Saveion McConnell and his mother Michelle Washington pose for a picture at Saveion’s 2025 Lee’s Summit North High School graduation
In the last minutes of his life, Saveion McConnell was struck by a sheriff’s patrol car, got up off the pavement, kept running, and was shot to death beside a Missouri highway. He was nineteen years old. He was unarmed. No weapon was found on him, near him, or anywhere at the scene. The state has confirmed every one of those facts itself.
More than a month later, no agency has accused him of a single crime, because there was never anything to accuse him of. And the agency investigating his killing, the Missouri State Highway Patrol, says it holds body camera footage that justifies all of it, footage it will not release and will not describe.
“Saveion should be alive today,” said Joshua Levin, the senior attorney at the national civil rights firm Romanucci & Blandin, announcing the firm’s investigation into the killing. The deputy, in Levin’s words, used his police car as a weapon moments before shooting to death an unarmed teenager who posed no threat that could justify deadly force. The firm calls it “completely unjustified.”
There is a strong chance you are reading his name here for the first time. That is not an accident of your attention.
In the five weeks since a deputy killed Saveion McConnell, the coverage of his death has amounted to a handful of local television stories, and with a single opinion piece as the exception, not one headline among them has carried the word unarmed.
Friends and family of Saveion attend his balloon send-off
This Friday morning, June 12, at ten o’clock, his mother, Michelle Washington, will stand in Lexington, the seat of the very county whose deputy killed her son, to demand that footage and to demand charges against the man who fired. She is asking Kansas City to come stand with her.
Missouri Cops Have Lied & Covered Up Killings Before, and We Can Prove It
There is a reason Black Kansas City does not take the word of the state when the state explains why it killed one of us. The reason is the record.
In Kansas City, where the police department answers not to the city but to a board appointed by the governor, the agency that investigates the killing of a civilian by police is the Missouri State Highway Patrol and its findings go to the prosecutor, who decides if anyone is charged. It was the Highway Patrol that issued the words “a struggle ensued” on the night Malcolm Johnson died at the hands of KCPD in March 2021, words this paper documented as fiction, before pastors released video showing officers swarming a man who had been rendered unable to fight back, before a cop’s own bullet struck another cop, before shots were fired into Malcolm Johnson’s head.
Malcolm Johnson
Ryan Stokes was shot in the back. Police said he had a gun and would not put it down. His mother, Nayrene, went to view her only son, her baby boy, and found the wound where no one running toward you puts a bullet. The gun the police described never existed.
Ryan Stokes and his 1-year-old daughter
And then there is Cameron Lamb, because Cameron Lamb is the case that ends the argument. When a Kansas City detective killed him in his own garage in 2019, nine seconds after walking onto his property, police said there was a gun beneath his left hand. The first officer to reach the scene testified he saw no gun there. A gun appears in the police photographs taken later.
Bullets surfaced in Lamb’s pockets at the morgue that crime scene technicians never found at the scene. And Lamb was right-handed, with an old injury that had taken the use of the hand the state’s story required. Prosecutors put all of it before a judge and argued the scene had been staged and the weapon planted, and a judge convicted the detective who fired. A Missouri appeals court upheld that conviction.
Cameron Lamb with his children
And notice who did the investigating. Police investigated police when Ryan Stokes was killed, and no one was charged.
Police processed their own staged crime scene when Cameron Lamb died, and the conviction a prosecutor wrenched out anyway was erased by a governor’s pen.
The exact same Missouri State Highway Patrol investigated when Malcolm Johnson was brutally executed then framed, and a special prosecutor reading the Patrol’s file found insufficient evidence to charge a soul.
Three dead Black men, three state investigations, zero officers serving a sentence. That is the apparatus now alone in a room with Saveion’s footage, asking the public to trust it.
So when the Highway Patrol tells us that footage we are not permitted to see disproves what witnesses say they watched with their own eyes, we are within our rights, we are within the lessons of our own history, to refuse to take it on faith.
The families of the dead in this city have always had to become their own investigators, their own press offices, their own truth commissions, because the official state-sanctioned account arrives first and arrives whole and is designed to outrun the facts. They should not have to.
Saveion McConnell graduated from Lee’s Summit North in the spring of 2025, barely a year before he was killed. He played football and basketball. He was the only son his mother had, one of four children, and hundreds of people loved him.
He was looking at trade programs and weighing college the way a young man does when he believes the whole length of his life is still ahead of him, when none of it has been taken yet. On the last night of April he drove out to Warrensburg with friends to a fraternity party, which is the most ordinary thing a teenager can do in the spring of his life.
