Dear friend,

This newsletter has rapidly evolved. What started as a professional development tool for medical educators has become a travelogue during a period of historical significance. Which is not to say that I’m historically significant, but a record is a record.

This past week I had the honor of leading workshops for faculty and professional staff of a small liberal arts college located in rural red country.

The workshops were on a topic near and dear to my heart: supporting transgender and non-binary college students.

While the workshops were very much about that, they were also about something else.

It’s not that there was an elephant in the room. It was more of an exploding elephant piñata that covered every person and surface in wet sand, because filling it with glitter would’ve been too gay.

I’m talking, of course, about (gestures wildly in every direction) the current political climate.

Heresy

You can’t talk about transgender and gender non-binary people without talking about biological sex and gender. Specifically, about how those two (independently complex) things are different. Which means I broke with the official government stance in the first few minutes. The heresy didn’t end there.

If you’re curious, here are a few highlights:

• It is intuitively obvious that biological sex and gender are distinct. There is no gene telling you to wear a dress. Testosterone doesn’t bind with affinity to the color blue. There are no laundry secrets in the vaginal wall.

• The core disagreement between “woke gender ideology” and mainstream gender ideology isn’t transgender vs cisgender or boy vs girl. It’s accepting a child as they are or forcing an adult’s opinion upon them. It is just as abhorrent to me to insist that a trans girl is a cis boy as it would be to insist that a cis boy is a trans girl.

• Sometimes strong emotional messaging can overload an otherwise logical person’s capacity for rational thinking. Enter the moral panic about harming children. And so we must say and repeat the truth: no one is advocating for gender-affirming surgical intervention for pre-pubescent children. Care up until puberty is about supporting, talking, and listening, to the child and the child’s community. When a child enters puberty and is concerned about the changes their body will undergo, a licensed medical professional may offer puberty blockers to hit “pause” on puberty to give everyone a little more time. This is safe and 100% reversible. When the adolescent turns 16, they, along with their care team and guardians, can make an informed decision about which hormones should predominate in puberty.

• It is far more dangerous to deny a child’s identity than to accept them for who they are. According to the 2024 Youth Survey by the Trevor Project, 46% of transgender and non-binary youth in America had seriously considered suicide in the prior year. Young people living in very accepting communities considered suicide at half the rate of their peers.

The audience received the information I had prepared and asked thoughtful, clarifying questions.

But as we turned our attention to supporting students in the campus environment, the questions took on a different tenor.

One faculty member asked, “how can I visibly support a trans student if I might be fired, doxxed, detained, and/or deported for doing so?”

I believe it’s important to say when you’re out of your depth. So I did.

I said, “I have expertise on being trans and providing gender-affirming care, but I’ve never had to survive in an autocracy before, so I honestly don’t know.”

This let some of the tension out of the room, but we were still left looking at each other, desperate for answers.

We’ve Crossed the Rubicon

I believe we’re now governed by an authoritarian regime. Some may argue over semantics, but it seems undeniable to me.

Evidence abounds, but a few specific examples:

• The President recently signed an executive order that, among other things, tasks the Vice President with removing “improper ideology” from the Smithsonian Institution. He provides an example of this impropriety: a sculpture representing that “[s]ocieties including the United States have used race to establish and maintain systems of power, privilege, and disenfranchisement."

• A Tufts graduate student was abducted from the streets of Boston by six plainclothes officers, some with their faces masked. She has not been charged with anything. Her peers and professors know her to be peaceful and introverted, and believe the detention can only be linked to her co-authoring an op-ed critical of the war in Gaza.

• DHS Secretary Kristi Noem filmed a propaganda video using posed inmates at a maximum security prison in El Salvador as a backdrop that is (intentionally?) reminiscent of the crowded bunks of Buchenwald. We do not know who has been imprisoned there by the United States government, but reports indicate that at least some of the inmates are innocent, rule-following members of society targeted due to tattoos and the color of their skin.

This isn’t to say that we are doomed. But we won’t be able to effectively fight back unless we accept the reality of the situation.

Risk Management

As our discussions in the workshop continued, it became clear that we were each considering our ability to tolerate risk. What chances were we willing to take? How would we know when to stick out our necks and when to strategically sit back and live to fight another day?

I, for example, have been invited to lead workshops in other parts of the country. But I’m honestly scared to travel to some places, particularly when that means turning over my identification documents to government authorities. Is it wise to decline for my safety, or would that be obeying in advance?

Wisdom from a True Expert

I’m grateful to have come across an essay by Ned Resnikoff called “Living with a Murderer: On personal responsibility under the second Trump administration”.

I think it’s worth reading in its entirety. The author makes compelling arguments about capitulation and the politics of respectability.

The majority of the piece, however, relays lessons from Hannah Arendt, a Jewish refugee from Nazi Germany and one of the most influential political thinkers of the 20th century.

Resnikoff mainly draws from Arendt’s essay, “Personal Responsibility Under Dictatorship”.

This essay is an incredibly rich work worthy of much thought and discussion.

One part stands out to me in this moment, when I have so many questions about my obligations. She says this of the “nonparticipants”, who chose not to comply with the Nazi regime:

“[T]hey asked themselves to what extent they would still be able to live in peace with themselves after having committed certain deeds; and they decided that it would be better to do nothing, not because the world would then be changed for the better, but simply because only on this condition could they go on living with themselves at all. Hence, they also chose to die when they were forced to participate. To put it crudely, they refused to murder, not so much because they still held fast to the command ‘Thou shalt not kill,’ but because they were unwilling to live together with a murderer—themselves.”

The choices of if, when, where, and how to resist are personal ones. I don’t presume to know what’s best for anyone else.

Arendt’s argument is that we each have to live with ourselves. We must know ourselves well enough to find the lines that, should we cross them, would haunt us and make living intolerable. Morals applied by external forces can change with the culture or the whims of the ruling class. But it isn’t our peers or rulers whose judgement matters, it’s our own.

The part that I most needed to hear in this moment is easy to miss: “they decided that it would be better to do nothing, not because the world would then be changed for the better, but simply because only on this condition could they go on living with themselves at all”.

I find this idea freeing and instructive.

Maybe it’s due to the constant influx of opinions and data, but I’ve felt like I need to make every choice based on the impact it might have on the world. Or how people will react to it. Even the most consequential news of the day is framed by pundits and influencers as something that will or won’t “break through”, and by how it will play in this state or with that demographic.

Of course there is a role for strategic thinking, but Arendt reminds us that there’s danger down that path, too.

And so I ask myself: what do I care about? What kind of person am I willing to be?

Standing up is scary. Living with a murderer is scarier.

Thanks for reading. Hang in there, everybody.

Ky

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Retro-Viral

Have you seen this meme popping up around the internet?

It’s a screenshot from the “educational” computer game called The Oregon Trail.

For millenials of my vintage, it’s the perfect meme: topical, cynical, and nostalgic.

It’s topical because there has been a rise in cases of dysentery, caused by the Shigella bacteria, in Multnomah County, Oregon.

A Golden Age for Preventable Diseases

Dysentery is just one of the “blast from the past” diseases making a comeback in American life.

Notably, Measles continues to spread despite the availability of a highly effective vaccine that helped us eradicate the disease in this country decades ago.

Pertussis is both vaccine preventable and also on the rise. Cases have been reported around the country (NC, OR, WY, ID) but Oklahoma has been particularly hard hit. The state is now facing its largest outbreak in 69 years.

Kansas has been experiencing one of the largest TB outbreaks in a one-year period of the last several decades. Both preventable and treatable, TB is a leading killer globally, but (usually) a relative rarity in the United States. Our ability to treat the disease is now imperiled.

There’s reason to believe these medical disasters are just the tip of the spear, as other individual and public health decisions portend rising rates of unnecessary disease:

• Drinking raw milk, a habit promoted by HHS Secretary Kennedy (sigh), can cause outbreaks of e. coli, listeria, Rift Valley Fever, and bird flu (H5N1).

• Utah will be the first state to ban fluoride from public drinking water. Scientists predict this will lead to increases in cavities and other sequelae of tooth decay.

… and boy could I go on.

Anyone have a chimpanzee milk hook-up? Asking for a friend…

Back to the Future

While #WellnessInfluencers try to bring back times when men were men and lungs were iron, we’re also living through an age of fanatical futurism.

It’s disorienting and, in many cases, mind-numbingly dumb. For example, several carmakers are trying to radically redesign the gear shifter for seemingly no reason.

Customers are confused: “I didn’t even know how to drive this damn car.”

Behold the “Crystal Sphere” Gear Shifter

You may have also seen the Salesforce Super Bowl commercial, “Dining Al Fiasco”, in which world-famous actor Matthew McConaughey is forced to sit at a table outside in the pouring rain and eat foods he dislikes because… he didn’t use Salesforce’s proprietary AI to decide what and where to eat?

As one critic puts it, “It is simply wild that Salesforce has this opportunity to highlight to a mass audience, even indirectly, their best and most promising use-case for AI, and here they are aggressively pitching an inscrutable solution to a non-existent problem.”

Some of the “future-is-now” gambits are more dystopian than others. For example:

• McDonald’s is testing facial recognition in their drive-thru lanes, and it’s not the first fast food chain to do it.

• The LA Times had to decommission a new AI-powered “Insights” tool designed to generate summaries to articles because it defended the KKK.

The healthcare system is far from immune. A recently published study in Health Affairs reports that 65% of U.S. hospitals use AI-assisted predictive models, most commonly to anticipate inpatient health trajectories, but only 61% of those have evaluated their model for accuracy with local patient data, and only 44% have evaluated their model for bias.

The failure to evaluate for accuracy and bias is dangerous. Just this past week, a team out of Virginia Tech reported that, when tested, current medical machine learning models missed a whopping 66% of injuries related to patient mortality within hospital settings.

If that doesn’t give you the heebie-jeebies, maybe this will:

Ana, Hippocratic AI’s new nurse bot

Hippocratic AI, a company founded in 2023 to address the global healthcare workforce shortage, is touting its AI Agents as a replacement for expensive nurses and allied health professionals. They’ve got more options than Baskin-Robbins:

I am sure that these predictive machine learning models and AI bots were designed by good-hearted people trying to improve healthcare. But I can’t help but think they are being deployed—like the other futuristic fixes above—as ways to cut costs, charge more, or both.

Michelle Mahon of National Nurses United seems to agree: “Hospitals have been waiting for the moment when they have something that appears to have enough legitimacy to replace nurses. The entire ecosystem is designed to automate, de-skill and ultimately replace caregivers.”

If It’s Not Broken, Fix It

Whether we’re trying to find an “alternative cure” to measles or design the gear shift of the future, we seem hellbent on reinventing all of the wrong wheels.

If it’s tried and true it’s tired. If it’s widely accepted it’s suspicious. If it involves human-to-human interaction, it’s inefficient. If it doesn’t come with an AI co-pilot, you can bet one is on the way.

We are all Matthew McConaughey sitting in the rain with our sad shrimp cocktail. Menus and indoor dining are too ‘woke’ now, I guess.

This is Not a Game

Back to dysentery (a sentence no one wants to read or write).

There is a reason dysentery is spreading in Oregon. Portland has a large homeless population, with 1 in 165 Portland residents homeless on any given night. There are not nearly enough beds for homeless residents (0.61 per unhoused person), in either emergency or permanent housing.

There are also far too few public restrooms. The roughly 116 public restrooms in Portland are predominantly located in parks and libraries. About 61% of public park toilets are closed in the winter to avoid freezing pipes, and libraries are only open during the day.

Dysentery and other communicable diseases are bound to spread when people live in crowded encampments without access to sanitary toilets, clean water, and soap.

Working on public restroom infrastructure and housing policy is decidedly unsexy. It won’t be fixed by an AI chatbot, memecoin, or seed oil ban.

Improving the situation will require substantial investment and individual sacrifice for the greater good. It’ll be about handwashing education and zoning rules. Reliable, boring solutions to serious problems.

I’m afraid we’ve lost our appetite for that kind of large-scale civic response.

We could’ve had vaccines for cancer, energy-efficient affordable housing, and litter-free hiking trails. Instead, we’ll get tooth decay, 18th century plagues, and cars we don’t know how to drive.

I guess that Oregon Trail meme isn’t so funny, after all.

Around the Internet

• Federal Revenue Tool

  An interactive data dashboard that shows how much educational funding your state could lose due to federal cuts.

• What is an Infodemic?

  A nice primer on infodemics, including strategies to help you navigate them and stop the spread of misinformation.

• The FDA is Cracking Down on ‘Poppers’ Producers

  This week, the FDA went after companies manufacturing poppers, a type of inhalant drug. As this article points out, RFK Jr. has argued that use of poppers, not HIV, causes AIDS.

