The US midterms: protest voting or conservative revival?

What can we expect from today’s election results?

It's been a long and a noisy election – and today, as voters across America go to the polls, there's been no let-up in the campaigning, from rallies to radio phone-ins and those incessent negative ads. Only Delaware was spared a 30-minute ad from the Tea Party darling Christine O'Donnell: her team left it too late to buy network airtime, and the public access channel that was supposed to run it just plain "forgot". Twice.

President Obama, who's been staying put in the White House since the weekend, called in to four radio shows and taped an interview for American Idol's Ryan Seacrest, hoping to boost Democratic turnout in a handful of key battleground states.

In his place, out on the ground, Michelle Obama has been stumping alongside the embattled Senate majority leader, Harry Reid, in Nevada, pleading with voters to be patient about the pace of change, before heading to Pennsylvania to lend support to Rep Joe Sestak in his tight Senate race.

And Bill Clinton, who seems to have been everywhere in the past few weeks, was back in Florida – in case the Democrats' Alex Sink can slip through in a two-way Republican fight.

But – unless all the polls are suddenly proven wrong, and barring any last-minute surprises – today's election looks like producing the worst results for the Democrats in at least 60 years.

Some pundits have cautioned that this may not turn out to be the expected Republican rout – but according to the latest Gallup poll of 1,539 likely voters, the GOP has built up a 15-point lead.

The survey predicts Republican control of the House of Representatives is "highly likely" – the party needs 39 seats to take over, and Gallup says the party's gains could be "anywhere from 60 seats on up". Thirty-seven seats in the Senate are up for election this year: Rasmussen Reports predicts that the Republicans will pick up 25 of these – not enough to take control of the upper house – but GOP leaders are already talking confidently of "finishing the job" in 2012.

Dozens of races are considered too close to call. Some early signs could come from the first polls to close tonight – with key races in Virginia, Pennsylvania and New York pointing to the size of the Republican sweep, though it'll be several hours before the outcome of some crucial seats is clear.

There are plenty of senior Democrats in danger – not Reid, who's neck-and-neck with the Tea Party's Sharron Angle in Nevada – but even Massachusetts Rep Barney Frank, who is facing an unexpectedly tough fight. Another surprise upset could come in Arizona, where the staunchly liberal Raul Grijalva could fall to the 28-year-old rocket scientist and Christian conservative Ruth McClung, whose mother is running her campaign.

And six Democratic governors are at risk, too vulnerable to the white working-class voters who probably backed Hillary Clinton in the presidential primaries, and who now seem likely to switch parties altogether – or simply stay at home.

It's all such a far cry from the euphoria that overwhelmed Washington just two years ago: the queues of excited people who waited hours to cast their vote, the sense of belonging, of making a difference, of a moment in history.

But if the people clamoured for change back in 2008, they're demanding it again now – albeit change of a rather different kind.

Now the grind of hardship, their uncertainty about their jobs, the fragility of their trust in Washington to make it all better – all of this has turned people against the man who once promised so much, and who is now slated (fairly or not) for delivering so little.

Part of this backlash is only to be expected: in times of economic troubles, the party in control gets the blame. And history shows that not only does America expect to have a divided government, in which a different party controls the White House and Congress – most people actively prefer it.

Many independent voters, suggests the pollster Mark Penn, are planning to vote Republican today to achieve just that, a sign that they are "extremely dissatisfied" with what this particular Congress has been doing. Never mind Obama's approval ratings – take a look at how unpopular the pols on Capitol Hill have become. It ain't pretty.

So, rather than some kind of mass conversion towards conservative values, we could view this as a vote against the guys who happened to be in charge during the most challenging economic crisis in living memory.

But the president must take the blame for this much at least: the gaping "enthusiasm gap" that means so many Democratic supporters simply won't bother to show up at the polls. Whether it's been a mixed message, an elitist message, or no clear message at all, Obama has signally failed to sell his agenda to the nation. The man whose own personal narrative was so compelling has consigned his first two years in office to narrative oblivion.

Instead, the wider story of this election has yet to emerge. What has been the real impact of the Tea Party – and how big will its future influence be? How quickly can the Democratic Party – and the president – regroup and recover? And, after all those billions of dollars spent, did money persuade that many people to change how they voted?

All of these questions are waiting for answers. Not least for those planning the next election campaign – the race for 2012.

Felicity Spector is chief writer and US politics expert for Channel 4 News.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear