Fifth Street

October 1, 2020

In this issue: My Showgirls Theory | Health Information Exchange | Rediscovering Black Literature | Barrick's Transformation | Media Sommelier

SHOWGIRLS IS BAD. This is close to a universally accepted truth. A lot has been written about how and why Paul Verhoeven’s 1995 stripper saga is bad. Some say it’s simply astoundingly bad; some argue its badness is a species of exotic camp worthy of cult-movie status; others make the case that the film is a satire whose badness is part of its stinging commentary.

I’ve never found these statements satisfactory. They certainly describe the range of possible intentions behind the film’s badness, but, to me, they fail to sufficiently account for Showgirls’ uniquely uncanny and often nonsensical badness. The apparent badness of Showgirls is exceptional in how it seems to wildly overshoot the rhetorical aims of camp or satire. If you’ve seen the movie, you know what I mean. Showgirls has a charged, glossy cheapness to it, and there’s a strenuous, hyperbolic quality to the dialogue and acting that suggests the lurking presence of a Potemkin facade. It’s so overwrought with a fugitive … something.

I think I finally understand what it is. To mark the 25th anniversary of the film’s release, I propose a new theory that explains Showgirls. My theory determines that Showgirls is bad because it’s actually really good. Admittedly, my theory is insane.

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Showgirls is a work of science fiction. Protagonist Nomi Malone — ostensibly a drifter with a mysterious past who winds up in Vegas — is a robot. Specifically, she is an advanced prototype of a sentient android whose misadventures in Las Vegas are part of an open-ended beta test. On a general level, the foamy drama and histrionic tics of Showgirls are much more legible, coherent, satisfying, and even pleasing when you think about the movie in this theoretical framework. On a more granular level, this theory, I hope, offers cogent explanations for the film’s many baffling — and sometimes even surreal — scenes.

Consider just a few of Nomi’s most celebrated (read: ridiculed) moments that suggest not overacting or bad directing but, instead, the unsubtle operations of a machine consciousness: Nomi violently flailing like a malfunctioning droid in the pool sex scene with Zack Carey (Kyle MacLachlan); or her precisely (algorithmically?) naive mispronunciation of “Versace” as “Ver-SAYS”; or her whipping out a switchblade with almost heartbreakingly radiant, theatrical menace on the rando with the Elvis mullet who gives her a ride into Vegas at the beginning of the film — a rando who, I should point out, conveniently picks her up at film’s end to whisk her away … hmm … as though he’s in charge of Nomi-bot’s initial deployment and post-mission debriefing. It’s one of Showgirls’ many ridiculous coincidences that, according to my theory, are actually ridiculously intentional.

The film is notoriously rife with scenes that are stunningly awkward, and involve such improbable character interactions that they make the best sense with the Nomi Malone robot theory. Take, for example, Nomi’s tête-à-tête with her dance rival Cristal Connors over a champagne lunch at Spago. It ostensibly aims to be a scene smoldering with arch, mutual fascination, envy, and a kind of erotic gamesmanship. That is, until their conversation about dancers’ diets leads to Cristal confessing, “I used to eat dog food … I used to love doggy chow.” To which Nomi says brightly, “I used to love doggy chow too! ” — while eerily mirroring Cristal’s movements (warning: language):

Sure, perhaps they were bonding over past poverty or heroin abuse (“dog food” is said to be slang for heroin), but I can’t help but think Cristal’s odd declaration and studious attention to Nomi’s responses suggest that Cristal, among others, is monitoring the android’s behavioral repertoire.

This suffuses the entire film — stilted, florid acting that’s a little too stilted and florid; dialogue so studded with non-sequiturs that conversations play out like some kind of hard-boiled dadaist performance; in every scene, the furtive, knowing glances between Nomi’s friends, rivals, and fellow dancers that glimmer with an awareness of the whole meta of the situation and evoke nothing so much as the bemusement of scientists. Are they marveling over Nomi’s naiveté, Nomi’s boldness, Nomi’s talent? Or are they marveling at a replicant’s emerging sentience and emotional development?