• The right dominates the online media ecosystem, seeping into sports, comedy, and other supposedly nonpolitical spaces

  I knew the right wing media ecosystem was formidable, but I didn’t know the half of it. This Media Matters study should be a massive wake-up call for anyone interested in political discourse and democracy in America.

Living Rent-Free in My Brain this Week

In red: U.S., Canada, Greenland, Russia

I’m not saying this is anyone’s plan… but I’m having a hard time unseeing it.

Quote I Like

Thanks for reading. Hang in there, everybody.

Ky

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Split Decisions

How do you feel about the economy? Are you optimistic? Pessimistic?

How did you feel about the economy eight weeks ago?

Unless you are an actual economist, your opinion is probably driven more by your political identity than your thoughts on the Consumer Price Index.

Check out the latest data from the University of Michigan’s monthly survey of consumer sentiment:

Just to show this isn’t an outlier, here’s a chart based on a separate dataset:

The trend is clear: Republican in charge, red line go up. Democrat in charge, blue line go up.

Poller Coaster

The idea that Americans view the economy through a partisan lens is not all that surprising. We know that we are in a hyper-partisan time, and the “economy” is a fairly nebulous concept for most people.

But this week I saw a chart that stopped me in my tracks (ok, doomscroll):

Additional insights from the poll

Just look at the right side of that chart! At exactly the same time (roughly the last few weeks), Republicans’ support for Ukrainian President Volodymyr Zelensky took a nosedive, dropping roughly 40 percentage points, while Democrats’ view of the man increased rapidly, by about 13.

Even by today’s standards, that’s pretty dramatic.

The chart can’t tell us why this happened. Fortunately, this week’s episode of The Focus Group podcast offers some insight.

On the podcast, The Bulwark’s Sarah Longwell and Pod Save America’s Tommy Vietor discussed audio from a focus group of people who voted for Trump in 2024 and support US aid to Ukraine.

The group shared some thoughts that surprised me, but provide context for that chart:

• “The amounts that the prior administration were[sic] giving to Ukraine need to be lowered drastically. We should not be funding parades, pride month, surgeries.”
  

• “We do need to continue, I think, to help, but there’s a lot of things that can be cut. Like he said, surgeries, gay pride. You know, these things that we’re helping with that’s unnecessary and if we continue to provide the financial for that, it’s never going to end, they’re just gonna keep asking for help with their hand out.”
  

• “I do agree that we should help them but not as much as we have and not now especially after we’ve found out that they’ve been using the money that was given to them for different stupid stuff, like fashion shows and whatever, like do they really need the money, or do they not need the money?”

It’s ok if you’re not totally up on geopolitics, or the ins-and-outs of our relationship with Ukraine. And if you don’t know what these focus group members are talking about, you’re in good company.

Apparently, the right wing media ecosystem (Fox news, conservative talk shows and podcasts, publications like the Daily Wire) has been pushing the idea that Zelensky is corrupt and that our money is being used for nefarious reasons.

The smears are having their desired effect.

Two Theories of the Case

There are at least two ways of looking at these charts. The first is depressing: reality doesn’t matter anymore, we’re just blue and red dots mindlessly following the crowd.

The second is more empowering: public opinion can change on a dime, and the most powerful way to achieve that change is by telling convincing stories through multiple channels.

It’s probably a little from column A, a little from column B.

What’s the Story with USAID?

Let’s look at another topic on which Republicans and Democrats disagree: The United States Agency for International Development (USAID).

So far, same story. Republicans and Democrats have opposing views of USAID.

But here’s an interesting thread from the same poll:

More from the poll

Apparently, new information and framing can still sway Americans.

That might be why President Trump used his Joint Address to Congress this past week to paint USAID projects as frivolous and unnecessary. A few excerpts:

• “$8 million to promote LGBTQI+ in the African nation of Lesotho, which nobody has ever heard of.”

• “$8 million for making mice transgender. This is real.”

• “$10 million for male circumcision in Mozambique.”

• “$47 million for improving learning outcomes in Asia.  Asia is doing very well with learning. Don’t know what we’re doing.  We should use it ourselves.”

The transgender mice thing got a lot of attention.

Initially, Trump critics assumed he and his team had simply misread/misunderstood transgenic mice. And they had some fun with it:

When the White House doubled down on the claim, it became clear that they were referring to studies using transgenic mice to understand the impact of sex hormones on HIV vaccine immune response, breast cancer risk, asthma, and more.

The phrase “making mice transgender” is silly and misleading. But you have to admit, the stunt was effective. An “issue” representing a tiny fraction of a tiny fraction of the US budget is getting wall-to-wall coverage.

Something to Believe

What have we learned?

The partisan divide is real and pronounced. But, people still respond to clear, compelling stories, especially when they are repeated and reinforced by multiple sources.

There are a bunch of reasons to stay quiet right now. Fear of losing funding, retribution, political attacks. All valid.

But I don’t think we should give up on Americans just yet. People are showing up to protest and demanding more of their representatives. They are looking for something to believe in again.

There’s a persuasion game afoot, and now is not the time to sit on the sidelines.

Around the Internet

• Why We Don’t Trust Doctors Like We Used To

  A Wall Street Journal piece by Clare Ansberry exploring some of the reasons why trust in individual doctors has diminished

• Exclusive: NIH to Terminate Hundreds of Active Research Grants

  March 6th article from Nature reporting that the US National Institutes of Health (NIH) has begun a mass termination of research grants that fund active scientific projects because they no longer meet “agency priorities”.

• RFK Jr. and the Texas Measles Outbreak: Round 2

  Dr. Paul Offit summarizes the HHS Secretary’s statements and actions regarding the ongoing Measles outbreak

Living Rent-Free in My Brain this Week

Source

The Public Service Loan Forgiveness (PSLF) program offers federal student loan borrowers a path to debt forgiveness. Created by Congress, PSLF forgives student loans for borrowers who make regular payments for 10 years while in public service.

The Executive Order just signed by Trump would alter the criteria for what counts as public service as it pertains to PSLF. Specifically, the EO says public service organizations will be excluded if they engage in activities with a “substantial illegal purpose”.

You’re probably wondering what those activities are. Here are a few:

• Child abuse, including "the chemical and surgical castration or mutilation of children or the trafficking of children to so-called transgender sanctuary"

• Violating federal immigration laws

• State law violations such as "trespassing, disorderly conduct, public nuisance, vandalism, and obstruction of highways."