By a little before four o’clock on the morning of May 1, he was dead on the ground near U.S. Highway 50, killed by a Lafayette County sheriff’s deputy who had moments earlier run him down with a patrol car.
What Happened to Saveion McConnell? Here Is What the State Itself Admits.
Begin with what Saveion McConnell was accused of, because the state has had more than a month to answer and the answer has not changed: nothing. He was never arrested. He was never charged. No prosecutor has named him in any document. No agency, in any official record, has alleged that he committed any crime, that night or any other night of his life.
The Missouri State Highway Patrol’s entire explanation for why officers from three agencies converged on a teenager walking near a highway before dawn is a single phrase. He allegedly matched the description of someone deputies were seeking after a shooting reported nearly two hours earlier where a 17-year-old girl was found with a gunshot wound in a vehicle near Warrensburg, an incident the Johnson County Sheriff’s Office responded to and is still investigating separately.
When a suspect fled that scene, all three agencies — Johnson County, Lafayette County, and the Odessa Police Department — joined the search. None of them has produced a single piece of evidence connecting that search to Saveion that the public has been allowed to see. We are not told what the description said. We are not told who gave it. We are not told how a description taken in the dead of night could be matched at all, in the dark, at a distance. We are told only that a nineteen-year-old Black boy walking at night came close enough to it to die.
He ran. He was a Black teenager alone in the dark on a rural Missouri highway, armed strangers closing in on him, and the area he was running through has spent two centuries teaching Black children what stopping can cost. A Lafayette County deputy and an Odessa officer pursued him, the deputy in his patrol vehicle and the officer on foot.
That vehicle struck Saveion while he was running, the Missouri State Highway Patrol later confirmed. Saveion got up, injured, and kept moving away from the men who had just hit him with a car, and the officers came after him on foot. Then, just before four, the deputy fired. Saveion was hit and pronounced dead at a hospital.
He ran from men he believed might kill him. They did.
The Missouri State Highway Patrol was not there that night; it was called in at the request of the Johnson County and Lafayette County sheriff’s offices to investigate the killing, standard practice in Missouri for officer-involved shootings. When its investigation is complete, the Patrol’s findings go to the Johnson County Prosecutor’s Office, the office that holds the actual power to charge the deputy. That office has charged no one.
Now look at the sequence the Missouri State Highway Patrol itself has given us. A teenager walking near a highway before dawn. A patrol car used as a battering ram against a body that was running away. Gunfire into that same body. And when it was over, when they searched the ground, there was nothing in his hands, no gun, no weapon, and nothing near them.
He was unarmed when the car hit him, and unarmed when the bullets did.
Why Saveion Ran. Lafayette County, Little Dixie, and Two Hundred Years of Reasons.
Anyone who asks why a Black nineteen-year-old would run from police should first learn the reputation and history of the cops in Lafayette County. Lafayette sits at the heart of the region Missourians have called Little Dixie since before the Civil War, settled by enslavers out of Virginia, Kentucky, and Tennessee who trafficked human beings west with them in chains.
By 1860 the county held 6,374 enslaved Black people, more than any other county in Missouri, roughly one of every three human beings inside its borders, worked in the hemp fields whose profits built the river town of Lexington. Lexington is the county seat. It is the town where Saveion’s mother is calling for a public rally on June 12 and asking anyone who believes her son deserved to live to come stand with her.
It is also a town where the old homes still have slave quarters standing out back. The courthouse at its center, the oldest in continuous use west of the Mississippi, was already hearing cases while a third of the county’s people were held there as property.
So understand what it means when a Black child of this region sees headlights swing toward him on a dark rural highway and his legs decide before his mind does. That is not consciousness of guilt, but instead can be interpreted as inheritance.
The people who fled this county’s hemp fields toward the river and the north ran for the same reason, from the same families of men, across the same ground. Black flight from armed white authority in rural Missouri is two centuries of accumulated instruction, handed down at kitchen tables and in church basements, about what happens to us when we stop.
The deputy did not disprove the fear that set Saveion running, but instead confirmed it. So when the question comes, and it always comes, why did he run, we should turn the question around.
Ask what Lafayette County has ever done, in two hundred years, to teach a Black child that stopping was safe?