I propose that Nomi Malone’s (no-me, I’m-alone) distinctly primitive, violent range of emotion — childlike glee to glowering rage — is a record of her entrainment to becoming more humanlike. Her human beta-testers, on the other hand — leaning into their roles with swerving momentum as though performing at a theme park — are acting like humans instructed to act like humans for the benefit of a cyborg debutante’s sentimental education. Showgirls is a terrible erotic drama because in actuality it’s really good sci-fi.

I submit as supporting evidence that Showgirls is bookended by a few other notable Paul Verhoeven works that could arguably all be part of the same imagined universe: Robocop (1987), Total Recall (1990), and Starship Troopers (1997).

Showgirls isn’t a latter-day All About Eve. It’s a prequel to Westworld.

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THIS PAST JULY, Ashley Sylvester, a director in UNLV’s advising office, joined the video meeting of Nevada’s Patient Protection Commission to share her story. In May of 2017, she’d given birth to her daughter. She’d had a C-section due to complications during her pregnancy, but they weren’t that serious — certainly not enough to prepare her for what came next.

“I did not feel good, even after hospital release,” she tells Desert Companion. "Other people I talked to who went through the same procedure weren’t experiencing what I was. I lost 40 pounds in three weeks, was ghost-white, my incision kept opening. And my OB-Gyn was kind of dismissing my concerns as normal.”

By 3:30 a.m. June 6, Sylvester was in the ER with a massive pulmonary embolism.

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“I had partial heart failure, post-partum cardiomyopathy, pneumonia, two blood transfusions, and pleurisy,” she says. Eventually her doctors diagnosed her with both anti-phospholipid syndrome, a rare blood clotting disorder, and lupus, but they still aren’t sure why she experiences some of the symptoms she does. She’s under the care of eight specialists, along with primary care providers, lab technicians, radiologists — each with their own electronic health records software, patient portal, app, login, password, and so on.

This is why Sylvester told the Patient Protection Commission her story: to give a clear, if extreme, example of the burden on patients to coordinate sharing their own health information among various providers. Sylvester is constantly updating one doctor on what another one has found or the drugs they’ve prescribed, sending labs or images requested by one physician to others. It’s time-consuming for someone who’s good at self-advocacy, overwhelming for someone who isn’t.

“Cross-care communication would be really good, so that, as patients, it isn’t on us to keep everything updated,” she says. “Chronic illness is so emotionally and mentally taxing. Patients shouldn’t also have to worry that X number of specialists have all your records and labs.”

Michael Gagnon thinks he has the solution to this problem. Gagnon is the executive director of HealtHIE Nevada, a health information exchange, or HIE (hence the “HealtHIE”). He describes an HIE as the medical equivalent of ATM technology in banking, which allows customers from any bank to get their money at any machine. If HealtHIE Nevada were commonly used, Sylvester and her doctors could see her entire medical history in one place; trafficking files among them would be unnecessary.

“You can think of it like any other utility, but for health data,” Gagnon says. “Everyone needs to connect to this thing; there’s only one of them; and we’re going to use it to improve the health of all Nevadans.”

A series of federal regulations in the mid-2000s set up the framework and funding to encourage states to establish HIEs. Though Nevada missed out on much of the funding due to its inability to match grants, it still benefits from the regulations, such as one in 2016’s 21st Century Cures Act that forbids providers from refusing to share health information.

“When you create an organization-based record, it belongs to that organization,” Gagnon says. “They’re not highly motivated to share information with other providers unless you ask.” The law made it mandatory to respond to these requests electronically.

It’s important to distinguish between electronic health records, “EHR” in industry-speak, and health information exchanges. In the ATM analogy, EHR would be each individual bank’s software, while HIE would be the common platform for distributing cash through machines.

Practically speaking, an exchange works by enlisting providers — hospitals, labs, pharmacies, practice groups — to participate. Participating providers send HealtHIE Nevada patient data, and HealtHIE Nevada converts all that disparate information into uniform records in a searchable database. For the service, HealtHIE Nevada charges a fee scaled to each provider’s size, around $300 a year on average.

One catch in Nevada is that healthcare providers need consent to see patients’ records (except for those on Medicaid, which includes default consent). In other words, we’re an opt-in state. So even if your primary care doctor and gynecologist are both in the exchange, neither can see test results or diagnoses from the other unless you’ve given them permission to do so.

One of Gagnon’s goals for 2020 was to lay the groundwork for changing this in the 2021 legislative session. Then came the COVID-19 pandemic and the governor’s public health emergency declaration allowing HIEs to operate under federal rules, which default to opt-out. HealtHIE Nevada was able to open all its patient records for viewing, and it also suspended user fees. Participation surged, increasing the number of patient records viewed from around 4,000 per day to around 9,000, according to Gagnon. Hospital participation in the surge has remained steady, at about 75 percent of the state’s facilities, but provider participation has jumped from 15 percent to 25 percent.

But the emergency’s best outcome, Gagnon believes, has been HealtHIE Nevada’s opportunity to demonstrate the exchange’s value to the overall healthcare system. Imagine having a surge of patients show up at your office or ER during a pandemic and being able to search a universal database for their pre-existing conditions, risk factors, and test results so that you can treat/quarantine them accordingly. HealtHIE Nevada was able to realize that scenario for members such as the Northeaster Nevada Regional Hospital in Elko and the Southern Nevada Health District in Las Vegas.

“The Washoe County Detention Facility was already using (the exchange) for their own purposes, but now they have access to all kinds of information they didn’t have before,” Gagnon says. “They had inmates come in with COVID-19 symptoms, so they’d put them in isolation. Then they used our system to find out whether an inmate had tested at a Nevada public health lab.”

Still, it’s easy to imagine the hurdles in the path of an HIE’s success. The tech company in charge has to develop a program capable of collecting data in myriad formats and converting it to a standard one whose search criteria satisfy the needs of diverse users. It has to persuade health care providers and their EHR vendors that it’s worth the cost and hassle of participating. And it has to persuade patients that their privacy will be protected.

“It does require buy-in up and down the information supply chain,” Gagnon says.

HIEs have faced these challenges in other states, including Vermont, whose HIE Gagnon worked for before moving to Las Vegas three years ago. Amid a struggle to satisfy all its HIE stakeholders, the Vermont board that oversees it hired a health technology consultant to analyze what was going wrong. The contractors studied HIEs nationwide and found Vermont’s problems were nothing new.

“Organizations have attempted to provide for the electronic exchange of digital health information between the clinical systems of non-affiliated providers for almost 30 years, beginning with Community Health Management Systems in the early 1990s,” the report read, quoting an academic study by Joshua R. Vest and Larry Gamm. “These initiatives have consistently faced technical, economic, and political challenges limiting both interoperability and sustainability.”

The solutions the contractor recommended mirror Gagnon’s hopes for HealtHIE Nevada: Create a public-private partnership with a nonprofit fundraising arm to keep it financially viable and a governing board to keep it accountable to participants and the public.

“The idea is to create something that takes it out of the hands of private parties,” he says. “It isn’t going to be owned by Renown or HCA (hospital corporation); it’s a community service. So, it has to be regulated, and the Patient Protection Commission is a perfect body to do that.”

Which brings us back to Ashley Sylvester and her testimony. “I think, like with everything, there are pros and cons to an HIE that patients need to weigh,” she says. “There are security issues. Who has access to my records, and what are they going to do with them? And then there’s the patient education piece that needs to go with it. But at its foundation as a technology that can relieve the burden on patients … it seems like a very big step in the right direction.”

