Medicare virtual visits on hold with shutdown

Medicare’s temporary telehealth flexibilities ended on October 1, 2025, due to a lack of Congressional action, meaning most virtual visits are no longer covered unless Congress extends them again. As a result, many healthcare providers have canceled or are rescheduling Medicare telehealth appointments, requiring patients to come in person. For patients who still have virtual appointments, a provider may ask them to sign an Advance Beneficiary Notice (ABN). 

What you can do

  • Check with your provider: Contact your doctor’s office to see if your appointment has been canceled or needs to be moved to an in-person visit.
  • Prepare for in-person visits: Be ready to schedule an in-person appointment if your provider requires it.
  • Understand your options: If a virtual visit is still available, you may be asked to sign an ABN, which confirms that you agree to pay for the visit out-of-pocket if Medicare does not cover it.
  • Stay informed: Visit the official Medicare.gov website for the most up-to-date information on telehealth coverage.
  • Consider other options: Explore the in-person visit options at your clinic.
  • Note: Some states have different rules. For example, Medi-Cal telehealth is not affected by this change, according to the California Medical Association

Why this is happening

  • The temporary flexibilities put in place during the COVID-19 pandemic have expired.
  • Without a new law from Congress, Medicare’s coverage reverts to the pre-pandemic rules, which only covered a limited number of telehealth services.
  • A government shutdown has prevented Congress from acting to restore these flexibilities. 
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Oh, so close!

Thanks to John R.

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People with some cancers live longer after a COVID vaccine

In nature 22 October 2025 (thanks to Mike C.)

Melanoma cells (artificially coloured). An immune-based therapy was more effective against this cancer in people who received an mRNA-based COVID-19 vaccine within 100 days of the start of their cancer treatment.Credit: Steve Gschmeissner/SPL

A vaccine that helps to fight cancer might already exist. People being treated for certain deadly cancers lived longer if they had received an mRNA-based vaccine against COVID-19 than if they hadn’t, finds an analysis of medical records.

Follow-up experiments in mice show that the vaccines have this apparent life-extending effect not because they protect against COVID-19 but because they rev up the body’s immune system1. That response increases the effectiveness of therapies called checkpoint inhibitors, the animal data suggest.

“The COVID-19 mRNA vaccine acts like a siren and activates the immune system throughout the entire body”, including inside the tumour, where it “starts programming a response to kill the cancer”, says Adam Grippin, a radiation oncologist at MD Anderson Cancer Center in Houston, Texas, an co-author of the report published today in Nature. “We were amazed at the results in our patients.”

The findings, which Grippin and his colleagues hope to validate in a clinical trial, suggest further hidden capabilities of mRNA vaccines, even as the administration of US President Donald Trump has slashed about US$500 million in funding for research investigating the technology.

The US Department of Health and Human Services, which cancelled the funding for mRNA research, did not respond to a request for comment.

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Julio’s last at bat for 2025

Thanks to Mike C.

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Prescient Pogo

Thanks to Tom S. and SRA Climate Impact Subcommittee

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Fighting Authoritarianism

Thanks to Mary Jane F.

Indivisible co-founder and co-executive director Ezra Levin joins the podcast to talk about how his group is changing under the second Trump administration, why organizing and protesting is so important, and how we can successfully fight back against authoritarianism. Plus, some thoughts on the recent ICE raids in Chicago and across the country and what these events mean for our collective rights.

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The Evolution of Classical Music From 1689 to 1935

Thanks to Bob P.

Lord Vinheteiro performed a seamless piano composition that featured the evolution of classical music from 1680 through 1935. As with many of his videos, the talented musician looked straight at the camera as he played.

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Peaceful Protest

Thanks to Mary Jane F.

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She can protest too

Thanks to Pearl McE.

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Undaunted

MIT, with several courageous universities to follow, shows it is made of sterner stuff
by Jennifer Rubin (thanks to Diana C.)

Elite institutions ranging from Columbia University to CBS News to the Paul, Weiss law firm have capitulated to Donald Trump’s bullying. Under the delusion that they could cut deals to save themselves from Trump’s wrath, they tossed overboard supposedly deeply held values including academic independence, freedom of the press, and the right to counsel. Instead, their cowardice whetted Trump’s appetite for more aggression and repression.

