Inside the June Issue

If saving your child’s life meant endangering the lives of children in the future, would you do it? The question is a variation on a familiar ethical problem. In the abstract, it’s easy to think in utilitarian terms about the cost of an individual life. But when things get personal, the greater good is nearly impossible to keep in sight. In this issue’s cover story, Helen Ouyang explores how the spread of personal narratives across social media has put pressure on pharmaceutical companies to distribute experimental drugs to dying patients. This practice, known as compassionate use, appears at first to be an unmitigated good: the stories of sick children are heartbreaking, and their need for medicine dire. But the ramifications turn out to be far more complicated. If an experimental drug fails to help someone, its chances of one day being approved by the Food and Drug Administration may be jeopardized, regardless of its actual efficacy. And each person who receives a drug through compassionate use is one less potential research subject for the randomized control trials—the gold standard of drug testing—required by the FDA. “It’s the person right there versus the statistical future people who are only real when you get to that point in time,” the former CEO of a pharmaceutical company tells Ouyang. “But they’re there! What if your loved one is going to be sick in the future, and they’re not going to get the drug?”

A different sort of parental dilemma unfolds in Sonia Faleiro’s Letter from India. One day in early 2013, a migrant laborer named Jagram Gupta returned home to his village on the Indian border of Nepal to find that his three sons had been abducted—an all too common occurrence in India, where an estimated 100,000 children are trafficked each year. Gupta discovered that they’d been put to work in a brick kiln some 370 miles away in Nepal. Faced with a corrupt and apathetic legal system, Gupta decided to take matters into his own hands. “Will I get my children back?” he asked a villager who claimed to have information about his sons. “Yes,” the man replied, “but you’ll have to be resourceful.”

Donald Trump’s win in the Indiana Republican primary has made him the party’s presumptive presidential nominee. It’s an outcome almost no one imagined when the crass Manhattan businessman entered the race last year. In this month’s Report, Paul Wood travels to Trump’s rallies in Florida, New Hampshire, and Iowa to learn why millions of Americans have thrown their support behind a man who called women “dogs,” accused his rival’s father of being involved in the assassination of John F. Kennedy, referred to Mexican immigrants as “rapists,” and advocated banning Muslims from entering the United States. “Many of the people at Trump’s events were looking to escape the circumstances of their lives,” Wood writes. “But they were also looking to Trump for serious answers to their problems.” Take the sixty-year-old supporter who legally changed his name to Donald Trump. Riding around in a black limousine, pushing his leader’s anti-Obama rhetoric, the ersatz Trump’s shadow campaign reflects the darker side of the real Trump’s manic, glittering operation. “All you’re finding is dead Americans all over America,” he tells Wood. “We want somebody who’s going to stop that.”

Also in this issue: Walter Kirn on political predictions; new fiction by Fiona Maazel; new poetry by Rosmarie Waldrop; David Means remembers his old man; Lidija Haas looks at efforts to reimagine love and its labors; Rivka Galchen reflects on the pleasure of FX’s The People v. O. J. Simpson; and Dan Chiasson marvels at Wallace Steven’s poetry of compassionate intellection.