Preventive medicine should not be housed in the same system that manages disease. One is about keeping people healthy. The other profits when they’re sick. "Show me the incentives and I'll show you the outcomes" Time to decouple them for good.

When views promoted by ethicists cause harm. My response: I read “Beneficial Bloodsucking” (Crutchfield & Hereth, Bioethics, 2025) with deep concern. The authors argue that alpha-gal syndrome (AGS)—a tick-borne allergy that renders patients unable to consume mammalian meat—should be promoted as a form of “moral bioenhancement.” Their thesis rests on two claims: first, that eating meat is inherently immoral, and second, that spreading AGS (for example through genetically modified ticks) would curtail this wrong. Both claims are gravely flawed, and publishing such a proposal risks undermining trust in bioethics and medicine. First, promoting disease is irreconcilable with medical ethics. AGS is not a minor inconvenience but a complex, often life-altering condition. Patients endure unpredictable reactions ranging from hives to anaphylaxis, sometimes hours after exposure. Some live in constant fear of accidental ingestion or even environmental contact with mammalian products. Social isolation, anxiety, and depression are common. AGS is an emerging public health problem with potentially severe, lifelong impacts, many impacts are yet unknown. To describe this as “beneficial” disregards both the morbidity and the profound psychological burden borne by patients. Second, the assurance that spreading AGS “doesn’t violate rights” is indefensible. Respect for autonomy and informed consent are bedrock principles of medicine. Inflicting illness on unsuspecting individuals to enforce a dietary ethic is a direct violation of bodily integrity. Unlike vaccination, which prevents disease, AGS confers no benefit to the individual—only harm. Ethical standards from the Nuremberg Code onward prohibit precisely this kind of coercion. Third, the moral premise itself—that all meat consumption is wrong—is stipulated, not demonstrated. Philosophers continue to debate this question. While critiques of factory farming have merit, many frameworks allow meat consumption when it is humane, sustainable, or nutritionally necessary. Billions worldwide rely on animal protein for survival. To declare their diets immoral is neither a consensus view nor a sound basis for coercive intervention. Genuine virtue cannot be manufactured through biological incapacitation; it requires free, informed choice. Finally, proposals of this kind corrode public trust. Patients depend on clinicians and ethicists to safeguard their health, not to advance ideology through disease. Troublingly, one of the co-authors, Parker Crutchfield, has previously argued that moral bioenhancement should be administered covertly—that is, without the recipient’s knowledge. In effect, he has defended lying to patients and the public in order to “promote morality.” Such views undermine the fundamental commitment of medicine to honesty and informed consent. Advocating deception or deliberate illness feeds public suspicion that scientists cannot be trusted to act transparently. In an era already plagued by misinformation, this rhetoric is profoundly irresponsible. For these reasons, “Beneficial Bloodsucking” fails on ethical, clinical, and philosophical grounds. The suggestion that society should deliberately proliferate a debilitating disease in order to enforce a contested moral stance deserves emphatic rejection. Public health must never be weaponized for ideology. In the end, it makes me wonder whether the [my perceived] recent uptick in AGS has been caused by human manipulation.

I think FieldLark.ai is giving me some excellent ideas for improving the health of my garden and orchard. Created by Advancing Eco Agriculture, it's an extension of their regenerative agronomy resources. Check it out for yourself at

FieldLark.ai

The founder John Kempf also has an AI clone at

John Kempf | Delphi

John Kempf, a visionary in regenerative agriculture, founded Advancing Eco Agriculture (AEA) and Crop Health Labs. Raised on an Amish farm in North...

which has been quite insightful as well.

Saw my first patient who did therapeutic plasma exchange after I recommended he do it. Has improved energy and basal body temperature increased from 96 to 97 degrees. But most importantly, his cognition has improved dramatically and the persistent thoughts and ruminations from the past have resolved! One month out from the procedure and the improvements have been maintained.

Posting these screenshots to avoid loosing them:

RFK Jr. fired the entire CDC vaccine advisory panel. Signs of "There are weeks when decades happen."

Reading the executive order on MAHA, where agencies are directed to work with farmers to ensure U.S. food is the healthiest, most abundant, and most affordable in the world, reminded me of the “cheap, fast, good” principle: you can only pick two. Healthy + Abundant = Not Affordable Abundant + Affordable = Not Healthy Healthy + Affordable = Not Abundant I think we should retire the "need" for "food" to be cheap.

"We have not succeeded in answering all our problems. The answers we have found only serve to raise a whole set of new questions. In some ways we feel we are as confused as ever, but we believe we are confused on a higher level and about more important things." - The more I learn about the human body the more this seems true.

Trialing the over the counter stelo CGM and I'm less than impressed with its accuracy. Then I look at the finer details. Accurate is considered to be within 20% variance either way. So a read of 100 may be 80 or 120 or anywhere inbetween. And it apparently has about a 93% accuracy...meaning it could be off even further. So helpful for trends but not very accurate in my opinion.