I have been counting on PSLF to pay off my (not insubstantial) loans from medical school. My employer offers gender affirming care for adolescents.

As a trans adult, and someone who routinely presents on the importance of gender affirming care for youth, I would rather find another way to pay off my loans than lobby my institution to stop offering this care.

But I’m far from the only borrower at my institution. Perhaps others will arrive at a different decision.

Now, this EO is probably illegal and will hopefully not be put into practice.

Even if it gets held up by the courts, I worry that the damage will already be done. They are creating scapegoats and pitting citizens against one another.

It’s a dangerous time.

Quote I Like

Thanks for reading. Hang in there, everybody.

Ky

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At a Loss

I’ve been struggling to write.

A possible reason: the lies have become too brazen.

My purpose in writing these newsletters is to point to instances of mis/disinformation, especially when it involves health care, and peel back the curtain to expose the tactics and purpose behind them.

To call it what it is, I wanted to be like one of my favorite fictional characters—a modern Sherlock Holmes. To investigate information crimes, digging into the backstories, the motives, the ingenious masterminds behind it all. Then, once a week, regale you with my dramatic summation.

But you don’t need Sherlock Holmes when a guy walks out onto fifth avenue and shoots someone in broad daylight. And that’s how obvious the lies have become.

That Ain’t It

I thought that was the reason for my writer’s block. That there’s just not much to say about a lie as artless as “the sky isn’t blue”.

But this week I walked out to a purple sky.

The lies have come to life. And they are wreaking havoc.

Musk and his allies are not just saying that government programs like US AID are riddled with “waste, fraud and abuse”. They are using that false pretense to gut them. And now people are starving to death. Grandparents suffocating. Babies born with HIV.

RFK Jr. and his followers aren’t just “undermining trust in vaccines”. A child has died of Measles in the United States for the first time in twenty-two years, and twenty-five years after we declared Measles eliminated. The outbreaks continue to grow.

It’s not just anti-trans rhetoric. Iowa just became the first state in history to rescind a group’s civil rights. Starting on July 1, 2025, Iowa law will no longer protect transgender people from discrimination impacting their housing, education, employment, public accomodations, health care, credit, and more. On Friday, the Montana House of Representatives passed a new indecent exposure law that would effectively criminalize being trans in public.

And the president is no longer playing footsie with the idea that Ukraine is to blame for being invaded. In a grotesque display in the Oval Office, America bullied a democratic ally and stood up for a murderous dictator. The post-WWII order is no more.

Stories Still Matter

It’s been a lot to process. Maybe for you, too?

There’s something surreal and depressing about watching something you’ve been warning would happen, happen. Especially when none of it is remotely necessary. It’s just death and destruction for the sake of death and destruction.

I’ve been stunned into inaction.

But none of this is an excuse to stop. Because even in this new world, stories matter. The people in power need to convince their supporters that what they are seeing isn’t real. We can and must poke holes in those stories.

We saw a new narrative created on the fly in this past week’s Cabinet meeting, when RFK Jr. insisted that Measles outbreaks are normal. He also provided a scapegoat: The Mennonites. He said, “I think there’s 124 people who have contracted Measles at this point, mainly in Gaines County, Texas, mainly, we are told, in the Mennonite community.”

First of all, Measles outbreaks aren’t normal. They are an increasingly common indication that vaccine rates are dropping. Every death and hospitalization from Measles is preventable.

Second, the blithe reference to the Mennonite community has led—intentionally or otherwise—many to believe that Mennonites oppose vaccines on religious grounds. That’s not true. The Mennonite religious tradition is not against immunizations. In fact, the pastor of Seminole’s Mennonite Evangelical Church in Gaines County is vaccinated, along with his entire family, children included.

Here’s what Dr. Peter Hotez, a Professor of Pediatrics and Virology and Microbiology at Baylor College of Medicine says is actually going on:

In other words, the anti-vaccination activists are to blame for this outbreak. Chief among them, RFK Jr.

Break’s Over

So I’ve been knocked sideways a bit. But I promise I’m back in the game.

As another one of my favorite fictional characters, President Jed Bartlet, would say: “Break’s over. What’s next?”

Around the Internet

• The Pandemic Center Tracking Report from Brown University

  Jennifer Nuzzo, the Pandemic Center Director: “We started the Pandemic Center Tracking Report as an internal document to help keep on top of the many (and growing) serious infectious disease outbreaks that are occurring. It became so useful, we decided to share it. With the rollback in US federal health communications, it is becoming even more important to have a central place for sharing pertinent health information. Sign up to receive our Tracking Report free each Thursday.”

• “We the Builders”

  “Around a dozen current and former federal workers are behind a new website created as an outlet to share anonymous stories and technical expertise about the Department of Government Efficiency’s dismantling of government agencies.” - The Verge story

• What Felt Impossible Became Possible

  In the 1920s, the KKK were mainstream. They controlled levers of government and were ubiquitous in public life. But one man continuously stood against them. His name was George Dale. Read this article to read about Dale’s resistance, and for a concrete reminder about the importance of stalwart resistance.

Living Rent-Free in My Brain this Week

Source: “Republican Men and Women Are Changing Their Minds About How Women Should Behave”, NY Times, 2/27/25

Patriarchy and authoritarianism go hand in hand. We all need to be vigilant in protecting women’s rights.

Quote I Like

Thanks for reading. Hang in there, everybody.

Ky

Did you find this newsletter interesting? Forward it to a friend

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The Worse Take of All Time?

You do not, under any circumstances, need to ‘hand it to Hitler’.

If you find yourself so addled by current events that you become Fuhrer-curious, go sit in a dark room by yourself until you come to your senses.

There is no partial credit for the Third Reich.

Fascism is Anti-Science

The framing of that article is also historically illiterate. Of course Hitler went after scientists.

Fascism is, by definition, anti-science.

The rigorous, objective study of observable phenomenon is in direct conflict with the fascist’s goal to maintain a manufactured reality built to serve one person, nation, or political party.

Here’s an excerpt from Jason Stanley’s book, How Fascism Works:

Just a few examples:

• Nikolai Vavilov starved to death in a gulag in 1943. He was persecuted for advancing the Mendelian concept of genetics and rejecting the pseudoscience of Stalin-backed Trofim Lysenko, who insisted, among other things, that acquired traits could be passed down to future generations.