Over several months, surrender by a fleet of weak-kneed institutions suggested that Trump might succeed in his dictatorial mission. However, that disturbing trend appears to have stalled. Perhaps Trump overreached, or perhaps popular protests convinced institutional leaders to show some backbone.

In any event, Trump’s familiar extortion playbook seems to have lost some of its punch. Trump’s latest gambit, the so-called compact that he sent to nine prestigious universities, may have flopped. The New York Times reported on Oct. 2:

The Trump administration promised a select set of universities what the government said would be a great deal.

In exchange for agreeing to a list of demands, like limiting international students and protecting conservative voices, universities would get a leg up on grants, potentially beating out the competition for billions in federal funds.

At least one institution, the University of Texas, said it would be eager to sign up.

But then, a curious thing happened. Faculty, students, and alumni began to push back. Condemnation of the compact and talk of boycotts started “while Dartmouth College’s president has responded by saying she will always defend her university’s ‘fierce independence,’” Johns Hopkins professor Harry Farrell wrote last week. Meanwhile, California’s governor, Gavin Newsom threatened “to pull state funding from any institution that signs.”


Then, the leader of one of the most prestigious universities weighed in. The Massachusetts Institute of Technology’s (MIT) president Sally Kornbluth in a letter to Education Secretary Linda McMahon effectively told the Trump bullies to get lost.

Kornbluth first recited her university’s principles: rewarding merit, admitting students regardless of economic need, and guarding free expression. She then drew a line in the sand in terms that old-school conservatives would have appreciated:

We freely choose these values because they’re right, and we live by them because they support our mission—work of immense value to the prosperity, competitiveness, health and security of the United States. And of course, MIT abides by the law.

The [Trump proposed compact]… includes principles with which we disagree, including those that would restrict freedom of expression and our independence as an institution. And fundamentally, the premise of the document is inconsistent with our core belief that scientific funding should be based on scientific merit alone. (continued on Page 2 or here)

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Like I-5 and the Skybridge

Thanks to John R.

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Original document

Thanks to Pearl McE.

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Where the #!(%&! are they?

Thanks to MaryLou P. (also the keys, phone and hearing aids)!

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I don’t think Washington understands how ticked off we truly are

By Dan Shanoff and Rafe Bartholomew in the NYT

Stephen A. Smith brought a taste of “First Take” to Washington, D.C., on Wednesday night.

The ESPN host, who has branched out into political commentary in recent months and even teased the possibility of running for president in 2028, issued a stern rebuke to the nation’s elected representatives over the ongoing federal government shutdown while participating in a cable TV town hall event for the cable network NewsNation. After he finished speaking, Smith walked off the stage for dramatic effect.

Seated alongside a bipartisan panel that included sitting lawmakers Rep. Jim Jordan (R-Ohio), Ro Khanna (D-Calif.) and Madeleine Dean (D-Pa.), as well as former U.S. Senator Joe Manchin (D-W.Va.) and conservative commentator Bill O’Reilly, Smith was reacting to a question from a Dallas air traffic controller who described needing to deliver food for DoorDash in his off-duty hours to make up his lost income during the shutdown. Thousands of federal workers have been furloughed while Congress negotiates a plan to reopen the government; employees deemed essential, including air traffic controllers, are expected to work without pay.

“I’m trying to be very respectful to everybody, because they deserve it,” Smith began. “But let me say this: I don’t think Washington understands how ticked off we truly are.”

He described the issues he and the panelists had debated that night — how to make health care more affordable, the U.S. government’s financial support for Argentina amid the South American nation’s fiscal crisis, concerns over politically motivated prosecutions at the Department of Justice — and accused the government of being insensitive to the problems faced by everyday Americans, including federal workers who are missing paychecks.

“We’re listening to this kind of stuff while a young man walked up to the microphone and said that he had to leave here to go and work on DoorDash to help pay for his daughter’s tuition,” Smith said. “Meanwhile, everybody up here getting paid, but he ain’t. … This is why you have so many Americans — excuse my language — so pissed off at Washington, because somehow, some way, you get to have these conversations, engage in specific elements of it, to talk about what we need to do to get things better.

