The Paradox at the Heart of Elon Musk’s OpenAI Lawsuit

The Paradox at the Heart of Elon Musk’s OpenAI Lawsuit

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It would be easy to dismiss Elon Musk’s lawsuit against OpenAI as a case of sour grapes.

Mr. Musk sued OpenAI this week, accusing the company of breaching the terms of its founding agreement and violating its founding principles. In his telling, OpenAI was established as a nonprofit that would build powerful A.I. systems for the good of humanity and give its research away freely to the public. But Mr. Musk argues that OpenAI broke that promise by starting a for-profit subsidiary that took on billions of dollars in investments from Microsoft.

An OpenAI spokeswoman declined to comment on the suit. In a memo sent to employees on Friday, Jason Kwon, the company’s chief strategy officer, denied Mr. Musk’s claims and said, “We believe the claims in this suit may stem from Elon’s regrets about not being involved with the company today,” according to a copy of the memo I viewed.

On one level, the lawsuit reeks of personal beef. Mr. Musk, who founded OpenAI in 2015 along with a group of other tech heavyweights and provided much of its initial funding but left in 2018 over disputes with leadership, resents being sidelined in the conversations about A.I. His own A.I. projects haven’t gotten nearly as much traction as ChatGPT, OpenAI’s flagship chatbot. And Mr. Musk’s falling out with Sam Altman, OpenAI’s chief executive, has been well documented.

But amid all of the animus, there’s a point that is worth drawing out, because it illustrates a paradox that is at the heart of much of today’s A.I. conversation — and a place where OpenAI really has been talking out of both sides of its mouth, insisting both that its A.I. systems are incredibly powerful and that they are nowhere near matching human intelligence.

The claim centers on a term known as A.G.I., or “artificial general intelligence.” Defining what constitutes A.G.I. is notoriously tricky, although most people would agree that it means an A.I. system that can do most or all things that the human brain can do. Mr. Altman has defined A.G.I. as “the equivalent of a median human that you could hire as a co-worker,” while OpenAI itself defines A.G.I. as “a highly autonomous system that outperforms humans at most economically valuable work.”

Most leaders of A.I. companies claim that not only is A.G.I. possible to build, but also that it is imminent. Demis Hassabis, the chief executive of Google DeepMind, told me in a recent podcast interview that he thought A.G.I. could arrive as soon as 2030. Mr. Altman has said that A.G.I. may be only four or five years away.

Building A.G.I. is OpenAI’s explicit goal, and it has lots of reasons to want to get there before anyone else. A true A.G.I. would be an incredibly valuable resource, capable of automating huge swaths of human labor and making gobs of money for its creators. It’s also the kind of shiny, audacious goal that investors love to fund, and that helps A.I. labs recruit top engineers and researchers.

But A.G.I. could also be dangerous if it’s able to outsmart humans, or if it becomes deceptive or misaligned with human values. The people who started OpenAI, including Mr. Musk, worried that an A.G.I. would be too powerful to be owned by a single entity, and that if they ever got close to building one, they’d need to change the control structure around it, to prevent it from doing harm or concentrating too much wealth and power in a single company’s hands.

Which is why, when OpenAI entered into a partnership with Microsoft, it specifically gave the tech giant a license that applied only to “pre-A.G.I.” technologies. (The New York Times has sued Microsoft and OpenAI over use of copyrighted work.)

According to the terms of the deal, if OpenAI ever built something that met the definition of A.G.I. — as determined by OpenAI’s nonprofit board — Microsoft’s license would no longer apply, and OpenAI’s board could decide to do whatever it wanted to ensure that OpenAI’s A.G.I. benefited all of humanity. That could mean many things, including open-sourcing the technology or shutting it off entirely.

Most A.I. commentators believe that today’s cutting-edge A.I. models do not qualify as A.G.I., because they lack sophisticated reasoning skills and frequently make bone-headed errors.

But in his legal filing, Mr. Musk makes an unusual argument. He argues that OpenAI has already achieved A.G.I. with its GPT-4 language model, which was released last year, and that future technology from the company will even more clearly qualify as A.G.I.

“On information and belief, GPT-4 is an A.G.I. algorithm, and hence expressly outside the scope of Microsoft’s September 2020 exclusive license with OpenAI,” the complaint reads.

What Mr. Musk is arguing here is a little complicated. Basically, he’s saying that because it has achieved A.G.I. with GPT-4, OpenAI is no longer allowed to license it to Microsoft, and that its board is required to make the technology and research more freely available.

His complaint cites the now-infamous “Sparks of A.G.I.” paper by a Microsoft research team last year, which argued that GPT-4 demonstrated early hints of general intelligence, among them signs of human-level reasoning.

But the complaint also notes that OpenAI’s board is unlikely to decide that its A.I. systems actually qualify as A.G.I., because as soon as it does, it has to make big changes to the way it deploys and profits from the technology.

Moreover, he notes that Microsoft — which now has a nonvoting observer seat on OpenAI’s board, after an upheaval last year that resulted in the temporary firing of Mr. Altman — has a strong incentive to deny that OpenAI’s technology qualifies as A.G.I. That would end its license to use that technology in its products, and jeopardize potentially huge profits.