• In May 1933, Nazis raided and burned down the Institute for Sexual Sciences, founded by Dr. Magnus Hirschfeld. The Institute conducted research, offered medical care, and provided safe haven to sexual and gender minorities. The Nazi party vilified Hirschfeld, a man of Jewish ancestry, accusing him of conducting a “Jewish plot to undermine German society”.

• Turkish forensic physician Şebnem Korur Fincanci was arrested and sent to prison in 2016 after accurately reporting what she found in Cizre, a small town in southeastern Turkey. The Turkish military had murdered innocent civilians, including children, while purportedly fighting a Kurdish insurgency.

#NotAllScience

The author of the article pictured above (I don’t want to reward it with clicks but you can look it up if you want) acknowledges that Hitler was bad for some science: “Hitler did seek to turn science to his own ends, to promote research on eugenics, new technologies for blitzkrieg war, sick medical experiments, and more efficient ways for the mass killing of Jews.”

If only he stopped there.

Incredibly, he follows that sentence with: “Yet civilian German science, long a mark of German pride, also thrived.”

To be clear: there is no reason to add a ‘yet’ or ‘but’ after describing atrocities.

Beyond that, I want to underscore the danger of lifting up some science as ‘virtuous’ to distract from or serve as a counterpoint to morally bankrupt anti-science.

Can We Just Defund the “Icky” Science?

Newspaper articles, cable news coverage, and the academic press are awash in stories highlighting the danger of cuts to scientific research, US AID, and public health.

Accurately, they explain that these actions are endangering research into such worthy causes as pediatric cancer treatments. Who would want to defund pediatric cancer research? Only, to use another popular phrase of the day, “the worst of the worst”.

I’ve never run for an elected office nor am I a political messaging consultant. I’ll assume they know what they are doing and are using that strategy to win over public opinion.

We in the scientific community absolutely cannot internalize that framing.

Kids are cute. Pediatric cancer is bad. Sure.

But multi-drug-resistant HIV is also bad. As is death from untreated opioid addiction. Maternal sepsis from incomplete abortions. Mass starvation in “third world” countries.

Suggesting that some scientific pursuits are worthy and others are dirty, based on an unaccountable, shifting ideology, is a terrible idea that will not end well.

It only supports another core feature of fascist regimes: hierarchy.

Authoritarians like Hitler seek to reinforce “natural” hierarchies in which some human lives are worth more than others. The woman is subservient to man. The Jew less human than an Aryan. The elderly less worthy than youth.

Advocating vocally for pediatric cancer research doesn’t make you an authoritarian. Obviously.

The problem arises when we stop advocating for less “palatable” fields altogether. When we agree to shave off the more controversial bits so that we can stay in the administration’s good graces. When we accept that some lives are more worth saving than others’.

Now is Our Moment

Here’s the bad news: scientists, as a whole, don’t have a great track record when it comes to rejecting authoritarian advances.

For example, the leaders of the German Chemistry Society asked their Jewish members to resign in 1933, just months after Hitler came to power, in what historians refer to as a cowardly act of “anticipatory obedience”.

In Mussolini’s Italy: “University administrators implemented the laws dutifully and efficiently, in many cases with alacrity, going out of their way to make their lists of Jewish employees as accurate as possible. Not one voice in the academic and scientific world was raised against this collection of data, nor against the expulsions.”

Already, academic institutions are making choices to acquiesce or resist the Trump administration’s ban on diversity, equity, and inclusion.

Here’s the good news: we can learn from the past.

Obeying in advance does not work. Sacrificing certain scientific theories or areas of inquiry in order to save others does not work.

Eventually, anti-intellectualism runs itself off a cliff. And it falls, because gravity still exists, even if the leader claims it doesn’t.

Now is the time for scientists to stick together. Do not obey in advance.

Around the Internet

• When ‘Just Asking Questions’ About Science Turns Into 300,000 Dead

  Opinion essay in the NYTimes by Yale Epidemiologist Gregg Gonsalves. He recounts the damage done when South African government officials were radicalized into thinking AIDS wasn’t caused by HIV and outlawed antiretroviral therapy, and how activists successfully

• ‘Everything you’ve been told is a lie!’ Inside the wellness-to-fascism pipeline
  This Guardian article isn’t new, but it’s interesting and related to today’s theme

• Letter from the United Science Alliance

  A letter to the researchers, educators, and academics of America, signed by 38 scientific organizations, including the American Psychological Association who coordinated the effort

• Trump Wants to Destroy All Academia, Not Just the Woke Parts
  A recent NYTimes opinion piece by Michelle Goldberg, describing what’s really behind the slashing of university funding

Living Rent-Free in My Brain this Week

This week, the US Park Service removed references to transgender people from the Stonewall National Monument.

Transgender people led the Stonewall Inn riot and are an integral part of LGBTQ+ and world history.

We will not let them erase the record of what our forebears have accomplished.

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Thanks for reading. Hang in there, everybody.

Ky

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News Media Scandal of the Century!

Politico is a news agency that specializes in—you guessed it—politics.

Founded in 2007, it “strives to be the dominant source for news on politics and policy in power centers across every continent”.

So why did the United States Agency for International Development (US AID) send millions in grant dollars to this for-profit company?

It didn’t.

US AID spent a grand total of $44,000 over two years on subscriptions to Politico’s in-depth energy and environment reporting. Other federal agencies—including the Departments of HHS, Energy, and Interior, and, previously, Trump’s Executive Office—also subscribe.

All told, the government spent about $8.2 million last year on Politico subscriptions, just as it does for The New York Times, Reuters, etc.

It’s all pretty standard and boring.

But the sleuths on Twitter thought it was the “biggest scandal in news media history”.

And no less than the President of the United States picked up on their “bombshell reporting”:

👆 This guy has >650,000 followers

This was not a scandal.

Honestly, this story is like a single tamborine shake in a heavy metal song. It’s ok if you missed it.

I only mention it because it illustrates a worrying trend: the LARPing of expertise.

LARPing Expertise

If you’re not familiar, Live Action Role-Playing, LARP for short, is a perfectly fine hobby in which people act as characters in a shared fantasy world. It combines storytelling, drama, physical activity, and gaming.

Think Ren Faire. Civil War Reenactments. Murder Mystery Parties.

The draw is obvious. You get to escape from the real world and be part of something bigger, nobler, higher stakes … better.

But at the end of the day, participants know it’s a fantasy. The people LARPing Quidditch know they aren’t flying.

The Twitter users LARPing forensic accounting, on the other hand, think they’re defying gravity.

That’s where things get dangerous.

