Last week, Brandon Bernard was denied clemency by the Trump administration and executed, despite significant public and bipartisan support for him to be exonerated from the death penalty. My heart breaks for him, his family, for the soul of our country. 

In seeing the outpour of support for Brandon Bernard and reading the coverage of the case, I was struck by how much public opinion on the death penalty has changed. In this essay by Sister Helen Prejean, an advocate and activist against the death penalty, she shares a Gallup poll that show 80% of Americans approved of the death penalty in 1993, and, by 2019, only 56% of Americans approved. One reason for this is that we, as a society, have learned that the death penalty is ineffective: we make mistakes (1 in 9 executions have been exonerated), it’s expensive, and it doesn’t actually deter heinous crimes. Another reason, which I believe is even more critical, is that our shared consciousness of law, order, and mercy has shifted, thanks to the great work of people like Sister Helen Prejean and Bryan Stevenson.

While the narrative has changed, it still hasn’t changed enough. In the coverage of Brandon’s case, the pitch for clemency is centered on respectability. He wasn’t really involved in the crime. He was forced to participate as a low-level gang member. And he was an outstanding citizen during the 21 years that he was in prison. Ultimately, Brandon had a “feel-good” story that made a strong, compelling case for his clemency. But I found myself wishing for the coverage to be more nuanced and to push us more as a society. His story, in some ways, was an easy story for many of us to digest. There are others that sit on Death Row with cases that won’t as easily appeal to our sympathy and our sense of mercy; they may make us deeply afraid and feel a primal desire for law, order, and justice.

Clinging to the feel-good story feels myopic. How do we go beyond these stories as a culture? How do we go beyond these stories in ourselves? The stories that only appeal to our comforts? 

If we don’t go beyond the easy stories, we will only have a very narrow aperture to see the world around us. We will not be able to see the hard truths to confront the entrenched flaws in our system. And we allow for heinous policies like the death penalty to continue. This is a failure of our society when such laws only impact the most vulnerable in our society: everyone on Death Row is poor, and 54% of those on Death Row are Black or Brown. With the research of Robert Sapolsky and others on the impact of poverty and inequality on brain development and our abilities to make decisions, other research on childhood trauma that shows similar impact, there’s a stronger case than ever for mercy. And ultimately, I find myself coming back to these explanations not mattering at all; no crime justifies execution.

From the op-ed linked above by Sister Helen: “Such horrific crimes make our blood run cold, and within us a righteous voice rises: These killers deserve to die. But here’s the inscrutable part of these life-and-death decisions. Prosecutors and juries must also consider mitigating circumstances that may move the jury to choose mercy. Each of the people awaiting death […] is a person — one whose life story cries out for mercy.” 

I went down a rabbit hole of research to understand the skyrocketing costs of insulin after reading this op-ed in the New York Times. Written by Dr. Danielle Ofri, a practicing physician at Bellevue Hospital in New York, she begins the piece by walking through the dizzying experience of managing her patient’s insulin for Type-1 diabetes: near-constant changes on what is covered, and how much is covered. As a result, her patient’s out-of-pockets expenses changed month to month, making it difficult for the patient to budget on a fixed income. This doctor was willing to go above and beyond to work with the pharmacist to figure out what was going on. Sadly, they had little success, and it struck me how few patients have advocates like Dr. Ofri on their end.

In my research, I felt the same dizzying experience as I navigated the pharma value chain, generics, drug patents, and the system of rebates and coupons that pharma manufacturers, distributors, PBMs and insurers play with to get drugs covered and drive up costs. All of this, at the devastating expense of their patients: people unable to pay the $1,000+ a month for their medication, people missing doses, people rationing their doses, and the black market, from people donating their doses once a loved one has passed away to people seeking alternative providers beyond our borders.

This research also led me to reflect on a company I recently reviewed. The company wanted to help low-income consumers access drugs at a more affordable cost, and a big piece of its model was using this system of rebates and coupons. That sounds promising at first glance, right? Lowering the cost of drugs means it’s more accessible, and then improved adherence, then improved health outcomes. But maybe not: the story behind insulin was a reminder of how some fixes can cover up the underlying dynamics that created these unjust systems in the first place. And exploiting a loophole (or something broken) here may mean something else must break down in another part of the system. Someone always pays. Sadly, it seems like it’s usually the consumer that has the least power in the system.