“Given Microsoft’s enormous financial interest in keeping the gate closed to the public, OpenAI, Inc.’s new captured, conflicted and compliant board will have every reason to delay ever making a finding that OpenAI has attained A.G.I.,” the complaint reads. “To the contrary, OpenAI’s attainment of A.G.I., like ‘Tomorrow’ in ‘Annie,’ will always be a day away.”

Given his track record of questionable litigation, it’s easy to question Mr. Musk’s motives here. And as the head of a competing A.I. start-up, it’s not surprising that he’d want to tie up OpenAI in messy litigation. But his lawsuit points to a real conundrum for OpenAI.

Like its competitors, OpenAI badly wants to be seen as a leader in the race to build A.G.I., and it has a vested interest in convincing investors, business partners and the public that its systems are improving at breakneck pace.

But because of the terms of its deal with Microsoft, OpenAI’s investors and executives may not want to admit that its technology actually qualifies as A.G.I., if and when it actually does.

That has put Mr. Musk in the strange position of asking a jury to rule on what constitutes A.G.I., and decide whether OpenAI’s technology has met the threshold.

The suit has also placed OpenAI in the odd position of downplaying its own systems’ abilities, while continuing to fuel anticipation that a big A.G.I. breakthrough is right around the corner.

“GPT-4 is not an A.G.I.,” Mr. Kwon of OpenAI wrote in the memo to employees on Friday. “It is capable of solving small tasks in many jobs, but the ratio of work done by a human to the work done by GPT-4 in the economy remains staggeringly high.”

The personal feud fueling Mr. Musk’s complaint has led some people to view it as a frivolous suit — one commenter compared it to “suing your ex because she remodeled the house after your divorce” — that will quickly be dismissed.

But even if it gets thrown out, Mr. Musk’s lawsuit points toward important questions: Who gets to decide when something qualifies as A.G.I.? Are tech companies exaggerating or sandbagging (or both), when it comes to describing how capable their systems are? And what incentives lie behind various claims about how close to or far from A.G.I. we might be?

A lawsuit from a grudge-holding billionaire probably isn’t the right way to resolve those questions. But they’re good ones to ask, especially as A.I. progress continues to speed ahead.

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What Did President Biden and former President Trump Wear to Visit the Border?

What Did President Biden and former President Trump Wear to Visit the Border?

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Joe Biden and Donald Trump are not yet the official presidential nominees of their parties, so voters have not had the opportunity to watch them go head to head, as in 2020, in a debate or interview setting. But on Thursday, as each visited the U.S.-Mexican border to address the issue of immigration, the two were as close to a face-off as has been seen since the last election — even if they were 300 miles apart.

The result was a picture not just of different policy and presentation styles, but of political positioning, with little to do with actual border conditions and more to do with the general election.

That’s clearly what both men were costumed for, anyway. It sure wasn’t for a stroll along the dusty edges of the Rio Grande.

Neither Mr. Trump nor Mr. Biden even bothered to doff his jacket or roll up his shirt sleeves, the universal sartorial signal for “I’m mucking in,” to pretend differently.

Rather, Mr. Trump seemed to be putting his own twist on the adage, “Don’t dress for the job you have, dress for the job you want,” while Mr. Biden seemed to be dressing to showcase the job he wants everyone to understand he is doing.

Note that for Mr. Trump, rather than wearing the khakis, windbreaker and white MAGA cap he wore to visit the Border Patrol station in McAllen, Texas, in 2019 (and which he favors for playing golf), he wore what has become his campaign uniform.

Which is to say, the blue suit, white shirt and bright red tie that were his signatures when in office and that envelop him in both the colors of patriotism and the trappings of aspiration, redolent as the combo is of businessman stereotype.

That identity may be under threat after a New York court ruled that Mr. Trump had fraudulently inflated his financial success, fined him $355 million plus interest and barred him from doing business in the state for three years. But Mr. Trump’s Texas appearance suggested that he’s not letting go of the camouflage, the one his base recognizes and to which they respond.

Instead, he’s doubling down. He’s drawing the line on policy, and he’s drawing the line on his wardrobe. He even wore well-shined dress shoes, not his recently introduced Trump “Never Surrender” sneakers, giving up what could have been a prime marketing moment to complete the look.

By contrast, Mr. Biden eschewed the suit and tie for a navy blazer, striped button-up shirt, gray slacks and what appeared to be his newly favored black Hoka Transports, sustainably designed comfy sneakers that at least seemed to acknowledge, unlike the more formal pants and jacket, the exigencies of the landscape. They are advertised by the brand as “conceived at the intersection of lifestyle and performance.”

In other words, they are the embodiment of compromise, just like Mr. Biden’s border pitch to Congress and just like the rest of his outfit, which was more awkwardly casual Friday approachable than Oval Office. To top it all off, he wore a navy baseball cap that looked as though it had the presidential seal on the front. Just in case anyone doubted who the actual POTUS was.

Why does any of this matter? Because as the photos of the men make their way through the media ether, they filter into the general consciousness, whether anyone scrolling or flipping past the pictures realizes it or not. In doing so, the images become a data point that shapes opinion. That’s partly why neither Mr. Trump nor Mr. Biden was simply playing to the home crowd. They were playing to the national audience, against an illustrative backdrop and with all the communications tools at their disposal — including footwear.