The Chosen One

A common fantasy trope is “The Chosen One”.

Due to some innate or accidental trait, the main character happens to be the only one who can save the world from certain annihilation. Maybe it’s a dormant genetic mutation, a radioactive spider, a prophecy, childhood trauma, unusual cunning, unnatural courage.

Whatever the origin story, we love to ride with the chosen one. We might want to be The Chosen One.

But then there are people who believe they are The Chosen One.

One of those people is Elon Musk.

Kara Swisher, a journalist who has covered Silicon Valley for decades, recently described Musk like this:

This time, Musk has engineered himself into the actual center of the universe. And that’s not great, for several reasons [Exhibits A, B, C, D, E, for starters].

He has no experience running large-scale government operations, but he’s LARPing his way through anyhow - hacking away at anything that seems “leftist”, wasteful, or has a purpose he doesn’t understand. Because “he alone can fix it”.

Similarly, RFK Jr. went before the Senate HELP Committee and repeatedly argued that he knows better than the overwhelming majority of scientists who have, among other things, proven vaccine efficacy and safety, and debunked race-based medicine.

Take a peek on social media and you’ll see this unfounded self-belief everywhere. People with no background in science genuinely believe that their interpretation of a single journal article carries more weight than every scientist in that field.

They believe that they alone can see the truth. That they’ve been chosen to free others. And that this public health stuff isn’t that hard, after all.

We Can Be Heroes

So, what do we do about this?

Honestly, I think this is going to get worse before it gets better. But, a few things to chew on:

• Sweat > Status

  Let’s emphasize the effort it takes to develop expertise, not just the prestige of having it. Simple change: Instead of saying someone got a degree, say they earned it. Example: “She earned her PhD for her work investigating…” instead of “She got her PhD from Stanford.”

• Show Our Work

  No one reads the methods section. Ok, scientists do eventually, but the point is it’s dense, boring, and full of jargon. Uninitiated readers either skip them or struggle to understand them. That’s a shame, because when you think about it, the methodology is where science shines. It’s the critical thinking, the problem-solving, the good stuff. We have a ton of communication tools at our disposal. Is it time to refresh the methods section?

• Normalize Not Knowing

  I don’t know everything. Neither do you. It’s exceedingly rare, if not impossible, to be an actual know-it-all. Instead of pretending, obfuscating, or lying, we should all get better at saying “I don’t know”.

• Celebrate that it Takes a Village

  No one achieves greatness alone, yet we often tell stories as if they do. It’s expedient. It’s exciting. But can we resist that impulse? Can we shift from idolizing singular heroes to embracing the interdependent collective?

  
  We need to make it abundantly clear that there is no such thing as a nonplayer character, and none of us are The Chosen One.

Around the Internet

• The RFK Jr. Playbook

  The latest from Dr. Paul Offit’s “Beyond the Noise” newsletter. Identifies 3 strategies used by RFK Jr. to skirt science that conflicts with his views: deny good studies exist, promote poor studies that reinforce your opinions, call dissenters shills for Big Pharma.

• Medical journal editors must resist CDC order and anti-gender ideology
  A BMJ opinion piece that pulls no punches: “Publication ethics and professional standards define the work of medical journals, editors, and researchers. These are safeguards of best scientific practice and integrity—and will not yield to bad practice like gag orders, suppression, and authoritarian whims.”

• American chaos: standing up for health and medicine

  Editorial in the Lancet published on February 8th. “This moment is a test. How should our community react?”

• Outnumbered, Outspent, and Out-Messaged: How Democrats Must Reset Their Communications Strategy To Win The Current Attention Economy

  A strong case for building up an attention-generating machine to persuade voters on immigration issues. Swap in health care/science and it’s just as compelling: “That means going beyond press releases and panel discussions—it means engaging in a full-scale, coordinated communications offensive built for modern media consumption.”

• In Idaho, a preview of RFK Jr.’s vaccine-skeptical America

  A Washington Post article about an Idaho Board of Health that has prohibited public health clinics from offering the Covid vaccine. The story highlights the medical doctors who led the charge for prohibition - despite having been sanctioned by their state licensing boards.

Living Rent-Free in My Brain this Week

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Thanks for reading. Hang in there, everybody.

Ky

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The Fog of War

You’ve probably heard the phrase, “fog of war”. But where did it come from?

Prussian military analyst Carl von Clausewitz wrote about a “fog of greater or lesser uncertainty” in the first volume of his 1830s series On War. He was describing the chaotic, high-stimulus/low-information environment in which military commanders have to make life-or-death decisions.

Over time, military commentators refined and simplified the term to “fog of war”.

Recognizing how debilitating it can be, the United States military started to artificially create these fogs as a form of psychological warfare in World War I, using two main strategies:

1. Cutting off or censuring sources of accurate information

2. Overwhelming people with a lot of information, much of it conflicting

Annalee Newitz describes the impact like this:

A Lot Going on at the Moment

Taylor Swift during “Red” set on the Eras Tour

The past two weeks have packed in two years' worth of news.

26 executive orders, 12 memos, 4 proclamations. And that was just on day 1.

Then came:

Withdrawal from WHO. Global aid cut off. CIA report on COVID-19’s origin. DEI initiatives ended. Biological sex “redefined”. ICE raids at schools and churches. Global aid reinstated. Grants frozen. Employees invited to resign. Grants unfrozen. CDC sites removed. FBI purge…

And it’s not just the sheer number of actions.

Each new piece of information launches a series of questions:

• Is that legal?

• How is that going to work?

• Does that take effect immediately?

• Who is impacted?

This all amounts to a situation where you know a lot is happening, but you don’t know what is happening.

In other words, a fog of greater or lesser uncertainty.

Infodemic

An infodemic is much like a fog of war applied to an epidemic:

Infodemic

abundance of information – some accurate and some not – that occurs during an epidemic. It can lead to confusion and ultimately mistrust in governments and public health response.

www.who.int/health-topics/infodemic#tab=tab_1

Like the fog of war, infodemics are destabilizing. They induce a wide variety of responses:

Defogging

You are currently living in a fog of war - or something near to it.

As a result, you might be feeling a range of emotions: anxiety, anger, helplessness, defiance, distress, nihilism, fatigue, etc.

Whatever you are feeling is normal. 

We weren’t built for this kind of informational onslaught - that’s why it’s a successful military weapon.

So what should we do?

You know what works best for you, and you should listen to and trust yourself.

