’s Maternal Mortality Review Committee is so upset about this that it’s going to… do absolutely nothing. In fact, the chair of the committee announced that it’s not going to review data from those two years at all. The committee is fast-forwarding to 2024. Lest you get suspicious, the chairwoman promises there is “absolutely no nefarious intent” behind this decision. I mean maybe there’s nothing more nefarious going on here than apathy, but apathy is pretty bad in the face of that many dead pregnant women.
It's unclear if it’s apathy or antipathy (for the needy) that made Trump take aim at USAID, but the results show that women outside of the U.S. really don’t matter. Guttmacher did that math and found that if the freeze lasts 90 days, 11.7 million women and girls will be denied access to contraceptive care. If 11.7 million women go without contraception, we can expect 4.2 million unintended pregnancies. If 4.2 million women have unexpected pregnancies, we can expect 8,340 deaths from complications during pregnancy and childbirth. (It’s like a grim version of If You Give a Mouse a Cookie.)
Of course, it’s not just women that don’t matter, Riley. No one really cares about the babies either. Additional research out this week found a 5.6% relative increase in infant mortality between 2021 and 2022 in those states with abortion bans or restrictions. Specifically, infant mortality rates were 6.26 per 1,000 live births, compared with an expected rate of 5.93 per 1,000. That means that there were 438 infant deaths that would not have happened had the Supreme Court not overturned Roe or state legislatures not tried to punish pregnant women for daring to have sex (with men).
The data also shows a relative increase of 10.87% in infant deaths from congenital anomalies during that time. Researchers say this can be directly tied to abortion restrictions because women with non-viable pregnancies were forced to carry to term anyhow. What’s less straightforward is why deaths went up among infants without congenital anomalies. Researchers suggest that delays in receiving timely medical care among already disadvantaged populations may be the issue. This is supported by additional data that shows that Black infants had an even higher rate of death (11.81 per 1,000 live births). We know from research and anecdotal information that OB/GYNS are fleeing states with strict abortion laws and hospitals have been forced to shut down their maternity departments. Turns one needs doctors and hospitals to ensure healthy babies.
But, hey, if you happen to be lucky enough to have an infant who survives being born in a conservative state, you can be sure that the Trump administration won’t make them suffer the indignity of being on a sports team with someone who produces different gametes.
I’m Allergic to Your Nuts
A woman from the UK is allergic to nuts. Brazil nuts specifically. But also her boyfriend’s nuts after he’s eaten Brazil nuts.
The unique case began after the women, who was in her 20s at the time, and her boyfriend had sex. Her vulva and vagina started to swell and itch. She developed additional swelling elsewhere under her skin. Hives appeared all over her body. And she began to feel faint and short of breath. She wisely went to the hospital where they gave her an antihistamine, and her symptoms faded pretty quickly.
The source of the allergic reaction wasn’t entirely a mystery. The woman knew she had a severe allergy to Brazil nuts. She also knew that her boyfriend had eaten Brazil nuts earlier in the day. To prevent just this kind of thing from happening, the boyfriend had taken a bath, scrubbed under his fingernails, and brushed his teeth before sex.
Doctors were, therefore, curious about what set off the allergic reaction (the obvious—he missed a spot of nutdust on his left index finger—apparently didn’t satisfy said curiosity). So they conducted some further testing which both the woman and her boyfriend agreed to. Using a sample of his semen and a pin, they gave the classic skin prick test a whole new meaning. The woman’s skin did not react to semen taken from him on a nut-free day. (Can a day when you give a semen sample really be considered nut free?) The sample taken 2.5 hours after he’d had a handful of the offending tree nuts, on the other hand, caused a quarter-inch welt to appear.
The doctors were satisfied that they had their answer: the allergen was transmitted by semen. They suggested she not have sex with him when he’d recently eaten Brazil nuts and that she keep both an antihistamine and an epipen on hand.
Simple enough, but I have some more questions.
If you knew that your girlfriend’s allergy to Brazil nuts was so severe that you’d need to scrub under your fingernails before you could touch her, why would you have Brazil nuts in the house let alone actually eat one? Half the people in my house can’t eat gluten. They can touch it, they can inhale it, they just can’t eat it and still we don’t keep gluten in the house. Do you really like Brazil nuts so much that you have to have easy access to them even though it might kill your partner? I mean, he was a supportive enough boyfriend to jerk off into a cup multiple times for science. He couldn’t just give up the nuts?
I read about this case in a January article in Live Science. When I clicked on the link to the original article, I realized this all went down circa 2007. Almost twenty years ago. Now I have more questions. Did they stay together? Are they married with a house full of kids? Are the kids allergic to Brazil nuts? Was the thought of little Billy dying from anaphylactic shock enough for him to switch to peanuts? Or did his love of nuts win out in the end driving him to dump the girl and seek a life partner with no food allergies? Did that partner later get diagnosed with an allergy to sesame, forcing him to give up his favorite carry out Chinese Food and falafel? Did he leave her?
We will never know.