Indeed, by the end of the day, it seemed as if the only thing Mr. Trump and Mr. Biden had in common was the tiny American flag pin on their lapels. And a keen awareness of the nuance of the photo op, of course.

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Biden Says U.S. Will Begin Aid Airdrops in Gaza

Biden Says U.S. Will Begin Aid Airdrops in Gaza

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President Biden said on Friday that the United States would begin airdropping humanitarian relief supplies into Gaza, a decision prompted by the dozens of Palestinians who were killed as Israeli forces opened fire near an aid convoy in Gaza City a day earlier.

“Innocent people got caught in a terrible war unable to feed their families, and you saw the response when they tried to get aid in,” Mr. Biden said before meeting with Prime Minister Giorgia Meloni of Italy. “And we need to do more, and the United States will do more.”

Mr. Biden said that the United States would work with Jordan, which has been at the forefront of airdrop efforts to Gaza, as well as other allies to deliver aid by air and that supplies could, eventually, also be delivered by sea.

“Aid flowing to Gaza is nowhere nearly enough now,” Mr. Biden said. “Innocent lives are on the line, and children’s lives are on the line.”

Mr. Biden and Ms. Meloni discussed efforts to prevent the war in Gaza from becoming a larger conflict, as well as support for Ukraine and steps to address human trafficking and global migration.

John F. Kirby, a senior National Security Council official, said that the first airdrops would focus on food, followed by water and medicine. A U.S. military official said the Air Force plans to drop 50,000 meal rations.

The Biden administration has been considering airdrops for some time, but so far has chosen not to in part because of the logistical challenges of dropping aid into a dense war zone. But Mr. Kirby said that the chaos on Thursday had underscored the need to “find more creative ways of getting assistance in faster and at a greater scale.”

The deaths around the convoy have brought the humanitarian crisis in Gaza into a sharper focus for administration officials, they say. Officials have said they do not know what precisely happened at the convoy, but that they believe the disastrous events on Thursday show the lack of security in Gaza, throwing in sharp relief a failure of Israel’s war and the increasingly desperate situation for Palestinians there.

The deaths may prove to be something of an inflection point, prodding the White House to put greater pressure on Israel to allow more humanitarian aid in.

Mr. Kirby said that the deaths show the need for Hamas and Israel to agree to a cease-fire and release the hostages held in Gaza. A pause in Israel’s military operations would allow more humanitarian aid to move into the territory more quickly, he said.

Many questions remain unanswered about the killings around the aid convoy on Thursday, for which the Israeli military and Gazan officials offered divergent accounts.

Gazan health officials say that more than 100 Palestinians were killed and more than 700 injured on Thursday when Israeli forces opened fire on crowds gathered near an aid convoy in Gaza City. Witnesses said they saw people shot as they ran toward the aid trucks.

The Israeli military said a large crowd rushed the convoy and Israeli forces fired on a mob that “moved in a manner which endangered them.” The Israeli military said that most of the deaths had been caused by trampling and that people had also been run over by the aid trucks.

Mr. Kirby said the Biden administration believed that Israel was conducting a fair investigation into the violence.

“The indications are they’re taking this seriously,” Mr. Kirby said, adding that the United States wants answers as soon as possible. “Let’s see what they come up with and see what they learn.”

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A Change in Our Poll: We’re Keeping Respondents Who Drop Off the Call

A Change in Our Poll: We’re Keeping Respondents Who Drop Off the Call

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On Saturday, we’re releasing the results of the latest New York Times/Siena College national poll, including what voters think about the candidates, the election, and how voters feel about the state of the country.

This time, we’re making a modest methodological change that we wanted to tell you about in advance: We’re keeping respondents who started our survey but then “dropped off” before the end of the interview.

It’s a bit wonky (6/10, I’d say), but hopefully helpful for those following our polls closely. It does move our results, albeit by only a percentage point.

Here’s the basic problem: The interviews for our national surveys are conducted by phone (mostly cellphones), and they take about 15 minutes to complete. About 15 percent of the respondents who tell us how they’ll vote in a coming election decide to stop taking the survey — politely or not — before answering all our questions.

We’ve been calling these respondents “drop-offs.”

Careful readers of this newsletter know we’ve been interested in “drop-off” respondents since our Wisconsin experiment in 2022. The “drop-offs” are less likely to vote, less likely to have a college degree, younger and more diverse.

These are exactly the kind of respondents whom pollsters already struggle to get to take polls, making it all the more frustrating that we lose a disproportionate number of them while a survey is underway.

Even if there’s no effect on the result, losing these respondents reduces our response rate, drives up costs and increases the need for “weighting” — a statistical technique to give more weight to respondents from groups who would otherwise be underrepresented. At worst, the “drop-offs” may have different political views than the demographically similar respondents who finish the interviews, biasing our survey toward the most interested poll respondents.

Over the last eight Times/Siena polls, we’ve been evaluating the effect of losing these voters and experimenting with how we can retain them. The only visible indication of this experimentation is that we’ve been asking about age and education up high in our surveys — questions that have allowed us, behind the scenes, to more fully evaluate how these respondents differ.