Also, related, I’m currently reading Elizabeth Rosenthal’s amazing An American Sickness. I don’t know why it took me so long to pick the book up, but I highly recommend if you’re interested in or working in healthcare.

I just spent an eye-opening ten days in Vietnam, filled with overwhelming amounts of food, tropical fruit, and great conversation.

I went in knowing that Vietnam was one of the fastest growing economies in the world.  And Vietnam’s middle and upper class were enjoying everyday evidence of this, from pizza to craft beer, while new skyscraper developments scattered across Saigon’s skyline. I also knew the other side of the story: one party rule, corruption, repression, and inequality.

But knowing is not as powerful as seeing, and I found myself startled by the poignant signs of unequal growth. Through out the entire trip, this feeling gnawed at me, and I struggled to articulate the current that ran through my reflections.

I found my first clue to make sense of this tension in re-reading Barack Obama’s extraordinary Dreams from My Father. He writes of his Indonesian stepfather’s sudden change in disposition when the family moved to Indonesia (bolded emphasis my own):

“Power. The word fixed in my mother’s mind like a curse. In America, it had generally remained hidden from view until you dug beneath the surface of things; until you visited an Indian reservation or spoke to a black person whose trust you had earned. But here power was undisguised, indiscriminate, naked, always fresh in memory. Power had taken Lolo and yanked him back in line just when he thought he’d escape, making him feel its weight, letting him know that his life wasn’t his own. That’s how things were; you couldn’t change it, you could just live by the rules, so simple once you learned them. And so Lolo had made his peace with power, learned the wisdom of forgetting…”

I’m flooded with reactions, but I’ll let this clue (and the others I’m finding) marinate for now and report back. Hold me accountable to it.

Some contextual reads, if you’re interested:

• Vietnam is a Frontier Market for Good Reason (Bloomberg)
• Even it Up: How to Tackle Inequality in Vietnam (Oxfam International)
• Trọng tâm đặc biệt về bất bình đẳng ở Việt Nam (World Bank)

And a few current-ish events to know:

• Vietnam under the microscope: Its prospects for a startup future (Tech in Asia)
• Blockchain Technology in Vietnam: Becoming a Global Leader? (Vietcetera)
• Timeline of Vietnam’s Dissident Crackdown (Radio Free Asia)
• Six Vietnamese Activists Sentenced to Sixty Six Years in Prison (Loa)
• New Cybersecurity law a devastating blow for freedom of expression (Amnesty International)

In April, I spoke at Utopia’s San Francisco studio opening.

Utopia is an urban design and innovation firm that looks to re-imagine slums, and to develop tools to help people design their own city. A group of us were asked to speak about considerations in city design and beyond, and we had the opportunity to openly interpret this prompt:

• Barry Pousman (Institute for the Future) shared the narrative power of VR to start movements and raise philanthropy
• Karen Mok (Citizens Advisory Council of the SF Grants for the Arts) talked about the frictions in public arts funding, and why it’s important to invest in a vibrant arts community and cultural policy
• Lance Cassidy (DXLabs, Singularity U) shared his work at DXLabs, and how they’re enabling people and companies to consider and design for the distant future

I shared something very close to my heart: my community in San Jose. And the economic arrangements that we created to survive and to build our lives.

Slide from my talk: my favorite tofu house in San Jose, with prices that have not risen to match inflation or the rising cost of living in the Bay Area

Like other refugees that immigrated to the United States after the Vietnam war, my parents didn’t have much when they arrived. They slowly built a life for themselves and their families, and I credit much of this to our community and the informal economy we created to make ends meet. What does that mean? Rather than transact in cold hard cash, we traded in goodwill and services. Together, we bootstrapped toward a more tolerable quality of life. 

For example, I damaged my car in an accident and the local mechanic effectively fixed that car for free because my mom helped his son find a job. I was fresh out of college, I had student loans, and I would’ve otherwise wiped out my savings. I’m not unique: 44% of Americans are unable to cover a $400 emergency expense out of pocket.