But if you’re looking for places to start, here are a few suggestions:

• Spend 20 minutes a day alone with your thoughts

  I’m borrowing this one from Chris Hayes (who borrowed it from Jenny Odell, who borrowed from Kirkegaard). The argument is that we all need to spend time in conversation with ourselves; to build up our ability to refuse distraction and to understand what we truly believe when everyone else’s voices go quiet.

• Talk to your circle about how you share information

  In WWI, the United States’ Propaganda Section dropped millions of leaflets on the German people to undermine their morale. Nowadays, we use screens for things like that. This is good and bad. The bad news is that the onslaught of information is constant and with us at pretty much all times. The good news is that the propaganda no longer falls on our heads. We control the spigit.
  
  While it isn’t reasonable to avoid screens for 4 years, we can talk to our circles about how/when/if we send each other ‘news’ updates. Do we text incendiary articles? Send emails? Screenshot things we see on social media? Avoid the news when together in person? Make sure we have two sources before sharing? There’s no right or wrong answer, but the point is that you get to make your own rules.

• Recognize and connect emotions to behaviors

  To again quote Senft and Greenfield, “Emotions can trigger behaviors in individuals. When related to overload, these behaviors can range widely. However, there is one thing that they all have in common: in some ways, they all represent attempts to soothe, lessen, or eliminate negative emotions.” It’s a good idea for us all to keep an eye on the emotions driving our behaviors.

Around the Internet

• LinkedIn Post: “The strategic exploitation of cognitive limits”

  Swiss sociologist Jennifer Walter offers some good food for thought and strategies for remaining clear despite the overload.

• People Who Get Most of Their News From Social Media Sources Are More Likely to Think Climate Change Is a Conspiracy: Study
  Research on how our news sources impact our civic values scales. One idea that stuck with me: “it is not enough to provide people with accurate information. What counts is the mindset they bring to that information”.

• Do People Want to Hear About Uncertainty?
  Short answer: yes. This new piece from Dr. Sara Gorman goes over a relevant study and how we can communicate uncertainty in ways that gain trust.

• How to create a public health disaster

  A short video connecting current science denialism and its potential consequences to the politically-driven and preventable HIV/AIDS outbreak in South Africa at the start of this century. My one small quibble: could’ve used at least one line about how LGBT people fought to get the research leading to the miraculous ARTs.

• “RFK Jr Testifies, MAHA Flexes, and Public Health Panics”

  An episode from “Why Should I Trust You?”, a weekly podcast that looks at the breakdown in trust for science and public health. The first 40 minutes features a conversation with Travis Tripodi, an ambassador with Braver Angels, health tech consultant, and supporter of RFK Jr.

  I’ll be honest, I had a tough time listening and wanted to shut it off multiple times. But I know I need to improve my ability to calmly listen and respectfully engage with people who share Travis’ views. A couple of phrases I heard that I want to keep an eye on: “two things can be true at once” and “anti-credentialism”.

Living Rent-Free in My Brain this Week

I think it’s generally true that we should ignore the daily bluster and focus on impact, for both our sanity and efficacy.

But Anne Applebaum’s warning is worth squirrelling away and revisiting from time to time.

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Thanks for reading. Hang in there, everybody.

Ky

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Yesterday, the Trump administration issued an Executive Order aimed at gender affirming care for minors.

It reads, in part:

This EO is full of misinformation and propaganda.

If you want to understand what’s wrong with the content, keep reading to the end.

But first…

Can You Spot the Tactic?

In this past Sunday’s newsletter, I shared some lessons I learned from a book about manipulating media.

The first strategy I shared was use of the 3 Vs to make a story compelling.

The 3 Vs are:

• Villain

• Victim

• Vindicator

Can you identify a victim, villain, and vindicator in the EO text?

Why do you think this framing is so compelling?

How might we, as medical educators, public health proponents, and allies, use this tactic to share quality information?

Facts

In reality, very few minors receive gender affirming hormonal care or surgical care.

Most of gender affirming care for minors consists of talking, including therapy for both the child and the family.

Social affirmation and puberty blockers are completely reversible. Hormone therapy is partially reversible. Surgery, obviously, is irreversible. It’s also exceedingly rare.

Gender affirming care improves mental health and wellbeing for children and adolescents.

A recent analysis of over 5 million adolescents’ medical records showed that between 2018 and 2022:

• The rate of adolescents receiving puberty blockers was 0.02%

• The rate of adolescents receiving hormone therapy was 0.05%

• No adolescents younger than 12 years received a hormone prescription

Similarly, a 2024 analysis of 22.8 million adolescents’ medical records showed that in 2019:

• The rate of undergoing a gender-affirming surgery with a TGD-related diagnosis was:

  • 2.1 per 100 000 minors aged 15 to 17 years (0.002%)

  • 0.1 per 100 000 minors aged 13 to 14 years (0.0001%)

  • 0 procedures among minors aged 12 years or younger

  • The most common gender affirming surgery for both children and adults is masculinizing chest surgery.

    • “Of the 151 breast reductions among cisgender male minors and TGD minors, 146 (97%) were performed on cisgender male minors”

All the Worst Humans

I want to understand how narratives are crafted and “selected truths” become the dominant story.

Phil Elwood is an expert at it.

He wrote a book called, “All the Worst Humans: How I Made News for Dictators, Tycoons, and Politicians”.

When he says “All the Worst Humans”, he means it. He’s shilled for brutal dictators Assad and Gaddafi. He tricked a member of congress into helping the Qatari government sabotage the US bid to host the FIFA World Cup, resulting in Qatar’s selection and, ultimately, human rights abuses and unexplained worker deaths.

He once helped the leader of a foreign country blackmail the United States.

I’m not saying he makes good choices.

But he does know how to spin a story with the best of them.

Here are the top 3 lessons I took away from the book:

Top 3 Lessons

Lesson 1: The 3 Vs

Medicine loves a triad. Let’s add one more:

• Victim

• Villain

• Vindicator

If you want a story to stick, you have to give people a victim to save, a villain to hate, and a vindicator to root for.

If your client is actually the villain, you’ve got a couple options:

• Find an angle that turns them into a victim or vindicator

• Find a bigger villain and draw as much attention to them as possible

(🤓 Nerd Challenge: If you can name more than 3 medical triads without looking it up, email me back and I’ll send you a celebratory GIF)

Lesson 2: “Once you have ink, your story becomes real”

Phil Elwood and other high-level PR operators may be good, but they aren’t magicians.

Even they can’t just publish a story and expect people to go along with it.

Instead, they launder their stories through legitimate outlets. Once it’s mentioned on CNN or published in a newspaper, the story is real. It has legs.

One of the most consequential health-related examples of this in the modern era:

The Lancet, 1998, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children”, Wakefield et al.

The title seems inocuos enough, but this paper still haunts us. It suggested a link between the measles, mumps, and rubella vaccine and autism.

The data were falsified. The whole notion has been debunked time and time again. The Lancet retracted the paper in 2010.

Doesn’t matter.

Once it gets printed—especially through a prestigious institution like The Lancet—it becomes ‘real’.

Lesson 3: Journalists are Woefully Outmatched

Here’s a scary stat: for every journalist, there are 7.5 PR pros.

And guess who makes more money? The PR pros, and it’s not even close.

But the relationship is part symbiotic and part abusive. (Symbusive?)

As Elwood says in the book, “[Journalists] need us because we’re a main source of information feeding today’s nonstop hunger for media content”.

And so, without technically lying outright, PR operators have found ways to feed the media beast with stories that advance their clients’ agendas.

Here are a few tactics they use:

• Field Testing Stories: When developing a story/angle for a client, Elwood will try out various narratives on a group of journalists. He calls them up individually and says things like, “If, hypothetically, my client decided to do ‘x’, would that be newsworthy?”

• Dangling Exclusivity: You can generally get a foot in the door if you offer information that ‘no one else has’.

  • Side-note: if you ever want to leak documents, Elwood implores you to do it “the old-fashioned way”, printed out and handed off in person. No email.

• Manufacture Legitimate Sources: “Astroturf organizations are shell nonprofits used to create the illusion of grassroots support for a cause.” One of Elwood’s astroturf organizations: “The Healthy Kids Coalition”. You can also throw money at credible experts, like the Sackler family did to push OxyContin.

• Strategic Selection: Know the goals of each media company, its rivalries, funding sources, and editorial practices. Pitch accordingly.

• Control the Negative Story: If you know that a news outlet is preparing a negative piece about your client, get ahead of it by pitching the story yourself to a different, less influential outlet. Give them everything they need and an urgent deadline.

Around the Internet:

• Science perspective on the US withdrawal from the WHO

• My friend, Dr. Carolyn Wolf-Gould, sent this letter to her patients in the wake of HHS communications blackout. (Carolyn and I worked on a book together)

• Antiabortion groups plan Facebook campaign to recruit men whose sexual partners have had abortions, encouraging legal action against healthcare professionals

• RFK Jr. has already made ~$2.5 million for referring clients to a law firm suing Merck over the HPV vaccine, an arrangement that would continue even if he is confirmed

• The President reinstated the global abortion gag rule, with a maximalist interpretation

• Study shows a diverse media diet is associated with higher trust in vaccines

• The World Economic Forum released its annual Global Risk Report, presenting findings from a survey of over 900 experts. Take a look at what tops the list of short-term risks:

Top ranked 2-year risk: Misinformation and disinformation

Living Rent-Free in My Brain

You know the iconic “Jerry! Jerry! Jerry!” chant we all associate with Jerry Springer? It was engineered into existence by the show’s executive producer (and evil genius) Richard Dominick.

Long before Jerry Springer became a household name, they recruited people off the street to fill the studio audience and told them to chant his name. Viewers at home assumed he was already famous. 

This is a prime example of how ‘social proof’ can be (mis)used to subtly convince you that someone is credible.

Source: “Jerry Springer: Fights, Camera, Action!” Netflix Documentary

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Thanks for reading 💪. See you next week,

Ky

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P.S - We’re all going to need ways to remain connected to the ‘real world’ and find moments of joy. I’m an amateur photographer who likes to take amateurish pictures. Here’s my favorite snap from the week:

My dog, Lulu, running through the snow at the dog park. She lost her front left leg, but she doesn’t let that hold her back!

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Dear Reader:

Thank you for being a MedEdge subscriber. Truly, it means more to me than you know.

If you caught the last few editions of the newsletter, you know that I’ve taken a keen interest in medical mis/disinformation. I sent an overview of the topic, a piece on the IKEA Effect, and in the most recent issue, I dug a bit deeper into the non-neutrality of search engines.

In my first newsletter of 2025, I shared a list of questions I hoped to explore further, all generally connected to the use and misuse of medical information.

I was following my curiosity and hoping you’d go along for the ride.

But then Monday, 1/20/25 came and brought with it a shocking level of science denialism and censorship:

• In the Inaugural Address and an Executive Order, the President rejected established science, insisting that there are only 2 “genders”, male and female. Intersex, trans, and non-binary people no longer exist, as a matter of policy.

• The President withdrew the United States from the World Health Organization

• The new administration acted swiftly to remove a government website offering reproductive health information. The archived site is still available here.

• On Tuesday, 1/21, the Trump administration ordered federal health agencies, such as the CDC, FDA, and NIH, to halt all external communications

New Purpose

My curiosity remains, but it is now propelled by a sense of responsibility and purpose.

As a member of the medical community, I feel called to protect medical science from these attacks.

As a medical educator, I feel obligated to find ways to share high-quality medical information in a way that breaks through.

I am committed to this new purpose, and will use this newsletter to share my progress as I try to expose the intent, strategy, and tactics behind medical disinformation, and trace medical misinformation from its roots to its impact.

But you didn’t sign up for that.

You signed up for a newsletter about medical education, written by a sometimes-goofy always-nerdy version of me.

So I’m giving you an out. If this new direction isn’t your thing, hit the button to unsubscribe. No hard feelings, I promise.

New Expectations

If you’re still with me, I want to make sure you know what you’re in for.

I’m not a journalist. Nor am I a sociologist, detective, or expert on any of this.

Every week I’ll be sending something akin to ‘dispatches from the front’ - but where the front is just me sitting on a couch reading or walking my dog while listening to podcasts.

I’ll be looking for examples of mis/disinformation or propaganda in action (sadly, I don’t think I’ll have to look too hard) and talking to people who know much more about these topics than I do.

Things are going to get personal. And political - though I’ll try to refrain from pure partisanship.

We’re going to touch on topics that you avoid at family meals: religion, money, relatives on Facebook.

I will probably make mistakes. But I promise to publish a full correction when I do.

Now, here’s another chance to jump ship:

If you’re still with me after all that, welcome aboard. It’s going to get bumpy.

See you on Sunday,

Ky