Despite their demographics, the drop-off respondents are likelier to back Donald J. Trump than those who complete the survey. Across the last eight Times/Siena surveys, Mr. Trump had a nine-point lead against President Biden among drop-off voters, compared with a three-point lead among those who completed the survey. Notably, this Trump edge survives or even grows after controlling for the demographic characteristics we use for weighting, like race and education. As a result, the average Times/Siena result among registered voters would have shifted from Trump +3 over the last eight surveys to Trump +4.

This one-point shift is not consistent in every poll. But it’s true of our last Times/Siena poll in December, which showed Mr. Trump up by two points among registered voters and would have shown him ahead by three points had we retained the drop-offs.

It’s also true of the Times/Siena poll we’re going to release Saturday morning, which would be one point better for Mr. Biden without the drop-off respondents.

It’s not a common practice to keep the drop-offs. I think almost everyone would agree that these respondents are worth trying to include in a survey, but there are serious practical challenges to doing so.

The difficulty swirls around how to handle all those questions toward the end of the survey that weren’t answered by a large chunk of respondents.

This creates two specific problems.

One is weighting: A drop-off respondent doesn’t get to the demographic questions we use to ensure a representative sample. The solution here is relatively straightforward: Ask the key demographic questions toward the beginning of the survey, and count anyone who makes it past those questions as a “completed” interview.

Second and more challenging is how to report the results of the later questions on a survey.

Imagine, for a moment, that the final question of a poll is whether the respondents are liberal, moderate or conservative, and the respondents say they’re 25 percent liberal, 35 percent conservative and 40 percent moderate. Imagine that 15 percent of the initial respondents have dropped off by this point in the survey as well.

If we retain the drop-off respondents and do nothing else, the industry standard is to report a result like 21-30-34 with 15 percent unknown drop-offs, rather than 25-35-40. That would be frustrating for many questions. It could even lead readers to complain we have too few liberals or conservatives, if they don’t do the math to extrapolate the number we might have had without the drop-offs.

Worse, the respondents answering by the end of the survey will not be representative of the full population. After all, the drop-offs are disproportionately nonwhite, young and less educated. That means that the 85 percent of respondents answering at the end will be disproportionately white, old and highly educated.

Oddly enough, retaining the drop-off voters will generally wind up biasing the survey results against the drop-offs in questions toward the end of the survey.

For the first half of the survey, we will report the results from the full set of 980 respondents who responded to the questions used for weighting, including the 157 respondents who dropped off later in the survey. They will be weighted in the same manner as an ordinary Times/Siena poll.

For questions asked after the demographic questions used for weighting, we will report the results from the 823 respondents who completed the entire questionnaire. This is the group of people who would have been the full Times/Siena poll result in the past. They will be weighted separately in the same manner as an ordinary Times/Siena poll, with one twist: They will also be weighted to match the general election results from the full sample, including drop-offs.

You may notice the most obvious change: There are 157 fewer respondents to the second half of the survey than the first half. But there’s more to it: The demographic makeup of the 823 respondents will be ever so slightly different from the full sample, since even weighting doesn’t force a perfect alignment between the characteristics of a poll and the intended population. Hopefully readers find this tolerable; if not, there may be other options we can adopt in the future. This is, after all, the first time we’re trying this. I expect we’ll gradually get better at figuring out how to present these results, especially once we see what other people notice.

So if you find yourself dissatisfied when you look at our poll results tomorrow, let us know!

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Biden Unites With an Unlikely Ally to Champion Ukraine

Biden Unites With an Unlikely Ally to Champion Ukraine

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President Biden turned to an unlikely ally on Friday in his drive to build support for Ukraine’s war effort as U.S. aid falters, declaring during a White House visit by the far-right prime minister of Italy that the two leaders “have each other’s backs” and “have Ukraine’s back.”

The warm tone, a striking departure from Mr. Biden’s assessment of Prime Minister Giorgia Meloni when she was elected, extended to a number of foreign policy fronts, as the leaders sought to portray themselves as united on topics including confronting global migration and trying to prevent a broader war in the Middle East.

“As you said when we first met here in the Oval, Giorgia, that we have each other’s backs,” Mr. Biden said. “We do, and you’ve demonstrated that from the moment you took office.”

But Mr. Biden highlighted their unity on Kyiv’s efforts to fend off an invasion by President Vladimir V. Putin’s Russia, creating a contrast with conservatives in Congress. “We also have Ukraine’s back,” Mr. Biden said. “That’s why I’m urging the House of Representatives to pass legislation” that would send billions of dollars to fund the war effort.

The meeting intensified an all-out assault by Mr. Biden to push stalled military aid for Ukraine through a reluctant Congress. He convened a meeting this week at which he sought to push Speaker Mike Johnson to allow a vote on aid. He has warned that the divisions over aid are a gift to Russia. And he has used meetings with European officials this year not only to ensure a united front against Russia’s invasion but also to pressure Congress.

In Ms. Meloni, Mr. Biden has found a surprisingly kindred spirit.

The Italian prime minister said on Friday that as the chairwoman of the Group of 7 nations, she was focused on “defending freedom and building peace for Ukraine.”