“Our debt is $37.8 trillion. Somehow, some way, the taxpayer has been paying this, been throwing money, because we all look at our check and it’s been going to the government. And somehow, some way, you’re supposed to be doing something constructive and productive enough to make sure that we don’t have that kind of deficit. It isn’t happening,” he said as members of the audience hooted whoops of approval.

“A government shutdown is going on right now,” Smith continued. “A man has to work on DoorDash when he’s really an air traffic controller that we applaud it, and we’re up here talking about how much some money is gonna cost, and the only person that don’t have a check coming is him.

“You know what I’m gonna do?” Smith asked, before standing up and leaving the stage. “I’m gonna take a break.”

Was this the debut of ‘America First Take’?

The first thing I thought of when I saw that clip of Stephen A. pop up on social media was the day in 2009 when CNBC correspondent Rick Santelli, on the floor of the Chicago Mercantile Exchange, went off on a diatribe that is credited, if apocryphally, with sparking the “Tea Party” movement.

To be sure, that wasn’t this: NewsNation in 2025 isn’t CNBC in 2009 (and society isn’t remotely close to where we were 16 years ago), but if you squint, you can see the outline of “Stephen A. Populism” — a form of straight talk layered with just enough visceral disgust to match the mood of a segment of the population. (“America First Take?”)

When Smith started dabbling in politics earlier this year, he made the point that in a debate, he would clean the clock of politicians. His rhetorical skill — honed over tens of thousands of morning arguments over Dak Prescott being over- or underrated — is unquestioned.

Simply stating the obvious can leave politicians off-balance, because so many of them carry on in a media bubble where “Embrace Debate” simply doesn’t exist. It doesn’t hurt that the national mood is decidedly against members of Congress; Smith wisely picked an easy target.

Was it performative for Smith to end his monologue by stomping off the set? Absolutely. Watching the clip, I don’t doubt that he felt genuine disgust, but I also don’t doubt that he knew exactly what he was doing. This might not spark the “Stephen A. Party,” but you can spot the outline of Smith’s more muscular approach to immersing in politics. — Dan Shanoff

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Somehow they crossed over

thanks to John R.

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Jealousy explained

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Chaos at the CDC

from The Epidemiologist

On Friday, about 1,300 CDC employees received a surprising email: they were fired. No warning. No time to plan. Their badges were immediately deactivated. The justification was a “reduction in force”—a bureaucratic term now being used as a political pawn in the broader Congressional shutdown fight.

This wasn’t the first wave. For months, CDC employees have endured mass layoffs, political interference, the firing of top scientific leaders, a lack of transparency, and fear and uncertainty. But this round struck at the agency’s core. Senior leaders, including the incident manager for the national measles response, were let go. The entire MMWR team—the scientific backbone that translates CDC data into outbreak reports and public guidance—gone. So were epidemic intelligence service officers, the nation’s “disease detectives” who detect and track emerging threats before they spread.

It didn’t stop there. Cuts hit every corner of CDC’s operations:

  • Data office: the infrastructure that collects, connects, and analyzes data nationwide.
  • CFA INFORM: the “weather service” for infectious diseases.
  • CDC Washington Office: the bridge between science and policy.
  • Global Health Center: the front line that stops diseases abroad before they reach U.S. shores.
  • Chronic Disease Policy and Comms: connecting science to action on diabetes and heart disease.
  • Injury Prevention Policy and Comms: addressing gun violence, opioid overdoses, and suicide.
  • Ethics teams, human resources, the CDC library (it’s hard to do science without access to scientific literature), and more.

Then came the whiplash. Within 24 hours, 700 employees were reinstated. The administration called it a “coding error.” Maybe. Or maybe it was a scramble to reverse a catastrophic mistake. It’s hard to know precisely who remains fired, but it seems to include staff from ethics, congressional outreach, health statistics, nutrition surveys, and all of human resources. Oh, also, the scientists who work on biodefense, such as weaponized pathogens, remain fired.