When emancipation came, the county did not repent. Lafayette County stood fiercely with the Confederacy through the war, and in the decades after Reconstruction white mobs there lynched Black men. The historical record shows white mob violence against Black people ran higher in this region than anywhere else in Missouri, in a state that carried out at least sixty racial terror lynchings, the second most of any state outside the South.
None of this is ancient. It is the soil. The county Saveion was running through remains overwhelmingly white to this day, and its institutions descend in an unbroken line from the ones built to hold his ancestors.
He was not fleeing justice. He was running through Little Dixie in the dark.
The Body Camera Footage Missouri Refuses to Release
Saveion’s uncle, Phillip Washington, says two witnesses who were there told him Saveion stopped when he was ordered to stop. They say he raised his hands and said, “OK, OK,” and that this is the moment another officer pulled up and shot him.
The Highway Patrol’s response to that account is worth reading slowly, because it tells you exactly where this is going. On May 4, Sgt. Justin Ewing wrote that the claim Saveion’s hands were up is “not accurate,” and that, in his words, “a review of available body camera footage disputes this claim.”
So there is body camera footage, and in Missouri the agency that investigates a deputy who kills someone is the Highway Patrol, the same agency now holding that footage. The agency investigating the deputy has watched it. The agency investigating the deputy has decided what it allegedly proves. And the agency investigating the deputy will not let this city see it, will not describe a single frame of what is on it beyond insisting that it clears the man who pulled the trigger. KCTV5 has filed a Sunshine Law request for every officer’s footage from the stop, the chase, and the shooting. As of the station’s most recent report in late May, that request was still pending.
There is a name for evidence that only the accused are allowed to see and interpret. It is not evidence but a verdict. If the footage truly shows what the Highway Patrol says it shows, there is no reason on earth to hide it, and there is every reason to release it now.
The body camera footage in the killing of Saveion McConnell belongs to the public, and it should be released today. And releasing it is not the only thing this city should be demanding. Under Missouri’s standard process, the Highway Patrol’s completed investigation goes to the Johnson County Prosecutor’s Office and that office holds the power to charge the deputy. There are two institutions that owe this family an answer, and only one of them has spoken.
Missouri law lets agencies keep investigative records closed while a case is active, and that closure is the shield the Patrol is holding up. But Missouri law also gives the family of a person killed on police video a path to ask a court for that footage even while the investigation is open. When a sheriff’s deputy killed Sonya Massey in Illinois, the footage was public within weeks. Concealment here is a choice.
The Firm That Won for George Floyd and Sonya Massey Is Now Investigating Saveion’s Killing
The family is not standing alone, and the people who killed Saveion should be losing sleep over what that means.
Romanucci & Blandin, a national civil rights firm out of Chicago, has opened a civil investigation into Saveion’s death. This is the firm that served on the legal team for the family of George Floyd and helped win the twenty-seven million dollar settlement from the City of Minneapolis, the largest pre-trial civil rights wrongful death settlement in the history of this country.
It is the firm whose founding partner won a ninety-eight million dollar verdict for the family of Botham Jean, the young man shot dead in his own apartment in Dallas. It represented the family of Daunte Wright. And it stood with the family of Sonya Masseyand won them a ten million dollar settlement. In Sonya’s case, the deputy was charged with murder within weeks of the killing. In Saveion’s, more than a month has passed and the deputy who killed him has been charged with nothing. These are not lawyers who chase small cases in quiet counties.
Their senior attorney, Joshua Levin, has already named the thing plainly. The deputy, he said, struck Saveion with his car, using the vehicle as a weapon, and then shot an unarmed teenager who posed no threat that could justify deadly force. He called it “completely unjustified.”
When a firm with that record arrives in a rural Missouri county before the body camera footage has even been pried loose, it is telling you that the facts already on the public record are bad enough to build a case on. It is telling you this does not stay a local story.
They go where the killing of a Black person can change the law. They have come to Lexington, Missouri.
Unarmed. The Word Kansas City’s Headlines Refused to Print.
There is one more institution that owes this family an answer, and it is the press. Five weeks have passed since a deputy ran down and shot an unarmed teenager who had been accused of nothing, facts confirmed by the state itself, facts that in other cases have carried a story to every screen in America.
The coverage of Saveion’s killing amounts to a handful of local television reports. And read the headlines of the stories published so far. To KSHB, Saveion was a “19-year-old shot, killed by Lafayette County deputy.” To FOX4, a “19-year-old killed by Lafayette Co. deputy,” and later a “vigil held for 19-year-old shot, killed.” Things that happened to him, arranged in the past tense, with the most important confirmed fact in the entire case missing from every one of them. With a single opinion piece as the exception, no headline in this region has put the word unarmed next to his name.
