The Fractured States of America

The quest to define the true essence of US identity dates back to colonial times, long before the nation itself was formally established. Yet, scholars traditionally situate the first explicit investigation into what constitutes an American citizen in J. Hector St. John de Crèvecœur’s Letters from an American Farmer (1782). The third of the titular letters, aptly named “What is an American,” offers a list of features that de Crèvecœur considered quintessential to Americanness: industry, freedom, individualism, equality, assimilation. All these elements converged in what later became known as American exceptionalism, a doctrine that undergirded (and, to an extent, still undergirds) most, if not all, of US foreign policy. De Crevecoeur’s essay also introduced the concept of the ‘melting pot’ to describe the yearned-for-homogeneity of a nation aspiring to merge the different cultures informing it, rather than to preserve their differences. Ever since, the United States has strived to present a solid front against the rest of the world, returning time and time again to the defining features of its citizens, and to what sets them apart from their European counterparts. Yet, over the past few decades, it has become evident that internal divisions and differences are increasing, rather than decreasing. While the national narrative of the United States insists on advocating the exceptionality of its people, it is also continuously confronted by the hard truth of their lived experiences (Sieber 2005; Hodgson 2009; Grandin 2019; Spragg 2019). A kind of internal splintering is especially noticeable in the polarization of contemporary public discourse and in the way it has exposed a country fractured into factions and bitter divisions across identity lines. Long overdue civil, political, and social rights battles have radicalized most public debates, from racial issues connected to voting rights and disenfranchisement (e.g., the long fight to ensure voting rights to African Americans, from the birth of the NAACP at the beginning of the twentieth century to the recent Fair Fight Action movement) to questions of representation and cultural appropriation (e.g., the debate surrounding Jeanine Cummins’s 2020 novel American Dirt, Scarlett Johansson’s casting as a Japanese character in the 2017 movie Ghost in the Shell, or the controversial use of fashion and hairstyles belonging to different cultures, as in the case of Katy Perry’s performance at the 2013 American Music Awards or Justin Bieber’s latest hair-dos). Furthermore, the United States has always been on the lookout for an enemy that would reinforce its own identity. During the American Frontier expansion, such figure was embodied by Native people living on conquered lands. Later on, a similar antagonistic mechanism was fueled by the animosity against Germany, sparked during the first global conflict and exacerbated during WWII. During the Cold War, the role of the archenemy was then played by the “Commies'' and,after the turn of the century, by “Arab terrorists.” Yet, despite its readiness to intervene on the international military stage and to single out an enemy that could function as its archetypal rival, the United States has also long been fractured by visceral internal fights. More than ever, after the January 6, 2021 attacks on the Capitol, an especially American tradition of domestic violence—spanning from the Civil War to the Civil Rights Movement—has taken center stage, leading to a reckoning that the enemy oftentimes lies within the nation itself. This issue of JAm It! seeks contributions that address how different iterations of real and/or symbolic internal enemies have been generated and represented in US culture. Further, we invite reflections on how, on the level of policy, discourse, and societal dynamics, such internal divisions have been flattened out for the sake of a uniform—rather than united—nation. Finally, to encourage a nuanced and balanced understanding of the topic, we also welcome contributions that highlight how fractures and differences, as well as the very need for a real or imagined internal enemy, have had virtuous outcomes in US history and its formation

Staying Human in the Post-Apocalypse

Naughty Dog's video games The Last of Us (2013) and The Last of Us Part II (2020) stage a complex tale of human drama in post-apocalyptic settings, retrieving several features of the Frontier myth. In this essay, I argue that the characters' narrative arc is a post-apocalyptic, American Frontier tale in which the individual and collective levels clash (as they often do in such stories), generating moral challenges for the characters and, in turn, for the player controlling them. Thus, I set out to analyze how TLOU draws on and subverts some of the traditional tropes and characters belonging to the classic American Frontier tradition, investigating a number of issues related to individualism, collectivism, violence, and selfishness

An Interview with Jenny L. Davis and Four Poems from “Trickster Academy”

An Interview with Jenny L. Davis and Four Poems from “Trickster Academy

Parental Androids

About forty years ago, feminist scholars formulated several independent definitions of an ethics of care (Gilligan 1982; Ruddick 1989; Noddings 1984), suggesting the need to reframe human collective and personal interactions. However, care theory fails for the most part to consider the lived experiences and the needs of marginalized subjects (Gary 2022). This study observes care theory from a linguistic perspective in three audio-visual texts featuring examples of non-normative care. The sci-fi TV series Star Trek: The Next Generation, Battlestar Galactica, and Raised by Wolves will be considered, with a focus on androids acting as caregivers. The linguistic analysis, following a Discourse-Historical Approach (DHA), will focus on discursive strategies relating to the parties involved, their relational ties, care behaviors, and the androids’ adequacy as caretakers. The emerging perspectives may be mapped onto current discourse on minority groups’ access to fostering or adoption and their reproductive rights

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients