Justify Wins 144th Kentucky Derby

After a day of steady rain on Churchill Downs, it was Justify who managed cross the finish line first in the mud.

Justify brought home Hall of Fame jockey Mike Smith a second Derby win, on top of his and trainer Bob Baffert’s $2 million prize.

Roughly 13 inches of rain made for muddy conditions at the 144th running of the Kentucky Derby.

Entering into the race, Justify was the favorite, with 5-2 odds, followed by Mendelssohn, 6-1, and My Boy Jack at 6-1.

Superstitious fans had been dreading the Apollo Curse. According to Sports Illustrated, no horse has won the race without starting as a 2-year-old since 1882 — when Apollo won the Kentucky Derby by defeating 4-5 favorite Runnymede.

Justify, with the best odds, and Magnum Moon, 13-1, had been the only candidates in the field eligible to break the 136-year-old curse.

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Students, Celebrities And The Faithful Protest Outside Of The NRA Convention

Young protesters chanted on Friday as they marched from City Hall to the Kay Bailey Hutchison Convention Center where the National Rifle Association is hosting an annual, four-day convention.

Sue Ogrocki/AP

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Sue Ogrocki/AP

Thousands of gun enthusiasts have walked into Dallas’s Kay Bailey Hutchison Convention Center to revel in displays of firearms and hunting accessories at the National Rifle Association’s annual convention — but some crowds are staying outside to protest what they believe is a dire problem in America.

“Our generation is the post-Columbine generation. We’ve seen tragedy after tragedy after tragedy,” said Waed Alhayek, a student who spoke to NPR affiliate KERA about the need for gun legislation. “People think we’re trying to take away guns, but that’s not the issue we’re focused on. We’re trying to regulate the amount of gun violence.”

She started “Rally 4 Reform” and led students outside Dallas City Hall, across from the convention center. The executive director of StudentMarch.org, she also organized the city’s March For Our Lives.

#NoRA, a coalition backed by celebrities like Jimmy Kimmel and Amy Schumer, hosted a rally nearby at Belo Garden Park. Speakers included Fred Guttenberg, the father of Jaime Guttenberg, a 14-year-old who died in the Parkland, Fla. shooting in February, and actress Alyssa Milano.

“Everybody in the U.S. feels like everything is so partisan at this point, and our political views have become so calcified and fossilized in a way that is disruptive to any common ground,” Milano told The Dallas Observer. “And I don’t think there’s a person in this country who doesn’t think we don’t have a gun problem. We’ve become so partisan that we don’t know how to even meet halfway to fix that problem.”

#NoRA Protest https://t.co/wSfm0Fpaxb

— Alyssa Milano (@Alyssa_Milano) May 5, 2018

“We’re asking for sensible gun laws,” Dominique Alexander, president of Next Generation, told NPR. Alexander said his social justice organization drew hundreds to Dallas City Hall Plaza before they marched to the convention center. When you look at the shootings in Newtown, Parkland, Orlando, Dallas, people are tired – on both sides. People are tired.”

A group called Faith Forward Dallas hosted a vigil near the convention center and vowed to pray from start to end of the NRA gathering. It wrote on its website, “We lament the loss of so many of God’s precious children and know that the only proper way to honor them is to work for change. We affirm the role of prayer in our work. But prayer is not the abdication of human responsibility in God’s dream for the world.”

In the midst of the four-day event, mobile truck billboards have been circling the convention center, the site of the NRA’s prayer breakfast and the country music stage. The signs read, “How much money have you taken from Russia?” and “Why have you cozied up to Vladimir Putin’s Kremlin?”

And at least one local business voiced support for gun control in its own way – on restaurant tabs. Ellen’s, a dining spot in downtown Dallas, put a message on the bottom of its receipts in anticipation of the NRA convention. It read, “A portion of this week’s proceeds will be donated to organizations dedicated to implementing reasonable and effective gun regulations. Welcome to Dallas!”

The move prompted the NRA to advise its followers on Twitter not to brunch there. The restaurant later wrote on Facebook, “We believe our position is anything but controversial. Rather, it is the American way of dealing with problems. Historically, every time we have had a big challenge, we have come together — Republicans, Democrats, Conservatives, and Liberals — and put our collective brain power and dedication to the task.”

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Iowa Bans Most Abortions As Governor Signs 'Heartbeat' Bill

Iowa Gov. Kim Reynolds signed the most restrictive abortion bill into law on Friday, setting the state up for a lengthy challenge in court.

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Charlie Neibergall/AP

Iowa Gov. Kim Reynolds signed one of the country’s most restrictive abortion bills into law on Friday.

The so-called “heartbeat” legislation bans abortions once a fetal heartbeat has been detected, at about six weeks of pregnancy. Exceptions are made in cases of rape, incest or medical emergency.

Republican state lawmakers worked late into the night this week to push the measure forward. During Tuesday’s debate in the State House, Rep. Sandy Salmon said, “A baby has become something we can throw away. This bill says it’s time to change the way we think about unborn life.”

The bill passed the state House on Tuesday and the state Senate early Wednesday. Then it landed on Reynolds’s desk.

“I understand that not everyone will agree with this decision,” Reynolds said in a written statement. “But if death is determined when a heart stops beating, then doesn’t a beating heart indicate life? For me, it is immoral to stop an innocent beating heart.”

The legislation drew firm Republican support. Iowa Sen. Joni Ernst tweeted, “Glad to see Iowa leading the way and standing up for the most vulnerable in our society, the unborn. Thank you @IAGovernor for taking this important step forward in protecting life.”

No Democrats voted for the bill. “This unconstitutional bill is nothing but a thinly veiled attack on Iowa women’s most basic rights and freedoms – every woman deserves the fundamental right to make decisions about her own body with her doctor,”Democratic National Committee Women’s Media Director Elizabeth Renda said in a written statement.

Iowa has permitted most abortions up to 20 weeks. Critics of the new law say the six-week deadline will prohibit abortions before women may even realize they are pregnant.

Protesters rally outside Reynolds’ office on Friday.

Charlie Neibergall/AP

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Charlie Neibergall/AP

“The likelihood that an individual can miss her period, get a pregnancy test, then make an appointment to see an abortion provider, take time off of work if she’s working, find childcare for her other children, get in to get her abortion and have all of that done prior to a six-week time period is absolutely unrealistic and unreasonable,” said Dr. Jamila Perritt, a fellow with Physicians for Reproductive Health which advocates for contraception and abortion.

Perritt said the law is simply designed to limit access to abortion. “The reality is that it’s justice by geography. Abortion is legal in this country.”

At a rally on Friday at the Iowa State Capitol, Suzanna de Baca, president and CEO of Planned Parenthood of the Heartland, said that the organization would file a lawsuit against the governor if she signed the bill. The organization tweeted, “We will fight like hell with everything we have.”

The American Civil Liberties Union also announced plans to sue with Planned Parenthood Action Fund.

Reynolds knew that her signature would be incendiary. “I understand and anticipate that this will likely be challenged in court, and that courts may even put a hold on the law until it reaches the Supreme Court,” she said in the statement. “However, this is bigger than just a law. This is about life. I am not going to back down from who I am or what I believe in.”

According to Planned Parenthood, the law will not go into effect until July 1, “and that is only if the courts don’t intervene first.”

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NASA InSight Kicks Off 6-Month Journey To Mars

The Atlas V rocket carrying the Mars InSight lander launches from Vandenberg Air Force Base, as seen from the San Gabriel Mountains more than 100 miles away, on Saturday morning. The InSight probe is the first NASA lander designed entirely to study the deep interior structure of Mars.

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NASA’s InSight lander is on its way to Mars, after a successful launch on Saturday morning.

The lander was launched by an Atlas V rocket taking off from Vandenberg Air Force Base in California shortly after 4 a.m. local time. It successfully separated from the upper stage more than an hour later.

The lander is in contact with mission control as it heads off on its six-month trip to the Red Planet.

I’m on my own now. Separation from the upper stage of my #AtlasV rocket is confirmed. This marks the beginning of my 6-month journey to #Mars. See launch blog: https://t.co/50dnoQSHB8pic.twitter.com/aQjGnvUvAc

— NASAInSight (@NASAInSight) May 5, 2018

Two CubeSats, or miniature satellites about the size of a briefcase, were launched by the same rocket, basically hitching a ride with the Insight. They are now traveling independently toward Mars, and will attempt to monitor Insight’s landing. If successful, they’ll be the first interplanetary CubeSats ever deployed by NASA.

As NPR’s Joe Palca reported Friday, InSight is a lander — not a rover — meaning it will stay put on Mars as it carries out “an $813.8 million mission to study the interior of the Red Planet”:

“Recent Mars missions have snapped pictures of the surface, studied rocks, dug in the dirt and looked for signs that water once flowed on Mars. But as Insight’s principal investigator William “Bruce” Banerdt sees it, that’s just scratching the surface.