Another example: my uncle – a doctor in the community – gives free health advice. In return, his patients share what they can. We get the sweetest, most mouthwatering oranges from one of his patients.  This is a compelling arrangement when you compare it against the exorbitant cost of being healthy and well in our country.

Certainly, the informal economy also allows for bad actors. You don’t have to look hard to find the hundreds of vulnerable domestic workers that are unseen by our society.

But in the best way, our informal economy acted as a de-facto social safety net that we, the people, built. A safety net of our own design.

So my case to the room:

• How might we consider the informal economy in our design, while providing the necessary social protections?
• How do we create space and policy that reflect and enhance dynamics of these arrangements?

SiR— Something Foreign ft. ScHoolboy Q

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It’s devastating that the Trump Administration is ending Temporary Protected Status for the 200,000 people who migrated to the U.S. after the 2001 earthquakes in El Salvador.  These Salvadorans must now leave the home they’ve known for nearly two decades, where they’ve had families, developed community ties, and contributed to our economy by working, starting small businesses, and paying taxes. As I woke up to the announcement this morning, I was reminded of the half-baked foreign and immigration policies between the U.S. and El Salvador in the 80s/90s—and the longstanding impact these policies have had on our country and beyond.

The first wave of Salvadorans entered the U.S. in the early 80s, seeking asylum from the Civil War between the military-led government and left-wing guerillas. This was a war that the United States actively supported via monetary and military aid to a government that committed scores of human rights offenses to stay in power. In its post-war report, the U.N. found that “more than 85 percent of the killings, kidnappings, and torture had been the work of government forces, which included paramilitaries, death squads, and army units trained by the United States.”

Many asylum seekers settled in Los Angeles, where they encountered the poverty of South Central and brutality of Black and Mexican street gangs. In response, Salvadorans banded together to form the violent MS-13 and Barrio 18. Against the backdrop of race-related gang violence was also the beginning of the Crack Epidemic, and Los Angeles saw a 50% increase in gang-related homicides during this time. Gang members began filling up California prisons, and non-US citizens were deported back to their home country.  For Salvadorans, El Salvador had just signed the Peace Treaty in 1992. The country was still rebuilding itself after the war. Without the infrastructure to support these deportees, the gang members of South Central returned to continue their reign of violence.

This violence still continues to plague the country today. San Salvador is one of the most dangerous cities in the world, where, in lieu of other opportunities, gang members rely on extortion and violence to make ends meet. Returning to El Salvador could be a death sentence for Salvadorans on the Temporary Protected Status. It’s also unlikely El Salvador will have the infrastructure to support this large influx of people. That’s 200,000 re-entering a small country of 6.4 million people.

When I shared the news with a friend, he responded: “Well, it’s a temporary protection. It’s not like they can stay here forever. What’s our responsibility?” In an imaginary world where the impact and consequences of our actions are neatly confined to our corner of the universe, and our corner only—um, sure, maybe. We wipe our hands clean and call it a day. However, with El Salvador, there is a very clear link between our actions and policies and what El Salvador looks like today. We are very much responsible. And today, our country chooses again to enact haphazard policies that may have irrevocable, devastating impact on Salvadoran communities here and abroad. And we are also responsible for what happens next.

In the case of El Salvador, the events are a bit more linear, closer to home, the timeline is shorter, and the impact is tangible. We’re afforded a tighter aperture to judge our actions, and it’s easier to connect the dots if you have the facts and do a little digging. That’s not always the case in other situations, and our complicated history is riddled with secrets and sins. Like say, compared to trying to comprehend what happened/is happening in Syria and the Middle East (but hey, this is a good start if you’re interested). It’s hard to sit down and parse out the nuance. Personally for me and my little pea brain, I often can’t find the mental space or emotional energy.

So what if, instead, we broke away from the minutia of figuring out who’s responsible for what and whom? What if we just flipped our mental model of how we should interact with the world beyond our borders? Start with: it’s always our responsibility. There are no borders. (Quick aside: being borderless could be our country’s ultimate reparation.) Let’s start from a blank slate on how the world could look. Perhaps then, we can begin thinking creatively about what comes next.

I’m very hopeful that what comes next is a more prosperous, inclusive world.