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LAST MONTH WAS supposed to see the rerelease of Tragic Magic, a 1978 novel by Wesley Brown — the first book in a series, from respected publisher McSweeney’s, titled “Of the Diaspora,” which will publish out-of-print and new works of Black literature. Thanks to COVID-19, Tragic Magic won’t come out until February. That hasn’t dampened the enthusiasm of series founder Erica Vital-Lazare, a CSN English professor and stalwart of the Las Vegas literary scene.

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Tragic Magic was championed by the late Toni Morrison, and the second book in the series, Praise Song for the Widow, from 1983, was written by Paule Marshall, whom Vital-Lazare cites as a mentor. (The third volume is a book of photographs by pioneering black photographer Lester Sloane, with text by his daughter, essayist Aisha Sabatini Sloane.) These volumes and the ones to follow are “all tied to the same narrative, of having crossed that treacherous triangle and becoming part of the slave trade — much of Western Civilization is based on that diasporic journey that was not voluntary in any way, but upon which our identity rests,” Vital-Lazare says.

Following are excerpts from a wide-ranging conversation with Vital-Lazare about the series, Black literature and life, the uses of the past, and more.

IT STARTED AT such an intimate level, just myself and my good friend who loves books talking about books. That friend would be Brian Dice, president of McSweeney’s. And we were just doing what we do, we’re talking about books, talking about classic Black works that sometimes fall out of print.

EVERY 20 YEARS or so, generations need to revisit what happened in the past. All the strides of the Civil Rights Movement and the turmoil that my parents and grandparents had to endure in order to be recognized as human, in the ’80s and ’90s we got further and further from wanting to revisit that struggle. We were told you can be anything, do anything, the playing field is now even. Then we get President Obama, which is confirmation. My degrees, the degrees of my sister, my mother working at NASA. All these things are a testament to an equanimity that you strive for, right? That your forbears died for and that you strive for to honor the aspirational philosophy of what it is to be an American, with or without the Black Americanness of it. Then in comes 2016. And Brian and I, talking about works of literature like we do, we’re talking about it after the election, and it had a particular urgency then. Almost like we were sleeping, we were dreaming, and then all of a sudden you’re reminded that there are certain powers that would prefer you not to breathe. And (that) love of this literature became conversations about how much it is needed. The message, the stories, the reminders, the beauty, the humanity, and the Black humanity in those works. We needed to revisit and remember.

“WE HOPE TO have gathered a cross-section of stories that take us back and slingshot us forward.” (Vital-Lazare, on the relationship between past and present, quoted in McSweeney’s promotional material for “Of the Diaspora.”)

THERE’S SANKOFA, the African symbol — “go back and get it,” is what sankofa means. You don’t go back (into history) and hold on. You don’t go back and wallow. You go back and get it.

NOSTALGIA IS A place of captivity. You don’t go back and get it, you go back and plant your flag.

PARTICULARLY AS A Black woman, I see the ways that reinvention is always necessary to survival. And what you really want to be reminded of is the thriving that is the ascendency of just survival.

WHAT I LOVE about these three works is that each of them is about liberating the self at a very personal level. There’s whiteness on the large exterior landscape and the particular ways it has impacted Black life. But in these works you’re looking at how these Black identities are able to reclaim for themselves who they are. That’s something I was very interested in.

THE GREAT IRONY that the works would not exist without the narrative of captivity is something that is very painful to think about, and also something that’s very liberating. Because a whole art form, a whole genre of literature, literature itself, I think — Toni Morrison in one of her essays talks about how white literature would not exist without the tension of Blackness, of otherness to support it. So that’s a lot to contend with. It’s amazing, horrifying, brutal, and lovely.

