The film depicts two weeks in the life of Hirayama, a toilet cleaner in Tokyo, who indeed lives Perfect Days. Koji Yakusho’s near silent performance is deserving of all the accolades it has received and more. In the final, two minute close-up of his face, (Spoilers to follow) we witness all the emotions of life: joy, sadness, disappointment, regret, betrayal, pain— and the way life gives it to us, unpredictably— washing over his face. The scene itself a staggering aesthetic achievement.

How can you live perfect days when you scrub a toilet? Wenders spends two hours showing the audience. By appreciating everything. By noticing the sunlight filtering through the leaves, casting dancing shadows. By taking pleasure in your job, no matter what it is. And, by accepting what life gives you: one day, your colleague calls in sick and you work like a dog, the next, your niece visits you unexpectedly.

And all the details: the cassette tapes, the stereo, the simple desk lamp on the floor, the buckwheat pillow, his coins laid next to his watch and keys— Wenders shows how joys of simplicity and a world where everything was analog.

When I was a high school student, my summers were like Hiroyama. I worked in a grocery store, bagging and pushing carts. I must have read a 100 novels a summer, devouring the same writers Hiroyama reads. I listened to music on my car’s Sony CD player, which I personally crammed into the dashboard. Later, this would lead to an easy theft. After work, I would drive to my friend Colin’s house. I didn't have a cell phone. At the time, I felt poor, but what was that worth? More than all of Hiroyama’s cassettes.

I read that the initial title of the film was Komorebi, which is a Japanese word that means to appreciate the light filtering through the trees. In our modern world, this has been completely lost.

The only time Hiroyama drinks in the film is after he witnesses his favorite waitress in an embrace. But he misunderstood the situation. Her ex husband was dying of cancer. As the husband reflects on his mortality he asks a simple question: do shadows get darker when they overlap?

That's how life is: when we die, it feels like we barely scratched the surface. We don't even know the answers to the most simple questions. Yet Hiroyama shows us life isn't over yet for any of us. Hiroyama tries to answer the dying mans question, on the bank of the river, under the street lamps. Their game of shadow tag, takes them back to childhood, the moments of pure unadulterated joy.

All the best moments in life are simple. Sitting in the grass on a sunny day. A dinner with old friends. Listening to a cassette tape.

Recently, a friend I hadn't seen in many years stopped by for dinner. He lamented where we were as a country, and said he wasn't sure that he would bring kids into this modern world. I told him what I tell everyone: that those thoughts are a mental illness, and should be purged. He was brainwashed by the brainwashed people who write for the news. He cared too much about politics that was more ambiguous than he would like to admit.

I gave him some advice. I told him he already didn't use social media, all that was left was for him to stop reading the news. He was so close to having perfect days. He just couldn't see it. But neither can so many of us. It's right there.

Here are my tips for how to read news stories in the era of biased and weak reporting.

Step 1. Fact check the source material. If you read an article that says Jay Bhattacharya supported the use of Ivermectin, locate the raw video or audio. You will find the article is factually wrong. Jay supported conducting randomized trials of ivermectin. I have had countless essays misinterpreted and misconstrued by illiterate journalists.

For e.g. this essay, read exactly what I said.

Step 2: Look up the quoted experts. If there is a quote by former CDC director Mandy Cohen, you can quickly find that she is the kind of scientist who actually thought cloth masking would make a difference (=/- praying to lord fauci?). AKA neither smart nor reliable

Another example. Michael Osterholm. How much of an ‘expert’ can you be if you were wearing a mask 3 YEARS after the pandemic started?

Step 3: Don’t listen to panicked statements from people who are worried about losing their jobs or funding. Of course researchers who are funded by taxpayers to study DEI will say that cancelling their funding will kill millions or billions of people and lead to a comet striking earth. But they are not objective. Someone fearful of their own job/ or someone recently laid off has no objective view on their value. Just ignore them, and seek out third parties who are not directly affected.

Step 4: Put things in context. If you read CDC has laid off 10% of the work force, ask how big the workforce was 3 years ago or 5 years ago. Often the media is depriving you of broader context that shows it is not that big a deal.