One word did make it through, and it came straight from the Highway Patrol’s press statements: suspect. Outlets carried it forward unexamined, and a FOX4 report managed to call Saveion an “unarmed 19-year-old suspect” in a single breath, apparently without pausing over the question the phrase begs. Suspect of what?
No crime has ever been alleged against him, before his death or in the five weeks since. The word has no charge behind it, no warrant, no case number. What it has is a function. It tells the reader, before a single fact arrives, that the dead teenager belongs to the story of crime rather than the story of his own killing.
When a Sangamon County sheriff’s deputy shot Sonya Massey in her own home, the body camera footage was released, the country saw it, the story became national news, and the deputy was charged with murder within weeks. Every element of that sequence began with the footage. In Lafayette County the footage is still withheld, the story has stayed small, and the deputy has been charged with nothing, and it is worth asking in which direction the causation runs.
The Black press was born for exactly this loop, for the stories the dailies judged too small and the dead they judged unworthy of a headline. So we will print the word, as many times as it takes. Unarmed. Unarmed. Unarmed.
Concealment starves coverage. Thin coverage relieves the pressure to stop concealing. Somewhere inside the loop, a mother is begging to see the last minutes of her son’s life.
Stand With Saveion. The June 12 Rally in Lexington, Missouri.
Michelle Washington calls her son’s killing what it is, and she will not let it disappear into the slow machinery of a prosecutor’s eventual review. “We’re not letting up and we’re not giving in,” she has said.
She is demanding criminal charges against the deputy who fired. His family is demanding that departments change how they pursue and how they detain, so that the next mother is spared this. And underneath the demands is the simplest thing a parent can carry, which is the wish that the world know who her child actually was. The graduate. The athlete. The young man who, his sister said, had a good heart, who loved his people in his own way. Loved by hundreds. His life, in his mother’s words, senselessly cut short.
The family has put their grief in the language of the church that raised them. If God is for us, who can be against us. God will never fail. It is the oldest theology of Black survival in this country, the conviction that no power on earth, not a deputy and not a Highway Patrol and not a sealed hard drive of footage, holds the final word over a life.
On Friday, June 12, at ten in the morning, Saveion’s mother and his sisters will gather in Lexington, in the seat of the very county whose deputy killed their son and brother. They have already made the posters. They are asking Kansas City to come stand with them, to bring our bodies and our voices to a place that would rather this stay quiet, and to say the name the state would prefer we forget.
In the last three months I’ve had people forward me four separate examples of a CEO losing his or her mind over AI. What’s been striking to me is the similarity in each case: It would be an “all hands” email in which the CEO talks up how amazing LLM tools are and saying that everyone in the company MUST start learning to use them immediately or they should look for a job elsewhere. Sometimes they talk about hiring “consultants” to come in and teach the team how to use the tools properly. Sometimes they are setting up “office hours” or internal “AI hackathons.”
But in every case the gist is the same “holy shit AI is amazing and you are expected to use it at your job all the time.” The worst case of these were the few companies that set up token leaderboards, which is perhaps the dumbest way possible to encourage learning how to use LLMs well. Good usage of AI includes learning how to view tokens as a scarce resource. Simply counting how much you use as a good thing is ridiculous because it’s incredibly easy to waste tokens on counterproductive uses.
As regular readers of Techdirt know, I actually do think that these tools are powerful and important, but I also think there are many problems with them and limitations to how useful they really are. I think when someone learns how to use them well and willingly chooses to use them as a tool to assist their work, they can be quite powerful. But the willingly choosing to use them part of that is important.
No one who is forced into using these tools will ever learn to use them well.
So CEOs losing their minds over the tech are not being helpful. Box CEO Aaron Levie — himself a genuine AI believer — puts his finger on exactly why.
CEOs are uniquely prone to AI psychosis because they’re sufficiently distant from the last mile of work that still has to happen to generate most value with AI.
So when they play with AI, they see the happy path results, often not considering the next 10 or 20 things that have to happen to get sustainable results from agents.
“Look I made this awesome product prototype”. Yes but you didn’t have to review the code before it went into production and fix a bunch of issues.
“Look I generated a contract”. Yes but you didn’t verify all the terms before it goes out to the counterparty and didn’t have to wire up all the past contracts to work with.
The best thing you can do as a CEO is to use AI a ton to figure out the real implications of agents in the enterprise, and come out the other side with an appreciation for both the upside and the real work that goes into them.