ONE OF THE most remarkable feelings for me is being able to actually have conversations with Wesley Brown. Whew! To talk to him about his relationship with Toni Morrison. And also with Paule Marshall. To talk to a man who introduced Toni Morrison and Paule Marshall in a joint reading — for me that just tied so many pieces of all the people and all the work that I love. It’s not just about the work between the pages, but the work of building and supporting one another, and Black art and Black life, and to hear (Brown) come back with that was a major gift for me.

WITHOUT SOUNDING too “Ebony and Ivory” about it, the fact that the project came out of the love that my friend and I have for this work, and he’s a white dude in San Francisco, and I’m a Black woman here, and we come from such different identities — and yet we share this love, and from this love and a conversation, this project is born. It’s one thing I’m often struck by.

Excerpts have been edited for length and clarity.

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"IT FEELS SCARY, naughty, and exciting to be making these changes,” Alisha Kerlin, executive director of UNLV’s Barrick Museum of Fine Art, told me in August, from her position deep in the crux of an organizational pivot. The Barrick was still closed then, feeling its way toward a September reopening. Like other museums, like everyone, it had been caught flatfooted by the twin disruptions of COVID-19 and the George Floyd racial-justice movement. The pandemic shutdown deprived it of audiences and resources, while the protests led to staff-wide soul-searching about whom the museum should serve, and how. It was a time of freighted questions —What will the community need when we come back? What will we be uniquely able to provide? — that called for something other than obvious answers.

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As a result, Kerlin and her staff were determined not merely to restore the museum to its prequarantine idea of success, but rather to put this tumult to transformational use — to change for the better. Which explains Kerlin’s giddily mixed emotions. From the museum’s floor plan to its curatorial focus, the Barrick team has speedily and ambitiously rethought their mission in ways that feel new, perhaps a bit risky, but tailored to this tricky moment.

Arts institutions statewide have had to adjust to the new imperatives. The Mob Museum, for instance, tinkered with its operations in ways large and small — reconfiguring exhibits with social distancing in mind, handing out styluses for use with interactive exhibits, converting its Speakeasy distillery to make hand sanitizer. Because its mission has as much to do with law enforcement as the mob, the museum organized a series of community conversations about police reform and the community. President and CEO Jonathan Ullman says the museum is examining its hiring practices at all levels to help ensure equitable representation. Up north, the Nevada Museum of Art moved many of its educational programs online and instituted an advance-ticketing system to better manage crowd sizes.

But the changes at the Barrick have been notably sweeping. Now that it’s reopened, you can pick up on some of this when you visit. Most obviously, the cavernous space has been subdivided (conceptually if not physically) into smaller exhibit areas. On a recent day, a murmur of socially distanced students joined artist Ashley Hairston Doughty in her exhibit in the walled-off center gallery; surrounding that was an expansive selection of the museum’s collection; a third exhibit, a traveling show of Nevada artists, occupied a side gallery.

This multi-show format is the new normal, and represents a significant shift. In recent years, the museum has seen big successes with outsized, gallery-busting spectacles: Axis Mundo, Jubilation Inflation, Sorry for the Mess, and others. These were immersive installations whose appeal was enhanced by their scale.

Those days are gone, at least for the foreseeable future. Practically, this emphasis on smaller shows reflects an honest assessment of what the Barrick will have to work with in a time of economic carnage. “We have the resources we have,” Kerlin sighs. Spectacle-size exhibits cost more.

But what the reconfigured space really does is facilitate a reconfigured mission: Over time, the Barrick’s curatorial focus will shift more toward local artists and local concerns.

This is no small matter for an institution that got a lot of national attention for its role in launching the sprawling Axis Mundo. But now, amid the altered reality of 2020, “bringing in a lot of outside artists doesn’t feel right,” Kerlin says. The city and its perpetually shaky arts scene have been battered hard by COVID’s health, social, and economic realities, with many artists and art-lovers out of work and suffering. So the museum’s team decided it would serve as an invigorated “mid-level exhibition space” for local artists who’ve graduated from emerging-level venues and need a respected place to show more mature work, garner support, and keep their careers moving forward.