” ‘Ninety-nine-point-nine percent of this planet has never been observed before,’ Banerdt says. ‘And we’re going to go and observe it with our seismometer and with our heat flow probe for the very first time.’

“The heat flow probe is basically a 16-foot long thermometer that Insight will pound into the planet to take its temperature.

“InSight’s seismometer will measure earthquakes — or more properly, ‘Marsquakes.’ Quakes on Mars don’t happen as frequently as they do on Earth, but they do occur and have been detected by previous Mars landers.”

Joe notes that many fundamental facts about the Earth’s interior were unknown to scientists as recently as 100 years ago.

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Telemedicine Takes Transgender Care Beyond The City

Telemedicine is helping transgender populations in rural areas receive health care.

Janice Chang for NPR

At an outpatient lab in Tifton, Ga., where Karen Williams gets her blood drawn, a clerk looked from her computer screen to Williams’ printed lab order, then back again.

“This is not right,” the clerk said, squinting at the lab order. There, the birthdate and address matched the ones on the screen, but the name displayed was a male one.

A transgender woman, Williams lived as a man for nearly 50 years before beginning to make physical changes several years ago. She’s grown out her hair and has gotten most of an old goatee lasered off. One of the things that hasn’t changed, however, is her legal name – so in most health care situations, she usually uses her old name and driver’s license.

The clerk looked at the computer again. Williams took a deep breath.

“Does it say ‘Karen Williams?’ ” she asked the clerk.

The clerk nodded.

“That’s me,” Williams said.

For many transgender people, moments like this, when a health care worker first becomes aware of their gender identity, are often fraught with fear and anxiety.

Ten percent of transgender people said they had been personally discriminated against when going to a doctor or health clinic, according to a 2017 poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. And 22 percent of transgender people say they have avoided a doctor or seeking health care out of concern that they would be discriminated against.

Many fear discrimination will increase with strengthened protections for doctors and nurses refusing to provide certain care on religious grounds. The more care refusals transgender people experience, the less care they seek, and the higher their rates of preventable and treatable conditions, including cancers, mental health problems, and substance-use disorders.

In rural areas, doctors and nurses competent in transgender care are few and far between. It can also be a challenge to find providers who offer respectful care for medical issues unrelated to gender identity.

Remote medical consultation by videoconference is one possible solution.

Williams has a primary care doctor at a family practice in town, where framed Bible verses hang on the wall and Christian music plays in the waiting area. When she felt ready to begin taking hormones for gender transition, she didn’t bother asking her local doctor. Instead, she made an appointment with Dr. Izzy Lowell, a family practitioner who specializes in caring for transgender and gender non-conforming people. But Lowell is based in Atlanta, a three-hour drive away.

Getting to the appointment took some doing. Williams teaches fifth grade and is the primary caregiver for her disabled 32-year-old son. She scheduled the appointment over her school’s spring break and arranged for care for her son during her trip.

After all the effort to get to her first visit, she was initially taken aback when Lowell informed her she would soon be scaling back her brick-and-mortar practice to focus on telemedicine. Williamscamearound to the advantages fairly quickly. “I know lots of people in rural areas, like me, where they don’t have any doctor who remotely knows anything about transgender care,” she said.

It’s those patients Lowell had in mind when she opened QMed in the late summer of 2017. The practice offers care exclusively to transgender and gender nonconforming patients in the southeastern United States. Lowell’s intent was to lower the barrier to access for adults and adolescents living in rural parts of the region. In less than a year, she’s been able to do that, with only occasional hiccups.

Williams, for instance, no longer has to plan weeks in advance for her visits with Lowell. They are now as close as her nearest webcam – at least, in theory. During Williams’ last appointment, Lowell’s videoconferencing software was uncooperative, and they had to make do with a phone call. But that was the exception.

Typically, patients are able to use the software to choose their preferred name and pronouns before each visit. These often change during gender transition, Lowell says. Patients encounter no one other than Lowell as she assesses sensitive issues like changes in body hair and sexual function from her location in a hip Atlanta neighborhood. Although she could conduct most of her patient care online, about half of her patients still prefer to come to her office.

Because Lowell uses headphones during video visits, patients’ voices aren’t audible in the room. But for an extra layer of privacy, and for the patients who still choose to come in person, Lowell keeps white noise machines in the waiting room she shares with another small business.

Before first visiting Lowell in her old office, Williams mentally prepared herself to endure being called “mister” by clinic staff and being stared at by others in the waiting room. The one-on-one contact of the virtual office eliminates that familiar dread.