For those keeping track, this now accounts for 1 in 3 CDC employees lost over the past few months. This doesn’t account for the 50% additional budget cuts coming in 2026.

What we’re testing in real time

The U.S. is conducting an uncontrolled experiment to see what happens when a public health agency is gutted with immense speed and without a vision beyond destruction. We are getting increasingly close to system collapse. As often attributed to Amit Kalantri: “Systems fail when people with ability don’t have authority and people with authority don’t have ability.”

The questions we’re testing are:

  1. How much trauma can the workforce absorb? Scientists have been holding the ship together after surviving mass layoffs, working under political interference, getting 500 bullets aimed at them, and mourning colleagues who lost jobs overnight. Public health employees are there for the mission (certainly not the pay), and it’s unclear how much longer that trumps trauma. Of course, cruelty is the point. In February, the OMB said, “When they wake up in the morning, we want them to not want to go to work, because they are increasingly viewed as the villains. We want their funding to be shut down… We want to put them in trauma.”
  2. How thin can CDC be stretched? One in three employees has now been lost—either fired or quit—within months. And this is before the 2026 budget, which will cut CDC by an additional 50%.
  3. How political will CDC become? The fewer career scientists who remain, the more political appointees fill the void. Each round of cuts makes the agency less independent and more beholden to politicians.
  4. What breaks first, and how will it be felt in American lives? The ultimate question haunting many in public health, including me.

Many of you have asked how MAHA (the movement I’ve been talking with for months) is reacting. It’s complicated. Some are cheering the cuts, seeing them as long-overdue accountability for institutions that failed them. Many have been harmed or dismissed by these very systems. They feel unseen, unheard, and hungry for change. Others, though, are uneasy and recognize that the pendulum has swung too far. And many simply don’t know this is happening, because echochambers continue to drive our information ecosystems. This shouldn’t be too big a surprise, given that MAHA isn’t a monolith.

The real danger

I welcome radical transformation of our systems. They need it. But the danger here isn’t just in what’s being dismantled and how cruelly it’s being done, but in what’s not being built to take its place.

There’s no plan. No rebuilding strategy. No vision grounded in American values of innovation, imagination, and hope, nor the kind of long-term vision that could deliver the health ecosystem Americans deserve. If we don’t fill this vacuum with credible leadership, imagination, and execution, it will be filled with noise, chaos, and ideology.

What this means for you: You won’t feel these latest cuts on the ground tomorrow or the next day, especially since some cores (like the measles lead) were reinstated. But this will continue to be a slow bleed. Eventually it will be measured in American lives.

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Prophecy in Portland?

Thanks to Pearl McE.

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Something SERIOUS is About to Happen

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Columbus Day – commentary by Heather Cox Richardson

On October 9, President Donald J. Trump’s office issued an official proclamation declaring Monday, October 13, “Columbus Day.” The proclamation says that the day is one on which “our Nation honors the legendary Christopher Columbus—the original American hero, a giant of Western civilization, and one of the most gallant and visionary men to ever walk the face of the earth. This Columbus Day, we honor his life with reverence and gratitude, and we pledge to reclaim his extraordinary legacy of faith, courage, perseverance, and virtue from the left-wing arsonists who have sought to destroy his name and dishonor his memory.”

The proclamation goes on to present a white Christian nationalist version of American history, with much more emphasis on Christianity than Trump’s previous, similar proclamations. It claims that Columbus was guided by a “noble mission: to discover a new trade route to Asia, bring glory to Spain, and spread the Gospel of Jesus Christ to distant lands.” “Upon his arrival,” it says, “he planted a majestic cross in a mighty act of devotion, dedicating the land to God and setting in motion America’s proud birthright of faith.”

“Guided by steadfast prayer and unwavering fortitude and resolve,” it goes on, “Columbus’s journey carried thousands of years of wisdom, philosophy, reason, and culture across the Atlantic into the Americas—paving the way for the ultimate triumph of Western civilization less than three centuries later on July 4, 1776.”