After being elected in 2022, Ms. Meloni has steered away from the most Russia-friendly elements of her coalition, and Italy recently agreed to sign a security agreement with Ukraine to help Kyiv’s defense industry.

Mr. Biden’s embrace of Ms. Meloni has come as a surprise after he expressed concern for democracy when she rose to power. Her party, the Brothers of Italy, has roots in the neo-fascist factions that emerged after World War II. She drew comparisons to former President Donald J. Trump after addressing the Conservative Political Action Conference in the United States in 2022.

“She hails from Europe’s far right, and her coalition contains influential voices that are much more pro-Russian and sympathetic to Putin than the European mainstream, yet she has bucked that trend and located Italy firmly in the trans-Atlantic camp that is committed to supporting Ukraine,” said Charles A. Kupchan, a senior fellow at the Council on Foreign Relations and a Europe adviser on the National Security Council in the Obama administration.

While she has advanced other far-right causes, such as anti-L.G.B.T.Q. policies, in Italy, Mr. Biden has seemed content to set those moves aside to secure an ally on critical foreign policy matters.

Ms. Meloni also could benefit from the global spotlight that comes with a visit to the Oval Office, Mr. Kupchan said, especially as she seeks to convince her own constituents of the importance of defending Ukraine.

“The domestic debate in Italy is, I would say, more skeptical of aid to Ukraine than in most other countries,” Mr. Kupchan said.

Ms. Meloni also stressed the need to discuss strategies to combat human trafficking driving global migration, particularly from North Africa. Mr. Biden too has recently made combating illegal migration a central focus of his administration. Just the day before his meeting with Ms. Meloni, he traveled to the U.S.-Mexico border to push Congress to enact sweeping changes there.

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‘All in Her Head’: A Doctor Reckons With Sexism in Women’s Health Care

‘All in Her Head’: A Doctor Reckons With Sexism in Women’s Health Care

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Six years ago, Dr. Elizabeth Comen, a breast cancer specialist at Memorial Sloan Kettering Hospital in Manhattan, held the hand of a patient who was hours from death.

As Dr. Comen leaned in for a final goodbye, she pressed her cheek to her patient’s damp face. “Then she said it,” Dr. Comen recalled.

“‘I’m so sorry for sweating on you.’”

In her two decades as a physician, Dr. Comen has found that women are constantly apologizing to her: for sweating, for asking follow-up questions, for failing to detect their own cancers sooner.

“Women apologize for being sick or seeking care or advocating for themselves,” she said during an interview in her office: “‘I’m so sorry, but I’m in pain. I’m so sorry, this looks disgusting.’”

These experiences in the exam room are part of what drove Dr. Comen to write “All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today.” In it, she traces the roots of women’s tendency to apologize for their ailing or unruly bodies to centuries of diminishment by the medical establishment. It’s a legacy that continues to shape the lives of women patients, she argues.

Today, women are more likely to be misdiagnosed than men are and take longer to be diagnosed with heart disease and some cancers; they may be less likely to be offered pain medication; their symptoms are more likely to be written off as anxiety — or, as the book title suggests, as being all in their head.

“The anxious female, the hysterical female, has been a ghost looming and woven through all of medical history,” Dr. Comen said. “It’s a default diagnosis.”

Collectively, she argues in the book, these injustices help to explain why many women report feeling invisible, frustrated or ashamed in doctors’ offices. Shame may be the symptom, but Dr. Comen believes that a deeply misogynistic medical system is the disease.

A mother of three in her mid-40s, Dr. Comen is quick with a camera-ready smile, which has helped to make her a regular in media coverage of breast cancer. She occasionally tears up when discussing her patients.

She once wept on the job in medical school, and a male resident responded by telling her to “pull herself together.”

“I felt like I had to excuse my response,” she said, sitting behind her desk. “And now I cry with patients all the time.”

Her approach has been shaped by decades of experience, as well as by what she learned about the female body’s place in medicine while majoring in the history of science as an undergraduate at Harvard.

“The sense that women’s bodies were not just different but broken is obvious not just in the way doctors spoke of the female anatomy but in the medical vocabulary itself: the female external genitalia was termed ‘pudenda,’ a Latin word that means ‘things to be ashamed of,’” she writes.

In “All in Her Head,” Dr. Comen offers a sweeping look at the ways in which she says modern medicine has disregarded women. For centuries, she writes, early medical authorities believed that women were merely “small men” — though lacking external genitals and comparable mental capacity, ruled by noxious humors and hormones.

For too long, doctors dismissed “what could be legitimate physiological problems as irrelevant, as hormonal, and therefore not important,” said Wendy Kline, a professor of the history of medicine at Purdue University.

And this was the case for white women of means, Dr. Comen writes in the book. If you were a woman of color, or you were poor, you were viewed by medical authorities as even less of an authority on your own body, and thus less worthy of care and compassion.

“For Black women, when we go into a clinical setting, we have to think about racial and gender discrimination,” said Keisha Ray, an associate professor of humanities and bioethics at UTHealth Houston, who studies the effects of institutional racism on Black people’s health. “It tends to be more exaggerated, the lack of compassion and the lack of care that you receive.”