“That is one of the beauties of telehealth,” says Mei Kwong, executive director of the California-based Center for Connected Health Policy. In communities where everybody knows each other’s business, she says, telemedicine adds a level of confidentiality that is particularly beneficial to people with potentially stigmatizing conditions.

Telemedicine also reduces travel costs related to health care for people in rural areas.

In a study of rural sexual and gender minorities, 14 percent of transgender people reported traveling more than an hour to see their primary care provider – not necessarily the doctor who provided gender-related care. And in a 2017 survey by the Center for American Progress, 30 percent of transgender people living outside metro areas said it would be very difficult or impossible to find an alternative to their existing provider.

Rural transgender people aren’t alone in struggling to get health care. In the U.S., many rural households suffer from lower rates of health insurance coverage, shortages of doctors and nurses and low access to the private or public transportation necessary to get to a health care facility. But for transgender people, those challenges are exacerbated due to increased vulnerability to unemployment and poverty, says Laura Durso, who helped lead the Center for American Progress survey.

While telemedicine could give rural Americans a bridge to better health care, there’s a catch. Nearly 30 percent of rural dwellers in America don’t have access to broadband Internet service, a necessity for telemedicine to work well.

Underpowered Internet service can discourage health care providers from offering telemedicine services, says Kwong. Many state laws and insurance policies don’t regard audio-only interactions as telehealth, so if a video connection fails, as Williams’ did, the provider can’t bill for the visit.

As it is, insurance reimbursement for telemedicine services is often so low that many telemedicine providers struggle to break even, says Kwong. Analyses of 2013 data collected by the Health Care Cost Institute suggest that, on average, private insurers pay for telemedicine services at rates about 30 to 40 percent lower than for the same services provided face-to-face. Kwong says many providers are motivated more by altruism than profit: “They do it because this is the only way they can get those services to their community.”

Lowell is lucky to live in one of 32 states with a telemedicine parity law, which mandates that private insurance companies pay her as much for a telemedicine visit as they would for a face-to-face visit.

Less than a year into her practice, she is almost breaking even, and is near the point of covering her startup expenses from 2017.

While she bears the significant administrative burdens of an independent practice by herself, the occasional headache is worthwhile because providing access is so important. “The current system is not at all fair to transgender people,” she wrote in an email, “and I don’t like unfairness.”

Williams has been fortunate. Much of her care with Lowell is covered by insurance. And she has been pleasantly surprised by the reactions of health care workers to whom she’s disclosed her status. Back at the outpatient lab, when she explained to the confused clerk that she was in the process of transitioning, she got an unexpected response.

“That’s awesome,” said the clerk. “This is awesome. So, which name do you want to use?”


Keren Landman, a practicing physician and writer based in Atlanta, covers topics in medicine and public health.Reporting for this project was supported in part by a grant from the Solutions Journalism Network.

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Fresh Air Weekend: Comic Michelle Wolf; Journalist Alex Wagner's 'Futureface'

Michelle Wolf says the title of her HBO special, Nice Lady, was inspired by real life: “For the longest time … I thought that’s how I was supposed to be. I thought I was just supposed to be nice and pleasant — and then I realized that’s no fun.”

Tasos Katopodis/Getty Images for Netflix

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Tasos Katopodis/Getty Images for Netflix

Fresh Air Weekend highlights some of the best interviews and reviews from past weeks, and new program elements specially paced for weekends. Our weekend show emphasizes interviews with writers, filmmakers, actors and musicians, and often includes excerpts from live in-studio concerts. This week:

Comic Michelle Wolf Responds To Backlash: ‘I’m Glad I Stuck To My Guns’: Though critics argued that the comedian’s barbed monologue at Saturday’s White House Correspondents’ Dinner was too pointed, Wolf stands by her set: “I wouldn’t change a single word.”

A Journalist Seeks Out Her Roots, But Finds Few Answers In The Soil: Alex Wagner says the birth of her son made her want to learn more about her heritage. “I wanted to tell my son a story that was true,” she says. Wagner chronicles her journey in Futureface.

You can listen to the original interviews here:

Comic Michelle Wolf Responds To Backlash: ‘I’m Glad I Stuck To My Guns’

A Journalist Seeks Out Her Roots, But Finds Few Answers In The Soil:

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Philippine Lawyer Faces Death Threats After Filing Case At The Hague Against Duterte

Jude Sabio displays the communication he submitted to the International Criminal Court. He says he felt it was his duty to bring President Duterte’s war on drugs to the attention of prosecutors.