Step 5: Anyone who uses the word “misinformation” is an idiot. Scientific arguments exist on a spectrum from high to low confidence. And even some weak arguments contain a kernel of truth. For instance, COVID vaccines did harm one group on average— for mRNA young men btw the ages of 18-24, high confidence, and 12-40, slightly lower confidence. Misinformation is a word used by weak thinkers who don’t understand the nuance of claims. It is poorly defined and has been overused to the point of meaningless. Often they mean to say: I just disagree.

Step 6: Read prior stories from that reporter. Some reporters are hopelessly bad. We analyzed NYTimes corrections, and found one reporter is a correction factory. If a single spine surgeon for e.g. was an outlier like this with so many botched surgeries, you would suspend their license, and yet, reporters face no accountability.

These are 6 tips to combat the current media, which is doing a horrific and dishonest job of covering this administration. If you want to support someone who is objective, please subscribe.

1. Helen’s argument that COVID-19 shots can’t be tested because the timespan the virus is transmitted is within a short season is false. The virus spreads year round. This is a basic fact, and in contrast with the actual seasonal respiratory viruses.

Contrast that with Flu and RSV

2. It is standard practice for vaccines to undergo clinical testing, showing improvement in clinical endpoints, prior to approval. This standard practice was even adhered to in 2020 with the initial vaccine studies. Although we can debate the methodological rigor of the trials, they were done. It was later abandoned in the setting of subsequent boosters— leading to the resignation of Gruber and Krause at FDA— but there is no logical basis to abandon it now, as the risk of bad COVID outcomes has fallen.

3. The American people have shown they are unwilling to get an unproven annual booster. Rates of booster uptake remain abysmal. This graph would be EVEN WORSE if you include babies over 6 months olds. The surest way to get a lower percentage in 2025 is to further waive the basic requirements of trials.

   

4. Other nations do not give COVID shots annually to all babies over 6 months old. This is not the practice across Europe. It is hard to fully capture just how absurd such a policy is. Taking the lowest risk individuals in a society and exposing them to an absolutely unproven, injected novel medical product. Under Joe Biden, America was a demented outlier.

5. As vaccines undergo strain modification, they are entirely new products. Their efficacy and safety may be untethered from prior products. Without trials, it is only a matter of time before the FDA approves a vaccine that causes some bad outcome like vaccine-induced narcolepsy If this happens, you can kiss faith in vaccines goodbye. You will see vaccine hesitancy like you have never seen before. The FDA must have a strong commitment to safety and efficacy to preserve vaccine’s remaining reputation.

Folks who think COVID-19 vaccines should continue to roll out without randomized trials are anti-vaccine, anti-science, and pro-corporate.

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Yet, in the article, I was disappointed to read this quote by Paul Offit, whom I generally respect.

“It’s like in Jurassic Park, when the Tyrannosaurus rex keeps checking where in the fence is a weakness,” said Paul Offit, a pediatric infectious disease specialist at the Children’s Hospital of Philadelphia. “He could do a lot of harm. I think he will do a lot of harm unless somebody stops him.”

Removing an unproven vaccine from the schedule, and one that is widely not accepted in Europe is not akin to letting a t-rex escape, but rather an important course correction. Medicine must admit when we make mistakes. If anything, removing unnecessary shots from the childhood schedule will bring focus to the necessary ones, such as measles.

Next, look at this. The CDC is finally contemplating what it should have done ALL ALONG. The COVID shot should only ever have been recommended to populations with a net benefit.

It is astonishing that this is remotely controversial. As you well, know, I, and some of my colleagues, have been saying this all along.

The Trump administration wants universities to do some things. Ban masks so protesters can be identified. Note: there is no evidence that community masking improves any health outcome based on high quality data. End DEI. Use merit to govern admissions and many other things. Right now, universities are squirming. Harvard claims it will #resist. But they are borrowing cash and will soon be crippled if they do not capitulate. I think Alan Garber is smart enough to know this.