Take heart disease, for example. In the late 19th century, Dr. William Osler, one of the founding fathers of modern medicine, declared that women presenting with what we now know to be symptoms of heart attacks or arrhythmias — including shortness of breath and palpitations — were almost certainly suffering from “pseudo angina,” or false angina, “a collection of neurosis-induced symptoms masquerading as genuine disease,” Dr. Comen writes.

It’s only in the past 25 years that cardiology studies have included women in significant numbers. Today, some heart attack symptoms that are more common in women, such as jaw and back pain, are still described as “atypical” simply because doctors don’t see them as often in men, and are less likely to be taken seriously, even though 44 percent of women will develop heart disease at some point in their life and one in five women will die from it.

“We have used the male model for diagnosis, for treatment, as the gold standard,” said Dr. Jennifer Mieres, a cardiologist with Northwell Health and co-author of the book “Heart Smarter for Women.” This has “led to continued misrepresentation, misdiagnosis, under-recognition of heart attack in women.”

In each chapter of “All in Her Head,” Dr. Comen interviews physicians who are working to improve the system, starting with taking female patients’ complaints seriously — not just chalking up physical symptoms, from chest pain to fatigue to gastrointestinal discomfort, to anxiety until all other causes area ruled out, for example.

Dr. Comen also shares practical tools to better partner with an imperfect system.

First, she writes, it’s essential for all patients to trust their knowledge of their own bodies and advocate for themselves. Before an appointment, ask yourself: What truly concerns you about your body?

“Not what you think you should be worried about,” Dr. Comen writes. “Not what you think your doctor will be able to most comfortably and easily address.”

Next, if you feel anxious about your health or that you’re not being heard, enlist a friend or family member to accompany you to appointments. This person can serve as an advocate and an extra set of eyes and ears.

Finally, if you don’t like your doctor, find a new one. This can be easier said than done, she acknowledged, but a trusting and respectful relationship with your health care provider is every patient’s right.

Audio produced by Sarah Diamond.

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DeSantis Vetoes Blanket Social Media Ban for Youths Under 16

DeSantis Vetoes Blanket Social Media Ban for Youths Under 16

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Gov. Ron DeSantis on Friday vetoed a sweeping social media bill that would have effectively barred Florida residents under the age of 16 from opening accounts on services like TikTok and Instagram, even if their parents permitted them to do so.

In a post on X, Mr. DeSantis said he had vetoed the teen social media ban bill because the state’s Legislature was “about to produce a different, superior bill” that recognized parents’ rights. Last week, the governor had suggested the measure went too far by superseding the authority of parents.

Soon after the news of the veto, Paul Renner, a Republican who is the speaker of the Florida House of Representatives, said in a post on X that the new bill would be “an even stronger product to protect our children against online harms.”

While several states have recently passed laws requiring parental consent for children’s social media accounts, the Florida measure that Mr. DeSantis vetoed was designed as a more blanket ban. It would have required certain social networks to verify users’ ages, prevent people under 16 from signing up for accounts and terminate accounts that a platform knew or believed belonged to underage users.

Parents’ groups including the Florida Parent-Teacher Association had urged Mr. DeSantis to veto the bill after the state’s Legislature passed it last week.

The bill would almost certainly have faced constitutional challenges over young people’s rights to freely seek information. It also would have likely ignited online protests from teenagers who rely on social apps to communicate with friends and family, express themselves creatively, keep up with news and follow political, sports, food and fashion trends.

NetChoice, a trade group representing Meta, Snap, TikTok and other tech companies, said it welcomed Mr. DeSantis’s veto. In an email, Carl Szabo, NetChoice’s vice president and general counsel, said the measure, if signed, would have “replaced parents with government and Silicon Valley.” He added that the bill’s provision requiring social media sites to verify users’ ages would have led to “data collection on a scale never before seen in the state.”

Now Florida lawmakers are planning to amend a different bill that would regulate sexually explicit online material “harmful to minors,” adding provisions to restrict certain social networks that have “addictive features,” like endless content scrolls.

That bill would require pornography websites to verify users’ ages and keep out those under 18. Over the last two years, Louisiana, Utah, Mississippi and other states have enacted similar laws.

In his post on X, Mr. Renner said the amended bill would “empower parents to control what their children can access online while also protecting minors from the harm caused by addictive social media platforms.”

The Supreme Court is weighing free speech challenges to other social media laws, in cases that could reshape the internet. One of those cases involves a 2021 Florida statute, currently on hold, that would prohibit platforms like Facebook and X from permanently barring political candidates. (NetChoice is one of two tech trade groups challenging the state laws in the Supreme Court cases.)

But the Florida teen social media ban bill that Mr. DeSantis vetoed on Friday went further, representing one of the most restrictive measures that a state legislature has passed so far amid an escalating national effort to crack down on services like TikTok and Instagram in the name of child safety.

Over the last 18 months, other states have passed new online safety rules that would still allow younger teens to use social media.

Utah, Arkansas, Texas and Ohio last year passed laws that would compel social networks to verify users’ ages and obtain a parent’s permission before giving accounts to children under 16 or 18. In 2022, California passed a law that would require social networks and video game apps used by minors to turn on the highest privacy settings — and turn off certain features like auto-playing videos — by default for those young people.