Then the proclamation turns to MAGA’s complaints about modern revisions of this triumphalist history, saying: “Outrageously, in recent years, Christopher Columbus has been a prime target of a vicious and merciless campaign to erase our history, slander our heroes, and attack our heritage.” Our nation, the proclamation says, “will now abide by a simple truth: Christopher Columbus was a true American hero, and every citizen is eternally indebted to his relentless determination.”

This proclamation completely misunderstands the fifteenth-century world of expanding European maritime routes that entirely reworked world trade—including trade in human beings—and the role of Italian mariner Christopher Columbus, who worked for Spain’s monarchs Ferdinand and Isabella, in that expansion.

It also misses what historians call the “Columbian Exchange”: the transfer of plants and animals between the Americas and the “Old World”—Europe, Asia, and Africa—after Columbus’s first landfall in the Bahamas in 1492. That exchange went both ways and transformed the globe, but its effect on the Americas was devastating. When Columbus and his sailors “discovered” the “New World,” they brought with them both ideologies and germs that would decimate the peoples living there.

Estimates of the number of Native people living in North America and South America in 1490 vary widely, but there were at least as many as 50 million, and possibly as many as 100 million. In the next 200 years, displacement, enslavement, war, and especially disease would kill about 90% of those native peoples. Most historians see the destruction of America’s Indigenous peoples as the brutal triumph of European white men over those they perceived to be inferior.

Historians are not denigrating historical actors or the nation when they uncover sordid parts of our past. Historians study how and why societies change. As we dig into the past, we see patterns that never entirely foreshadow the present but that give us ideas about how people in the past have dealt with circumstances that look similar to circumstances today. If we are going to get an accurate picture of how a society works, historians must examine it honestly, seeing the bad as well as the good. With luck, seeing those patterns will help us make better decisions about our own lives, our communities, and our nation in the present.

History is different from commemoration. History is about what happened in the past, while commemoration is about the present. We put up statues and celebrate holidays to honor figures from the past who embody some quality we admire.

The Columbus Day holiday began in the 1920s, when a resurgent Ku Klux Klan tried to create a lily-white country by attacking not just Black Americans, but also immigrants, Jews, and Catholics. This was an easy sell in the Twenties, since government leaders during the First World War had emphasized Americanism and demanded that immigrants reject all ties to their countries of origin. From there it was a short step for native-born white American Protestants to see anyone different from themselves as a threat to the nation.

The Klan attacked the Knights of Columbus, a Catholic fraternal organization. Klan members spread the rumor that one became a leader of the Knights of Columbus by vowing to exterminate Protestants and to torture and kill anyone upon orders of Catholic leaders.

To combat the growing animosity toward Catholics and racial minorities, the Knights of Columbus began to highlight the roles those groups had played in American history. In the early 1920s they published three books in a “Knights of Columbus Racial Contributions” series, including The Gift of Black Folk by pioneering Black sociologist W.E.B. Du Bois.

They also turned to an old American holiday. Since the late 1860s, Italian Americans in New York City had celebrated a “Columbus Day” to honor the heritage they shared with the famous Italian explorer. In the 1930s the Knights of Columbus joined with media mogul Generoso Pope, an important Italian American politician in New York City, to rally behind the idea of a national Columbus Day. In 1934, President Franklin Delano Roosevelt, aware of the need to solidify his new Democratic coalition by welcoming all Democratic voters, proclaimed Columbus Day, October 12, a federal holiday. In 1971 the day became unfixed from a date; it is now the second Monday in October.

The Knights intended for Columbus Day to honor the important contributions of immigrants—and Catholics—to American society. But in the 1960s a growing focus on the lives and experiences of Indigenous Americans forced a reckoning with the choice of Columbus as a standard bearer. Currently, seventeen states and the District of Columbia use the official holiday to celebrate Indigenous history. Some Oklahoma tribal members simply use the day to honor their tribe.

As society changes, the values we want to commemorate shift. In the 1920s, Columbus mattered to Americans who opposed the Ku Klux Klan because celebrating an Italian defended a multicultural society. Now, though, he represents the devastation of America’s Indigenous people at the hands of European colonists who brought to North America and South America germs and a fever for gold and God. It is not “left-wing arson” to want to commemorate a different set of values than the country held in the 1920s.