I will say that I hate the term “AI psychosis” because the term is extremely misleading, and many psychologists and psychiatrists have complained that it is inaccurate and may cause more problems itself. But the general sense that CEOs are going overboard with AI is definitely happening.
And I think Levie’s thinking as to why is also dead on.
Much of the issue may be in how disconnected the traditional CEO is from the people at a company actually getting stuff done. Normally, they have teams and layers and the actual work of getting things to work in a real way is so far removed from a CEO that they just get snippets of the details that filter back through the various org charts.
The problem tends to show up when a CEO is handed an agentic tool like Claude Code, and has it create something, which will work just fine, and thinks “oh, wait, why do we need so many people, when I can just sit here and make things work?”
This is a bad CEO.
Making things work is different than making things work well. Or well at scale. Or well at scale in a specific environment. Obviously, it depends on the kind of project and what it’s being designed to do, but oftentimes the reason a company has a bunch of employees is to fill in the seemingly small, but incredibly important details that CEOs might not ever get much visibility into: things like security or legal compliance or accessibility or who knows what else.
Using an agentic tool to build something that works is all well and good, but building a product for the mass market to use — and use well, and use safely — involves much, much more. Agentic coding tools can sometimes help with that too, but the leap from “I built a thing” to “therefore anyone can build a thing” misses the entire point of why you hire knowledgeable, experienced people in the first place. It’s also why I think the best case of these tools is building totally personalized tools to assist you in accomplishing a specific task, and not for building mass market tools.
This all reminds me of cargo cult thinking: The CEO knows that somewhere in the org, employees are pecking away at computers and work gets done. So they figure that themselves pecking away with Claude Code and seeing work get done is the same thing. It’s not. All those other steps those people are handling — the ones the CEO never sees — still need to happen.
That’s not to say employees wouldn’t benefit from a deeper understanding of both the power and the limits of these tools — they would. But there’s something darkly comical about watching a CEO go all in on the tech and then immediately conclude it means they can fire half the staff.
It seems pretty clear to me that companies that think they’ll be able to layoff huge swaths of workers because of LLM tools are going to find out they’re mistaken pretty quickly. The power of LLMs is that when used well and used willingly it can help employees to get more done, but that doesn’t mean you need fewer humans. You need more humans who know how to work productively.
Separately, companies pointing to LLMs as a reason for large layoffs are, in most cases, just using it as an excuse. They over-hired, and “AI efficiencies” is a much more palatable story for Wall Street than “we made bad headcount decisions.”
Levie’s prescription, though, is right: CEOs should learn how the tech works, but that includes the limitations of the technology. If a CEO thinks the prototype they vibe coded is production-ready, let them ship it and see what happens. If they think a vibe coded contract is as solid as one a lawyer reviewed, let them find out what the legal bills look like when it falls apart.
Yes, the tools are powerful, but a CEO who thinks they replace the work of employees is simply a bad CEO.
U.S. Sen. Roger Marshall, R-Kansas, contends former Democratic President Joe Biden should have done more to interrupt spread of screwworm from Mexico into the southern United States. Marshall praises President Donald Trump's effort to contain the confirmed presence of screwworm in Texas and New Mexico. (Photo by Tim Carpenter/Kansas Reflector)
TOPEKA — U.S. Sen. Roger Marshall of Kansas responded to screwworm infestation of livestock by blaming former President Joe Biden for allowing immigrants to carry the parasite into the United States “maybe on their flesh.”
Marshall, who previously represented the rural 1st District of Kansas containing approximately 4 million cattle, theorized on Newsmax and Bloomberg broadcasts Monday that Biden failed to do enough before leaving office 18 months ago to inhibit migration of a fly that lays flesh-eating larvae in animal hosts.
The Republican senator praised President Donald Trump’s effort to combat spread of screwworm, which has been confirmed in livestock and a pet animal.
“This is another thing we can thank Joe Biden for — that when millions of people came out of Central America, they brought this screwworm with them. It was on their pets, maybe on their flesh as well,” Marshall said on Newsmax.
Marshall, who is running for reelection in 2026, received pushback from skeptics unconvinced the buck stopped with Biden. Remarks of the Kansas senator and physician also were criticized by the nonpartisan Kansas Coalition for Common Sense and the campaign of U.S. Senate candidate Adam Hamilton, who is seeking the Democratic nomination for Marshall’s seat in the Senate.