Let us be clear. This is not censorship. Harvard can give up federal funds and stop admitting whites and asians and men, and only admit under represented minorities. It can violate title IX, and commit fully to DEI. But as long as it chooses to accept public funding, it must follow the rules of the federal government, which are numerous. Trump is adding to these rules in an effort to make universities less woke.

The American people voted for this. They are sick of faculty being cancelled for saying “pregnant women” not “pregnant persons”. They think “people with uteri” is Orwellian. It's women. Why do unis hire someone to review slides to police for these words? (They do!)

They don't want Harvard to admit students who need to take remedial math (Google it), but rather the best. Universities meanwhile want to fire faculty who supported school reopening. If a faculty member opposed cloth masking 2 year olds, universities worked to punish that view, stripping them of teaching duties. In other words, universities are completely lost: veritas is replaced with left wing partisanship.

They also won't fix themselves. They don't admit error. They keep lying about lockdown and masks and school closure and gender medicine, etc. They have hired so many deranged left wing faculty to the point that the avg university professor makes AOC look conservative. Enter Trump: with the mandate of the people, he seeks to punish universities.

He is just getting started. First he threatens Harvard 9 billion in funding. He stops 2 billion. They fund raise 1 million, so they are only minus 1999 million. Next he threatens their tax exempt status. Next his DOE asks for a list of all foreign donors. Harvard does not want this. They will soon find unimaginable dirt. If Trump's IRS kills the tax exemption Harvard is game over. And Trump can do so much more. He can run Harvard into the ground. Harvard has no leverage on him. Trump can wipe Harvard from the face of the earth.

Some say Democrats would never do this. That is because they don't have to. When Biden wanted Universities to fire workers who didn't get a covid shot, he didn't threaten their funding. That's true. He just called and asked. Biden’s admin used soft power to make Universities their puppet. He fired nurses who got COVID on the job. Only a fucking moron would do that. Universities happily complied. That's because universities just do whatever Democrats ask for. That's how deep the bias is.

I think if a university takes federal funding, the average faculty should be close to the average American. Some faculty should be conservative, and some liberal, and the average should be centrist. At a minimum, universities should not punish faculty with views that align with conservatives. That's not the case.

And until it is, Trump should use all his powers to crush universities. He has no alternative. And Harvard has no public support. The average American thinks they have their head up their ass. The average American is right. Universities are a Democrat think tank. So why should tax payers fund them?

Ultimately, I am confident that Harvard will comply. They will comply because I think Alan Garber agrees that dei has gone crazy on Harvard campus. I think he agrees that viewpoint diversity is in crisis. I suspect he agrees that the treatment of Roland fryer and Martin kulldorf was inappropriate. I bet he is sick of incessant protests. And he knows, Harvard cannot afford to lose the money.

But Garber is smart enough to know that he can't look like he agrees too easily. If the faculty at Harvard smell that he is capitulating too quickly, he will be fired instantly. You saw that happen at Columbia.

He has to give the appearance of fighting back. And that is what Harvard did today. But make no mistake: Harvard will yield. All universities will.

The last few weeks have highlighted that universities are a giant welfare program funded by the taxpayer. Instead of trying, even a little bit, to represent the views of Americans, they went completely insane, and preferentially, almost exclusively, represent the views of a deranged minority on the far left. It's far beyond the humanities. It permeates biomedicine. It's the reason why you would reprimanded for saying 2-year-olds shouldn't wear a cloth mask. Because the people with power in the University have become left-wing ideologues who turned off their brain, or, even if they are not, they know they have to Shepherd so many such people.

The Trump administration has correctly deduced that they have all the power. These universities are completely addicted to this cash. Without the cash, taken from plumbers and bus drivers, they will go belly up in a matter of months.

They can sue all they want in court. But if the Trump administration merely delays the payments, files appeals, and otherwise relies on the machinations of government delay— that will be enough to cripple universities.

Anyone who works at University who was forced to write DEI statements or forced to take DEI training (akin to indoctrination) knows that Universities have gone too far. The American people don't care about the suffering of academics who didn't care about school closure or the other major expert lies. Thus Trump has the perfect moment to apply maximal pressure. And notably, universities have no way to pressure Trump back. It's entirely asymmetric.