Vinay Prasad to be Director of the Center for Biologics Evaluation and Research (CBER) at the US FDA; I'll miss his contributions on Sensible Medicine but I'm hopeful he'll create substantial positive impact at the FDA:

Sensible Medicine endorses Vinay Prasad for Director of the Center for Biologics Evaluation and Research (CBER) at the US FDA

Vinay Prasad is leaving Sensible Medicine to take a senior role at the the US FDA.

First time listing shift work circadian rhythm sleep disorder as the underlying cause of death in a patient..... yes, the final cause of death was different but I think the root cause was working nights/days, nights in artificial light leading to diabetes and progressively worsened.

Step in the right direction - allowing but not forcing fluoride in the water will propel the discussion on risk/benefit of fluoride to a greater level. https://childrenshealthdefense.org/defender/utah-first-state-ban-water-fluoridation/?utm_id=20250224

First time in politics that someone I've respected for a long time gets nominated to a high level in political office. Someone who wasn't just the less bad option. We'll see how this all turns out but I'm hopeful RFK Jr will guide a systemic transformation from #sickcare to #healthcare. Maybe some element of "hard times make strong men" progressing towards "strong men create good times."

This podcast about fake lighting and a number of other topics by Dr Paul Saladino and Tristan Scott is an absolute must listen!! Common sense. Ideas on high yield things to implement.

How is it that trademarked Roundup can be a whole variety of chemicals and isn't necessarily glyphosate? I always thought Roundup was brand name glyphosate. I bought some Roundup to do an experiment with magnesium binding. While trying to figure out exact details of how much roundup I would need to apply to a vial of blood to bind all the magnesium in it I realized that the Roundup didn't have any glyphosate in it. Lesson learned...look at the ingredient list.

Reflecting on RFK Jr’s confirmation hearings—centralized nutrition policies have long been a tool for concentrating power. Historical food policies had the intended effect of concentrating power by fueling armies, but they necessarily have shifted to preventing and reversing chronic disease. Because chronic disease is a greater threat than outside armies at this point. Technology now determines who amasses power. We build AI, robots, and code-driven armies—yet the same innovations drive rising cancer rates and other health risks in the people who are most involved in developing them. Food is still important. If RFK is confirmed, I think the food issue will be addressed well. I suspect he’ll address the issue of vaccines by at least making data available. I’m sure he knows the impact of things like artificial lighting and EMFs on our health. With the speed of worsening disease, I’m hopeful we’ll be addressing technology as a cause of disease much more in the upcoming years.

Did you know? The development of the PHQ-9, a tool for diagnosing depression, was funded by Pfizer, the same company that makes many antidepressants. 🤔 It was meant to help streamline diagnosis and thus would increase the number of people who are diagnosed with depression. Pfizer manufactures some of the medications commonly used to treat depression. Stopping antidepressants is extremely difficult for about 1/4 of people. I have several patients who have been trying for several years to get off the meds but have been unsuccessful due to withdrawal symptoms. Not depression symptoms. I find that simple, natural approaches are generally more effective and far less risky: ☀️ Regular sunlight exposure 📵 Reducing blue light/EMF 🍖 Eating nutrient-dense foods like meat 🤝 Cultivating healthy, supportive relationships Ask your doctor pointed questions about the above before starting antidepressants. Ask them about weaning off if you're on them already.

Medical study of the day: Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOTHEART randomised controlled trial in Scotland. Decreased risk of heart disease or heart attack is highlighted. It doesn't advertise that doing the added testing doesn't change risk of death at all. Overall I think it's a great study but you got to read the details to get the full picture.

For all the times I've wished I wasn't a doctor and a nurse and was doing something either in agriculture or the financial sector instead, here's a time when I was glad I'm both a doctor and a nurse. My wife got sick with some sort of viral stomach infection yesterday. I got out the IV fluids, started an IV, gave 2 liters of fluid, and saw her getting better. Still not drinking well this morning. Connected the IV again and gave another liter. The ability to do something that helps a loved one feel better immediately is tremendous.

Listened to the podcast by @jack and @ODELL at

Fountain: Podcasts & Music

Citadel Dispatch • CD150: JACK DORSEY • Listen on Fountain

Jack Dorsey is founder of both Twitter, now X, and Square, now Block. We discuss his strong focus on bitcoin and nostr, lessons learned across his ...

The part about migrating content posting to NOSTR makes sense and is very insightful. For the people like myself who don't have an engineering background Bitcoin rises to the challenge of what we need it for. The current system of using credit cards and other electronic payment methods works well and is relatively low friction. Store of value is a tremendous problem, however, and Bitcoin fixes that. I recognize my selfishness in not pushing the digital payments part more. I grew up in Paraguay at a time when we were not able to have a bank account. It is a real problem for many. But right now the bigger problem to solve for me and my family is store of value. And so that's what resonates with me more. Be patient...I'll get there.