Lauren Fitzgerald, spokeswoman for the Kansas Coalition for Common Sense, said one-fourth of U.S. Department of Agriculture employees in the Animal and Plant Health Inspection Service, or APHIS, were forced out last year through budget cuts ordered by Elon Musk’s Department of Government Efficiency, or DOGE. APHIS serves as the nation’s primary defense against livestock disease outbreaks.
She said Marshall was among lawmakers who applauded DOGE cuts, which included programs dedicated to monitoring screwworm in Mexico and Central America.
“Roger Marshall wants Kansans to believe he’s leading the fight against the screwworm, but he supported the very cuts that gutted USDA’s ability to protect Kansas ranchers,” Fitzgerald said.“Kansas farmers deserve better than politicians who vote one way in Washington and pretend they did the opposite when they’re back home.”
Tyson Brody, spokesman for the Hamilton campaign, said Marshall’s condemnation of the Biden administration was misplaced.
“Roger Marshall is doing what he does best: Running away and trying to blame anyone else for the consequences of his decision not to listen to Kansans,” Brody said.
In July 2025, Marshall took part in a news conference with USDA Secretary Brooke Rollins regarding the National Farm Security Action Plan. They were joined at the event by Department of Defense Secretary Pete Hegseth, then-Attorney General Pam Bondi and then-Department of Homeland Security Secretary Kristi Noem.
“I want to just commend the Department of Defense and all the agencies up here today for your joint efforts to combat disease — diseases like avian influenza, screwworm and foot and mouth — protecting our farmers and communities,” Marshall said.
On Monday, Marshall said the U.S. government was in the process of breeding in laboratories millions of sterile screwworm flies so they could be released into the wild to disrupt reproduction of the insect. The tactic could eventually help control outbreaks of screwworm, the senator said.
“I’m disappointed that the previous administration, the Biden administration, didn’t start making these screwworm male laboratories where we’re sterilizing these flies,” Marshall told Bloomberg.
Movement north of the fly led to a ban on shipments of live cattle from Mexico in May. That decision meant, on an annual basis, 1 million head of cattle wouldn’t enter the U.S. market.
USDA says screwworm flies lay eggs in wounds or openings of animals. The larvae hatch quickly and burrow into healthy tissue of cattle, horses, deer or other warm-blooded animals. Left untreated, the parasites spread infection rapidly before dropping off the host to reproduce.
When Tove Danovich recalls the first time she got an IUD, one thing stands out: the sheer pain of the procedure. After the IUD was placed, she remembers horrific, debilitating cramps.
Around a decade later, when Danovich went to a clinic for another IUD—a small, T-shaped birth control device that’s inserted past the cervix into the uterus—she asked the doctor for pain medication. The doctor gave her Ativan, an anti-anxiety drug, which Danovich found insulting. But she didn’t want to argue.
Unfortunately, Danovich’s experience is all too common; patients receiving IUDs are frequently told to take ibuprofen, grin, and bear it. But it doesn’t have to be this way.
Many clinicians point to the paracervical block—a simple, targeted injection of a local anesthetic around the cervix—as a way to greatly reduce pain during IUD insertions. Yet, in practice, paracervical blocks are rarely used for IUD procedures, a discrepancy rooted in the historical dismissal of women’s pain, limited research into IUD pain management, and patient anxiety about receiving an injection near their cervix.
One physician, however, is working to change this. Over the past two years, Roshni Kakaiya, a San Diego–based family medicine doctor, has created a training model that lets clinicians easily practice paracervical blocks—education she believes should be foundational for anyone in women’s health. The now-patented product has drawn national attention: Since last November, Kakaiya has sold 80 kits and compiled a long list of interested buyers. A kit costs $150 and comes with both a “beginner”-level silicone cervix to get the basics down, and a more realistic “advanced”-level cervix.
The hope is that these more highly trained providers will be able to offer patients a full range of pain-relief options and that paracervical blocks will become the standard of care for IUD procedures. “If we can make this experience slightly better for people, or if they feel like they have more agency, I feel like it would make a big difference,” Kakaiya said. “We can’t give patients their full range of choices if us as providers aren’t even trained.”
To insert an IUD, a clinician opens the vagina using a speculum and grips the cervix with a type of forceps, which can cause a sudden, sharp pain. A tube containing the IUD is then passed through the tiny cervical opening into the uterus, a process that is excruciating for many patients. Some experience cramping and discomfort for days after the procedure.