What is arson, though, is the attempt to skew history to serve a modern-day political narrative. Rejecting an honest account of the past makes it impossible to see accurate patterns. The lessons we learn about how society changes will be false, and the decisions we make based on those false patterns will not be grounded in reality.

And a society grounded in fiction, rather than reality, cannot function.

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Nobel Peace Prize committee explain why Donald Trump didn’t win despite him saying ‘he deserved it’

The 2025 Nobel Peace Prize went to María Corina Machado of Venezuela instead

Joshua Nair in LADbible (thanks to Bob P.)

The Nobel Peace Prize committee has revealed why Donald Trump missed out on this year’s award.

Trump has made it abundantly clear that he feels like he ‘deserves’ the prize on several occasions, and all eyes were on today’s official announcement following the news of a ceasefire agreement between Israel and Hamas, which the US President was heavily involved in.

The award instead went to María Corina Machado of Venezuela, the Venezuelan opposition leader who disappeared and went into hiding in August 2024, following elections in the preceding month.

She has been honoured for her contributions to promoting democracy in the South American country, which has been described as a dictatorship by some under current leader Nicolás Maduro.

The chairman of the Nobel Prize committee has now commented on why Trump didn’t walk away with the award, when asked by the press.

Machado wrote a letter from 'hiding' to give her thanks to the committee (AFP VIDEOGRAPHICS/AFP via Getty Images)

Machado wrote a letter from ‘hiding’ to give her thanks to the committee (AFP VIDEOGRAPHICS/AFP via Getty Images)

Jørgen Watne Frydnes, the Nobel Peace Committee’s chairman, was asked about the pressure from the US President and some in the international community to give the award to the 79-year-old, and if the pressure affected their decision at all.

He replied, noting that ‘in the long history’ of awarding the prize, the committee has experienced all types of ‘media tension’, even receiving thousands of letters each year from those who explain ‘what for them leads to peace’. (continued on Page 2 or here)

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Marjorie speaks up!

Thanks to Pearl McE.

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Among Portland Protests, It’s Frogs and Sharks and Bears, Oh My!

By Anna Griffin and Aaron West in the NYT (thanks to Linda T.)

Animal costumes are the new black.

Exceedingly aware that the black garb worn by demonstrators in 2020 informed President Trump’s apocalyptic view of Portland, Ore., protesters this year have gone to the frogs — and unicorns, raccoons, sharks, bears, dinosaurs and the hot animal of this particular pop culture moment, a capybara.

“It was just to contrast the narrative that we are violent extremists,” said Seth Todd, 24, whose appearance at Portland’s Immigration and Customs Enforcement facility early in the summer as a bulbous green frog started the trend. “The best way to show that for me is being in a frog costume.”

A person hula hoops in a green inflatable costume.

In Portland 2025, whimsy and merriment have replaced the masked anarchist look of 2020.Credit…Jordan Gale for The New York Times

Portland has long been a little bit different in how residents protest. Outside the ICE building, demonstrators against the Trump administration’s immigration policies have blown bubbles at ICE agents, formed a flash mob to dance the “Cha-Cha Slide,” held formal afternoon tea services and gone “ICE fishing” — tying doughnuts to poles and pretending to lure federal officers with the pastries. Cyclists are planning a special edition of Portland’s famed “naked bike ride” past the ICE facility on Sunday.

“Portland has a long heritage of ‘keep Portland weird,’” Steven Schroedl, 60, a retiree whose inflatable costume made it look as if he were riding an ostrich, said on Friday. “It’s something we didn’t necessarily cultivate. It’s just fundamentally who we are.”

But the arrival and proliferation of inflatable costumes at the ICE facility in South Portland has taken the city’s penchant for irreverence to new, surreal heights and eased some of the tension, at least as both sides wait for a court to decide whether President Trump can bring in the National Guard. (continued on Page 2 or here)

Posted in Advocacy, Animals, Dance, Government, Humor, Law, Military, Politics, protests, Satire | 1 Comment

Mastering vacuous circumlocution

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A remodel downgrade – David Horsey

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