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Philippine lawyer Jude Sabio doesn’t get out much these days — not after he accused his country’s enormously popular president, Rodrigo Duterte, of crimes against humanity at the International Criminal Court in The Hague.

“Nowadays I do not go out so much in public places,” Sabio says. “Specifically, I’m afraid that I’ll be killed at any time. Somebody will be just coming and pump a bullet into my head.”

The stocky Sabio, 51, says he’s received numerous death threats since he filed a complaint against Duterte with the ICC in April 2017. Individuals are able to bring crimes to the attention of the ICC’s prosecutor, who can then choose to investigate.

Even more threats have come since ICC Prosecutor Fatou Bensouda announced in February that her office had started a “preliminary examination” based on Sabio’s complaint.

“I would say that I am being viewed now as the foremost villain in the country because I had the guts and the courage to file a case against the president in the ICC,” Sabio says.

Sabio is living in Manila and has for more than a year. He can’t go back to his home in Mindanao, he says, because he’s afraid he’ll be more vulnerable there.

Human rights groups say Duterte’s war on drugs has left more than 12,000 dead since it began a few months after his election in 2016 — many attributed to so-called extrajudicial killings that Duterte’s critics say he encouraged. The president denies he encouraged police or vigilantes to carry out any extrajudicial killings, though some of his other public statements seem to contradict this.

And Duterte was initially dismissive of the case Sabio filed. Until the ICC accepted the case, that is.

“I felt elated and vindicated,” Sabio says, “because many critics said that the case would just be thrown into the garbage. And in fact, [the ICC] announced a preliminary investigation in record time.”

A month later, Duterte announced that the Philippines was withdrawing from the ICC. But rights experts noted that the withdrawal process takes a year and the Philippines can still be prosecuted for international crimes that took place while it was an ICC member.

“I view that behavior of the president as an indication of his fear of the ICC,” Sabio says. “He fears the ICC because he knows he is guilty of what he has done.”

Sabio admits he’s an unlikely candidate to bring such a high-profile case. “I would just like to emphasize that I was not a human rights lawyer in the usual sense of the term,” he says. “No, I was just a litigation lawyer or a court litigation lawyer for a long time since I graduated from the UP [University of the Philippines] College of Law. I handle the ordinary cases, but I thought to myself that in handling these ordinary cases I would be prepared for something big in the future.”

So how did a low-profile litigator become involved in the case against Duterte in the first place? Blind luck and a bad ticker, Sabio says.

“I underwent angioplasty in June 2016, and while I was recuperating from my angioplasty, I heard about Edgar Matobato,” he explains. “And I believed in the testimony of Edgar Matobato.”

Matobato was a self-described hit man for the so-called Davao Death Squad, which he says operated during Duterte’s more than two decades as mayor of Davao City. Matobato testified before the Philippine Senate along with former Davao policeman Arturo Lascañas about their involvement in the death squad.

When Sabio heard that Matobato had no lawyer, he volunteered. The testimony of Matobato and Lascañas became the basis of Sabio’s complaint to the ICC.

“Based on the testimony of Edgar Matobato and Arturo Lascañas, it is already an established fact that there was a system of death squad killings in Davao City,” Sabio says. “And based on the pronouncements of President Duterte when he was still mayor, a presidential candidate and even as president, it’s clear he continued the system in the war on drugs.”

Matobato is now in hiding. Lascañas has fled the country. Sabio says he’s constantly looking over his shoulder.

President Duterte’s spokesman, Harry Roque, a former human rights lawyer, declined to comment for this story, but in the past has called the ICC complaint the work of “domestic enemies of the state.”

Duterte’s supporters dismiss Sabio as a political stooge, a front man for one of Duterte’s detractors, Sen. Antonio Trillanes IV. Sabio angrily denies the accusation.

“I went to the ICC as an independent lawyer, practicing law on my own,” Sabio says. “It just so happens that Sen. Trillanes and I have the same conviction. But it doesn’t mean that I am a lackey or I’m a puppet of Sen. Trillanes. I’m not.”

But Sabio says he is scared. And broke. He still hasn’t paid off his heart operation from 2016, and his work is suffering as he tries to maintain a low profile. Even so, he says he has no regrets.

“I’m doing this because this is the right thing to do,” he says. “And the only way that we can achieve justice against the president is to bring this to the ICC, because there is no way that this can be done in the country right now.”

It’s a long shot. The ICC has received thousands of complaints since its inception. Fewer than a dozen have gone to trial.

Sabio doesn’t care. He thinks this one will. And when it does, he says, he’s confident President Duterte will be found guilty of crimes against humanity.

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