Research on IUD pain management is limited, and historically, there hasn’t been much data on cervical blocks. Consequently, the blocks just weren’t “valued as a procedure that was worth teaching,” said Kakaiya. “You had a whole generation of people who weren’t trained to do it, and then they can’t train others. And then that just keeps propagating.”
Today paracervical blocks during IUD insertion in the United States remain rare. One nationwide study of Veterans Affairs clinics found near-zero use. Another, based out of the University of California, San Francisco health system, found that less than half of patients receive blocks. Instead, the standard recommendation for pain relief during IUD insertion is to take 800 milligrams of ibuprofen an hour beforehand—a method that falls woefully short of addressing the intense discomfort experienced by many patients.
Yet, numerous studies over the past decade have determined that paracervical blocks are highly effective at reducing painduring the procedure. “I don’t think [clinicians] are as aware of these studies and interventions that can decrease pain during IUD placements,” said Sheila Mody, an OB-GYN and professor at the University of California, San Diego Health, whose 2018 study found that paracervical blocks significantly decrease discomfort during IUD insertion.
Although OB-GYNs like Mody are trained in paracervical blocks (they’re used in surgical abortions and miscarriages), many IUDs are placed by advanced practice clinicians—such as physician assistants and nurse practitioners—who often lack training in this technique. To address this issue, Mody trains APCs in paracervical blocks and is currently conducting three studies to further evaluate the procedure’s effectiveness.
Paracervical blocks are so effective that both the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention support using them during IUD insertion. “There is an urgent need for health care professionals to have a better understanding of pain-management options and to not underestimate the pain experienced by patients and for patients to have more autonomy over pain-control options,” notes a review of the literature from the American College of Obstetricians and Gynecologists, published last year.
That emphasis on patient choice is what motivated Kakaiya to develop a better way to train clinicians to perform paracervical blocks.
The training process, however, proved more complicated than Kakaiya initially expected. She quickly discovered that available pelvic models have hard plastic shells around the cervix where providers practice injecting; this prevents trainees from getting the necessary tactile feedback to learn where to inject. In response, clinicians have created their own unique prototypes to mimic the cervix, including a tomato attached to a plastic cup, a lemon attached to a PVC pipe, or, in Kakaiya’s case, a dragon fruit attached to a thick silicone tube. But these templates don’t come anywhere close to the real thing, so Kakaiya decided to make an anatomically precise, patented 3D-printed model.
The product offers clinicians an easy way to learn without having to practice on patients already undergoing nerve-racking procedures. Since last fall, when Kakaiya began selling the model, clinician interest has mushroomed. “It has been an overwhelmingly positive response,” she said. The next step is to expand the product’s reach to even more clinicians who perform IUD placements.
Mody, who recently received her own kit, believes that the device can help build confidence—especially for clinicians who are APCs or work in family medicine but haven’t received paracervical block training. “I think if you’re being trained to put IUDs in, you should be trained how to do paracervical blocks as well,” Mody said.
When Danovich decided to have her IUD removed, she was told there were a few complications and that the process would be more involved than is typical. To avoid any additional pain, she sought out a clinic that offered paracervical blocks—a process she found to be surprisingly difficult. “I remember the first things that came up were concierge clinics … but it’s cash pay, ‘we don’t take insurance,’ ” Danovich said. “It took a while to find this normal doctor’s office.”
In the end, the IUD removal was easy and relatively painless, with only brief discomfort from the injection. “I’m glad there are doctors that are really taking the fact that these procedures can be incredibly painful into consideration,” said Danovich. “That feels like the bare minimum.”
Great news that someone's working on this! First insertion felt like I was being punched in the cervix (do not recommend). Second insertion I managed to convince them to spray some lidocaine on the cervix first and it was less terrible. Ibuprofen doesn't cut it for IUD insertion and I'll throw it at migraines.
I will just note that when I got a vasectomy they were going to send me home with a gigantic bottle of OxyContin even I though I only needed a couple of ibuprofen the first day. There’s no *medical* explanation for the double standard.
The Federal Communications Commission (FCC) wants to make it effectively impossible for people to buy what many call burner phones—a phone not explicitly linked to your identity at the point of purchase—which would impact privacy-conscious people, to domestic abuse survivors, to journalists, and many more. The FCC plans to do this by legally forcing the country’s telecoms to store a wealth of personal information about essentially all phone customers, including a government issued identification number and their physical address, alarming privacy advocates and civil rights activists who compare the measures to those from authoritarian countries where it can be difficult to buy a mobile phone plan without giving up your identity.