For these reasons, and because I believe Garber is smart, I think he is trying to thread the needle of complying with Trump, while keeping his job at Woke University. An initial strong statement was needed to save himself. And now, the slow, and eventual capitulation begins. To be perfectly honest: many of these reforms are needed to make sure the set point of Universities mirrors the set point of America.

There are lots of things I prefer to avoid. I don't eat cake. I don't eat fries or any fried food. I don't drink sugary drinks. And yet, like many, I am not perfect and once every few months I do. If I am travelling and jet lagged and skipped meals and feel headache-y and have to give a lecture, I will have a coke. If I am in Belgium and order mussels, I will eat pomme frites. If it is a special occasion, I will have a piece of cake.

In these situations, I don't want a diet coke. I want a Mexican coke with real sugar not high fructose corn syrup. I don't want a cake baked with half the sugar and half the butter, but one that sticks to the recipe fit for Paul Hollywood. I don't want fries cooked in safflower oil, but ones made in tallow.

If you are going to indulge, then indulge. And yet, I see so many protest this philosophy. Don't eat fries, but if you do, it's better they are cooked in shitty oil and are floppy and lifeless. Really? Don't drink coke, but if you do, take the one with aspartame. And the shitty cake that comes in a box and doesn't rot is the same as the handmade cake from simple ingredients with butter frosting. Proponents of this view cite disgracefully poor observational studies and act so confident. Seed oils are better than tallow they claim!

Really? If you randomize people to tallow vs seed oils do they eat the same amount of fries? Do they get hungrier sooner? What else do they eat over the course of the day? If tallow makes the price go up, do they eat fries less per month? Also what about pleasure, texture, mouth feel? What happens to mood?

They have no fucking clue. And yet they keep talking.

The move away from simple ingredients to processed ones was largely a profit maximizing move by the food industry. Improving shelf stability makes more money. Meanwhile, the quality of food has deteriorated from a chefs/ diner perspective. That's why Bourdain continued to use tallow. That's why Bakers use butter and eggs and not margarine and whatever sad polymer you need to replace eggs.

Along comes RFK and others who are skeptical that advances in food technology are unalloyed good. They want to ban or reduce dyes and stabilizers and novel oils that can only be produced under industrial level conditions. And many oppose this saying: we don't have strong evidence that these are harmful.

Who gives a fuck? The entire modern American diet is the end product of unprecedented chemistry for which there is no evidence people are healthier. And, the food tastes shitty. And, any chef worth their salt, rejects these conveniences from their kitchen. So why is the burden of proof to show that tallow is healthier and not the other way around? And what about all the forgotten and understudied aspects of eating?

In the absence of data on all these questions, I think it is better to stick the recipes, as they were intended to be made, and as they have been made for centuries. I find it odd to defend seed oils and dyes and food that doesn't rot.

It's funny to me that the same people who happily consented to closing schools for poor kids for years, absolutely indifferent to their suffering, saying nothing, while simultaneously sending their kids to private school, have finally found an issue worth #resist ing: their government subsidized jobs.

Yet unspoken throughout all this is a series of assumptions:

1. All scientific work being done is scientifically credible

2. If 10 scientists can find 1 cure, 100 scientists will find 10 cures (science is like a lottery and each ticket has equal odds)

3. Diversity research helps poor, black and hispanic kids

4. The best use of taxpayer money are these grants. They are more valuable than other uses like improving nutrition in kids schools, etc.

5. It is totally ok to preferentially fund grants loaded with DEI buzzwords. It is totally wrong to preferentially cancel grants with DEI buzzwords

6. It is totalitarian for a new government to pressure universities to do what it wants.

I think the challenge is nearly all these assumptions are wrong. Let's take them in turn.

All scientific work being done is scientifically credible.

The majority of science is neither true nor useful. Much of this work— particularly on hot issues like DEI- is prima facie biased. They won't publish results that don't fit the narrative (see recent gender identity study NYTimes). The methods are flawed. And much of even apolitical basic science is entirely irreproducible. The product of a system with massive incentives to make tall claims and nearly no incentives to verify them. The research being cut is some of the lowest quality science. Worse, universities don't even attempt to verify their own labs. Labs rarely reproduce their own findings. It's a sea of bullshit and most are happy to look the other way.