The crackdown on social media stands out for being unusually bipartisan. California, a Democratic-led state, and Utah, a Republican-led state, each recently enacted landmark laws that take different approaches to protecting young people online. Separately, Florida last year became the first state to require public schools to ban student cellphone use during class time.

Balancing new social media restrictions with free speech rights can be tricky. NetChoice has successfully sued to halt the new laws in Arkansas, California and Ohio. Judges in those cases said the children’s online safety statutes most likely impinged on NetChoice members’ free speech rights to distribute information as well as young people’s rights to have access to it.

Mr. DeSantis said last week that he was “wrestling” with the Florida bill and weighing it against parents’ rights to make decisions about their children’s online activities.

“You’ve got to strike that proper balance when you are looking at these things between policy that is helping parents get to where they want to go versus policy that may be outright overruling parents,” he said.



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What Elon Musk and Sam Altman Said About Each Other

What Elon Musk and Sam Altman Said About Each Other

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(Mr. Musk wrote back: “Thanks Sam!”)

In the “On With Kara Swisher” podcast, in March 2023:

“He’s a jerk, whatever else you want to say about him — he has a style that is not a style that I’d want to have for myself. But I think he does really care, and he is feeling very stressed about what the future’s going to look like for humanity.”

In the “In Good Company” podcast, in September:

“Elon was definitely a talent magnet and attention magnet, for sure, and also just like has some real superpowers that were super helpful to us in those early days, aside from all of those things.”

In a conversation at Vanity Fair’s New Establishment, in October 2015:

Mr. Altman: “The happy vision of the future is humans and A.I. in a symbiotic relationship, distributed A.I., sort of empowers a lot of individuals, not this single A.I. that kind of governs everything we all do that’s a million times smarter than any other entity.

Mr. Musk: “I agree with what Sam said. We are effectively already a human machine collective symbiot, like a giant cyborg.”

In an interview Mr. Altman conducted with Mr. Musk, in September 2016:

Mr. Altman: “Speaking of really important problems — A.I. — you have been outspoken about A.I. Could you talk about what you think the positive future for A.I. looks like and how we get there?”

Mr. Musk: “So I think we must have democratization of A.I. technology, make it widely available, and that’s the reason that obviously you, me, and the rest of the team, created OpenAI was to help with the, help spread out A.I. technology so it doesn’t get concentrated in the hands of a few.”

Cade Metz contributed reporting.

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C.D.C. Shortens Isolation Period for People With Covid

C.D.C. Shortens Isolation Period for People With Covid

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Americans with Covid or other respiratory infections need not isolate for five days before returning to work or school, the Centers for Disease Control and Prevention said on Friday, a striking sign of changing attitudes toward the coronavirus.

People with respiratory illnesses may resume daily activities if they have been fever-free for at least 24 hours without the aid of medications and if their symptoms are improving, agency officials said.

Acknowledging that people can be contagious even without symptoms, the C.D.C. urged those who end isolation to limit close contact with others, wear well-fitted masks, improve indoor air quality and practice good hygiene, like washing hands and covering coughs and sneezes.

The guidelines apply to Covid, influenza and respiratory syncytial virus, among other respiratory ailments, which should make it easier for people to comply, Dr. Mandy Cohen, the C.D.C.’s director, told reporters on Friday.

“Our goal here is to continue to protect those at risk for severe illness, while also reassuring folks that these recommendations are simple, clear, easy to understand and can be followed,” she said.

Dr. Cohen noted the sharp decreases in the numbers of Covid-related hospitalizations and deaths this winter compared with those in previous years, and said a vast majority of hospitalizations had occurred among Americans who did not receive the latest shots.

Vaccination also decreases the chances of long Covid, she added.

The C.D.C. last changed its policy on isolation for those with Covid during the Omicron wave two years ago, when record infections ground the nation to a halt. The isolation period was cut to five days from 10.

The agency is unifying the recommendation for respiratory illnesses because the symptoms are often hard to tell apart, the viruses spread in much the same way, and they can be prevented with similar strategies, said Dr. Brendan Jackson, who leads the agency’s respiratory virus response team.

Some outside experts applauded that change. “I think that makes a lot of sense, because people are not testing,” said Dr. Céline Gounder, an infectious disease specialist at Bellevue Hospital Center and editor at large for public health at KFF Health News.

“If you don’t know which virus you have, how are you supposed to follow the right guidance for Covid versus flu versus R.S.V. versus the common cold virus?” she said.

Even as the agency was considering the change, some experts expressed consternation that it might lead the public to think Covid was no longer a threat. They also worried that without a recommendation to isolate for five days, employers might pressure employees to return to work before they are well.

Little has been done to improve indoor air quality in most places, and wearing masks can be socially uncomfortable for many people, Dr. Gounder said.

“This is again putting a lot of burden on the individual to do the right thing by public health,” she said. Making masks affordable and providing them in public spaces and workplaces would help people follow the new guidelines, she added.

Raynard Washington, public health director of Mecklenburg County, N.C., said it was important that officials continued to emphasize that Covid still posed serious risks for many people.

Still, “having a streamlined, consolidated guidance across the respiratory viral portfolio will allow us to be able to do public health on the ground at the state and federal level, to send a very clear message to people,” he said.

