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buy metformin E. L. Doctorow, who was awarded the Medal for Distinguished Contribution to American Letters, spoke solemnly about the rip-tide change that the Internet has wrought on language, and questioned how much of it a writer must absorb: “When was the last time you heard the word mouse and thought of a small, gray rodent? When was the last time you heard the word Web and thought of a spider?” Mary Szybist, who won for her poetry collection “Incarnadine,” was visibly shaking and near tears, but she spoke steadily about the idea that culture is not altered by arguing well, but by “speaking differently”—that by rearranging language we can rearrange perception. This is what writers can do, she said.