If 10 scientists can find 1 cure, 100 scientists will find 10 cures (science is like a lottery and each ticket has equal odds)

We know nearly nothing about he relationship between scientists and discoveries. Many of the real discoveries are forced moves in design space, as the philosopher Dan Dennett would say. Meaning that within a short period of time, multiple groups will reach the same conclusion. E.g. crispr-cas9, sequencing the human genome, sequencing 1000 pts with AML and looking for recurring mutations. Very likely science is a lottery where in the beginning of funding, each ticket has greater odds of winning, and then with excess funding, tickets have diminished odds. We don't even know. Moreover, we train far too many phD students. They are used as indentured servants. Dulce et. decorum est. pro patia mori.

Diversity research helps poor, black and hispanic kids

To my knowledge there is no credible evidence that funding upper class and upper middle class academics to study diversity has helped poor black kids writ large. It has however given a lot of academics something to be smugly morally righteous about. It's like giving Generals more money to study the rations of soldiers and then watching the Generals get private drivers and chefs and the soldiers eat the same canned sardines.

The best use of taxpayer money are these grants. They are more valuable than other uses like improving nutrition in kids schools, etc.

Again, it is almost certainly not the case. Imagine a pipe has blown in my basement and it is filling with water. I could hire a plumber to fix it or an academic to study the problem. Obviously, remote, via zoom.

It is totally ok to preferentially fund grants loaded with DEI buzzwords. It is totally wrong to preferentially cancel grants with DEI buzzwords

This one I love. The Biden administration went so overboard with DEI. For a while everyone was told to find a way to tie their work to diversity. And, like sheep, most complied. And no one protested. Then we had an election and the shoe is on the other foot. Canceling a grant given and never funding one in the first place are treated very differently psychologically but practically they are similar.

It is totalitarian for a new government to pressure universities to do what it wants.

It is not. It's the consequence of elections. And if they did not take these actions: what would happen? Universities would slide further into mandatory DEI statements and training and pledges. Protesting would become the new most popular major. Faculty who voice different opinions would not just be pulled from teaching duties and stripped of teaching positions (as we saw during the pandemic), they would be forced to wear a sign “misinformation spreader, per MSNBC”. The only check and balance on universities is the public. And they are owed that right because as we see: Universities are a welfare program, so addicted to federal funds. The center point of the public and woke University is so far apart that a reset is needed. Even if it is painful to some, and, even if, it sometime misses.

Just like the pandemic, the media is totally wrong about what is going on today. They are in the “make sure you wipe down your packages” and “let's turn to Apoorva for school facts” stage of their coverage.

First, the media keeps talking about mass lay-offs but does not put this into the context of HHS growth over time. A reader sent me the figure I was asking for. HHS staffing by year.

I would not have truncated the y axis, but the point is clear. The recent cuts merely reduce the bloated agency to earlier staffing levels.

Second, this is White House guidance for what NIH grants to cut

It all seems reasonable to me. Issues that the voters directly voted upon. I would cut most of these as well. Vaccine hesitancy is an important issue, but most current researchers are not studying it honestly. They do not consider the impact of the unethical Biden vaccine mandates on public trust.

Finally, this was cut off from my last post

This issue remains entirely undiscussed in the media.

The media coverage has used words like blood bath, or the FDA is dead, or the US is over. Yet, here are some questions I have not seen answered.

1. The reduction in work force returns the size of these agencies to what levels? 2019 levels? 2015 levels or 1976 levels? The media coverage suggests the latter, but given the massive growth of these agencies we may be talking about the former.

2. In the private sector corporations downsize of all sorts of reasons, including incorrect ones. What is the burden in the public sector? Can it never downsize? Does it have to first commission a ten year committee to find out who should be laid off, and, in doing so, hire a few more people in the interim? How often do politicians run on cutting government size and actually cut government size?