The recommendations are for the general public and do not apply to health care settings or nursing homes.

Dr. Washington urged Americans to always consider that there may be people around them who are at high risk from a coronavirus infection.

“It’s not like people have on a sign that says, ‘I’m immunocompromised,’” he said.

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CVS and Walgreens Will Begin Selling Abortion Pills This Month

CVS and Walgreens Will Begin Selling Abortion Pills This Month

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The two largest pharmacy chains in the United States will start dispensing the abortion pill mifepristone this month, a step that could make access easier for some patients.

Officials at CVS and Walgreens said in interviews on Friday that they had received certification to dispense mifepristone under guidelines that the Food and Drug Administration issued last year. The chains plan to make the medication available in stores in a handful of states at first. They will not be providing the medication by mail.

Both chains said they would gradually expand to all other states where abortion was legal and where pharmacies were legally able to dispense abortion pills — about half of the states.

Walgreens will start providing the pill within the next week in a small number of its pharmacies in New York, Pennsylvania, Massachusetts, California and Illinois, said Fraser Engerman, a spokesman for the chain. “We are beginning a phased rollout in select locations to allow us to ensure quality, safety and privacy for our patients, providers and team members,” he said.

CVS will begin dispensing in all of its pharmacies in Massachusetts and Rhode Island “in the weeks ahead,” Amy Thibault, a spokeswoman for the company, said.

The chains will be monitoring the prospects in a few states, including Kansas, Montana and Wyoming, where abortion bans or strict limitations have been enacted but are enjoined because of legal challenges.

Mr. Engerman said that Walgreens was “not going to dispense in states where the laws are unclear” to protect its pharmacists and staff members.

As for CVS, “we continually monitor and evaluate changes in state laws and will dispense mifepristone in any state where it is or becomes legally permissible to do so,” Ms. Thibault said. In some states where abortion is legal, she said, pharmacists are prohibited from dispensing mifepristone because laws require that to be done by doctors or in a hospital or clinic.

It is uncertain how much initial demand there will be for the service at brick-and-mortar pharmacies. In the states where the chains will begin dispensing, abortion pills are already available in clinics or easily prescribed through telemedicine and sent through the mail. But some women prefer to visit doctors, many of whom do not have the medication on hand. The new development will allow doctors and other eligible providers to send a prescription to a pharmacy for the patient to pick up.

As the availability in retail pharmacies expands, they may become a more popular alternative, and depending on the outcome of a case the Supreme Court will hear later this month, the pharmacy option could take on more importance.

In that case, abortion opponents have sued the F.D.A., seeking to remove mifepristone from the market in the United States. An appeals court ruling in that case did not go that far but effectively banned the mailing of mifepristone and required in-person doctor visits. If the Supreme Court upholds that ruling, it could mean that patients would have to obtain mifepristone by visiting a clinic, doctor or pharmacy.

In order to obtain certification, the pharmacy chains had to take specific steps, including ensuring that their computerized systems protected the privacy of prescribers, who are certified under a special program that the F.D.A. applies to mifepristone and several dozen other medications.

Pharmacy certification is granted by manufacturers of mifepristone. Walgreens was certified by the brand name manufacturer Danco Laboratories, and is seeking certification from the generic manufacturer GenBioPro, Mr. Engerman said. CVS was certified by GenBioPro.

Medication abortion is a two-drug regimen that is now the most common method of terminating pregnancies in the United States and is typically used through 12 weeks of pregnancy. Mifepristone, which blocks a hormone necessary for pregnancy development, is taken first, followed 24 to 48 hours later by misoprostol, which causes contractions that expel pregnancy tissue.

The same regimen is also used for miscarriages, and those patients can now also obtain mifepristone from the pharmacy chains.

Mifepristone has been tightly regulated by the F.D.A. since its approval in 2000, and doctors and other health providers are required to obtain special certification to prescribe it. It has previously been available primarily from the prescribers or from clinics or telemedicine abortion services, in which the pills were generally shipped from one of two mail-order pharmacies that were authorized. Misoprostol has never been as tightly restricted as mifepristone and is used for many different medical conditions. It is easily obtained at pharmacies through a typical prescription process.

The American Pharmacists Association urged the F.D.A. to allow retail pharmacies to distribute mifepristone, even though the medication is unlikely to generate significant revenue. In a statement last year, the association said that it wanted the agency “to level the playing field by permitting any pharmacy that chooses to dispense this product to become certified.”

Shortly after the F.D.A. policy change was announced in January 2023, Walgreens and CVS said they planned to become certified and offer mifepristone in states where laws would allow pharmacies to dispense it.

Walgreens later became the focus of a consumer and political firestorm after it responded to threatening letters from Republican attorneys general in 21 states, confirming that it would not dispense the medication in those states.

Both chains have had protests outside their stores, mostly from anti-abortion advocates, and similar protesters interrupted a meeting of shareholders at Walgreens Boots Alliance, the chain’s parent company.

CVS is the nation’s largest chain with over 9,000 stores in all 50 states. Walgreens has about 8,500 stores in all states except North Dakota.

A handful of small independent pharmacies began dispensing mifepristone last year.

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