The proposed change would drastically shake up how people obtain phone plans in the U.S., and have all sorts of privacy and cybersecurity knock-on effects. The FCC is proposing the data collection partly as a way to combat scammers, with telecoms being required to collect other information on business and foreign customers like the intended use case of their bulk phone plan purchase and their IP address. But the changes would mean telecoms collect data on all new and renewing customers, and the FCC provides a long list of other things that the collected data could help authorities with.
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Do you know anything else about this proposed change? I would love to hear from you. Using a non-work device, you can message me securely on Signal at joseph.404 or send me an email at joseph@404media.co.
“For decades, civil libertarians have looked overseas at authoritarian countries where the government requires people to register to get a mobile phone to ensure they can be tracked. We never thought that would happen here,” Jay Stanley, senior policy analyst at the American Civil Liberties Union’s (ACLU) Speech, Privacy, and Technology Project told 404 Media in an email. “But make no mistake: with this rulemaking, the government is contemplating taking away people’s ability to get a burner phone, which will hurt low-income people, domestic violence victims, and anyone else who cares about their privacy.”
In a synopsis of the proposed changes, the FCC writes, “Specifically, we seek comment on requiring originating providers to, at a minimum, obtain and retain the name, physical address, government issued identification number, and an alternate telephone number of any new and renewing customer before granting access to its services.” The goal of collecting this data, the FCC writes, is to deter some scammers from getting onto a telecom network in the first place, and so “enforcers will be better able to identify the scammers when they do.” The FCC compares the changes to the sort of data collected by banks to prevent money laundering.
One section stresses that the newly collected data would help “law enforcement to more easily identify callers that use the network to perpetuate crimes by ensuring that voice providers have accurate and complete customer information.” It goes on to ask if the data would help identify people buying and selling illicit goods; the investigation of “fraud, espionage, or influence operations that undermine national security”, and “address abuse in text messaging networks.”
“Criminals continue to leverage the anonymity provided by phone calls and texts to defraud Americans and exploit communications networks to further other crimes,” one section reads.
At the moment, the FCC is seeking comments about its proposed changes, with interested or concerned parties—think telecom companies, law enforcement, or privacy advocates—able to weigh in. But the intention of the FCC is clear: the agency wants telecoms to be legally obligated to collect much more personally identifying information on new and returning customers, linking them directly to their phone number and phone usage data. The FCC also asks whether the amount of data collected should change depending on whether a customer is seeking a prepaid or a postpaid service plan.
Multiple privacy and technology experts strongly pushed back against the proposed changes. “This proposal by the FCC will do little to combat scams and robocalls, since most people doing that will have no trouble creating fake documentation or identities,” Cooper Quintin, security researcher and senior public interest technologist with the Electronic Frontier Foundation (EFF), told 404 Media. “Given this administration’s crackdown on free expression, protest, immigrants, and women’s health we have trouble seeing this as a bold attack on freedom of communication. They want to take away our ability to make an anonymous phone call.”
Eric Null, the director of the Privacy & Data Project at the Center for Democracy & Technology, told 404 Media in an emailed statement “To address the scourge of illegal robocalls, the FCC has unfortunately proposed to force every wireless subscriber in the nation to sacrifice their privacy and give up significant personal details before receiving or renewing a wireless line. While some carriers already collect such details, there are specific circumstances where a person may need privacy and anonymity when seeking a cell phone, including if that person is a victim of domestic violence, or is a journalist or whistleblower. This proposal represents a loss of privacy across the board, and from an agency whose remit includes protecting privacy. The FCC might let a few bad apples spoil the whole bunch.”
Cape is a privacy-focused telecom company that limits the amount of data it collects on its customers. John Doyle, the company’s CEO, told 404 Media in an emailed statement “We hate robocalls and support eliminating them, but entrusting telecom carriers to effectively create a nationwide ID registry for every American with a phone is not the solution. Mobile carriers have been breached time and again because the incentives to secure trillions of dollars of legacy architecture aren’t there. Further enriching compromised telecom datasets with government ID, physical addresses, and alternate phone numbers harms our security rather than improving it.”
Given this proposal is in the comments stage, the FCC has many questions it is hoping to receive information on, such as whether “renewing” customers should be only those new to the provider, or those switching plans with their current telecom; or whether they should not allow the use of P.O. boxes or shared office locations as the required “physical address.”
The FCC did not respond to 404 Media’s request for comment. The proposal is open to comments until June 25.
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