None of this, Kerlin adds, should be seen as a diminution of the museum’s ambition. More like a concentration. “You don’t have to fill 5,000 square feet to be groundbreaking,” she says. “The physical space may be smaller, but the impact doesn’t have to be.”

Back to Ashley Hairston Doughty’s center-gallery exhibit. Titled Kept to Myself, it’s the UNLV art professor’s urgent exploration — through fiber arts, video, text, and more — of life as a contemporary Black woman. Throw pillows are printed with catcalls she’s received; diaristic wall texts record her frame of mind at important life moments.

An emphasis on marginalized voices isn’t new to the Barrick — Axis Mundo and Sorry for the Mess brought into the museum aspects of Latinx culture not typically seen in high-art spaces. What is new: Kept to Myself is the first step in a long-term commitment to equity that will see the Barrick partnering with the Las Vegas Womxn of Color Arts Festival to program BIPOC work in the center gallery for the next year.

“If you want to bring more voices into the museum, how do you do that?” Kerlin asks. “One way is, you invite more curators in.”

By revising its own definition of success, reacting to the community’s drastically changing needs, and being willing to share its authority, the Barrick may have hit upon a model useful to other cultural institutions that want to remain relevant in a changing world. Needless to say, so much pivoting in such a short time isn’t easy. “It has been a bit like Tetris,” Kerlin allows. “But the staff has been so connected to this mission and this responsibility that they responded pretty quickly.”

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1. YOU'VE PROBABLY BEEN spending a lot more time at home in the last, oh, feels like forever. Same. Last week, I had this early-era pandemic notion that I’d take advantage of the incidental home time to spark some joy in the lightless, churning void that is my portion of our collective saga by tidying up and Kondo-fying my closets, but I lacked the energy to overcome my sad-based monolithic resting inertia and instead read this interesting literature review that considers whether we should blame the Victorians for our obsession with accumulating stuff. (Alternatively, if you’re a fierce pro-stuff partisan considering redecorating during the pandemic, know that IKEA has digitized and put online 70 years’ worth of its product catalogs.)

2. Language is the original virus. Okay, that’s not true. Viruses are the original virus, and that first line is paraphrased from William S. Burroughs’ The Ticket That Exploded. It also serves as a nice transition to sharing this link to a list of pandemic-inspired neologisms that have emerged to describe our new reality, which can variously be described, depending on your mood and outlook, as a pancession, anthropause, or coronapocalypse.

Oh. In The Ticket That Exploded, Burroughs also wrote: “Always create as many insoluble conflicts as possible and always aggravate existing conflicts.” Hm, sounds eerily like the policy platform of a certain feral, dyskinetic someone who presidential-debated a couple nights ago.

3. I never thought I’d be pointing you to Twitter to bookmark this concise but potent list of well-researched and practicable solutions to systemic police violence, but it's 2020 and I am.

4. In my backyard, I have a bird feeder and a bird bath. I used to just pour seed in the hopper, fill up the bath, and let it be. Lately, however, I’ve been playing amateur ornithologist and sticking around to watch how the different types of birds — sparrows, doves, grackles, pigeons — employ observation and communication to spread the word that dinner and drinks are on. My field notes so far: sparrows usually arrive singly and then dart off to literally tweet the news. Grackles watch cagily from afar but quickly zoom in to take advantage of the fresh water. Doves nervously wait in groups and then arrive and sip like overpolite tourists. Pigeons do a cartoon eyeball-pop with the old-timey horn sound and start a mosh pit. I haven’t seen any proper crows yet, but if they’re as smart as this article makes them out to be, I might just outsource feeding duties. Andrew Kiraly

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Photos and art: Showgirls © UNITED ARTISTS courtesy APL Archive; HealtHIE Nevada illustration by Christopher Smith; Erica Vital-Lazare courtesy; Barrick courtesy

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