3. Where is the US on the curve of spending on biomedicine and biomedical advances? Are we on the steep slope, i.e. each dollar spent means many more cures, or are we on the flat tail, meaning that we have long surpassed efficient spending. (provide data not quotes)

4. When people are laid off, how many staff remain in those departments? How many entire departments are instead gone, and what did they work on?

5. When experts are quoted, what percent were appointed by Democratic presidents?

6. And …

Read more

At FDA, Peter eventually became director of the Center for Biologics— overseeing vaccines and gene therapies. In this role, he made some of tbe biggest regulatory errors in the 21st century.

Without randomized data regarding clinical outcomes, he repeatedly approved COVID boosters for kids as young as 6 months

Without randomized data he approved these boosters for individuals who recently had COVID

When Biden wanted to mandate the COVID 19 vaccine via OSHA and to military members and to pressure companies to do the same, he faced a challenge. The vaccine was authorized only under Emergency use authorization and not full biologic licensing agreement. Legal experts disagreed if a vaccine could be mandated without BLA.

Peter Marks then pressured Gruber and Krause at FDA to grant full BLA. When they did not play ball, Marks pressured them to resign (This was also documented in Krause’ testimony to Congress.

Then, with the BLA in hand, Biden was allowed to advance the single greatest anti-vax action in the 21st century. Mandating a vaccine that did not halt transmission and has no third party benefit.

This has resulted in massive vaccine hesitancy.

Then to top it all off, Peter was a long time proponent of lowering the bar for gene therapy. Against the advice of 3 FDA scientists on 2 occasions he granted both accelerated and regular approval to Sarepta’s Duchenne’s MD gene therapy. A therapy that has no evidence it helps boys. Sadly, now, at least 1 is dead

Peter Marks, single handedly has indirectly killed more boys with DMD than he has saved with this regulatory action. The drug does not actually improve motor outcomes in randomized trials.

Meanwhile the media is lying about Peter Marks. They state that Marks was pressured to be anti-vax by RFK Jr. Yet, no single specific action is cited. What precisely did RFK Jr ask Marks to do? Some articles even call Marks a hero, and he is praised by past FDA officials who now consult for drug companies or serve on their board.

In short, Peter Marks was one of the most dangerous, pro-pharma regulators of the 21st century. He is leaving and crafting an narrative that portrays him as a saint. That’s natural. But what is shocking is that the media is so uncritical, and not honest about his actions. The same media that lied about lab leak, masks, and all things covid is lying about Peter Marks.

Overall, he is what happens when a mediocre academic becomes a pro-Pharma FDA regulator, and makes a series of the most calamitous mistakes in 21st century drug regulation. Because of him, the American people are poorer and worse off. Companies meanwhile profited from his actions. My only question is whether he starts working at Pfizer, Moderna, Sarepta or a consultant for all three.

1. Issue a comprehensive apology to the American people. We are sorry and wrong for telling you to mask your children. We are sorry and wrong for recommending community masking (Jefferson, Cochrane). We are sorry and wrong for urging vaccine mandates. We are sorry and wrong for recommending vaccinating and boosting individuals who recently had COVID. We are sorry and wrong for errors in counting children deaths, 6ft distancing, school guidance, and so on. Step 1: is to document and admit your errors. This should come with a plan to remedy these errors: Any individual at CDC who formulated or touched these policies without opposition is now fired. In cases where they cannot be fired, we have assigned them to field posts in Alaska to look for bird flu.

2. Advise Americans to not wear masks in public. If you still wear a mask on an airplane, you should stop. There is no evidence that a person who is intermittently compliant with public masking improves their long term health and you look like a crazy person. Please do not mask your children.

3. Remove the COVID vaccine from the childhood immunization schedule.

4. Fired all CDC advisors who receive payments from pharmaceutical firms (last 3 years), run trials for pharmaceutical firms, or hold patents on vaccine products.

5. Launch a prospective study to capture real vaccine side effects. This cannot merely be retrospective. The focus cannot merely be autism. The focus has to be any and all vaccine side effects. I am happy to offer methodological ideas, which we have detailed elsewhere.

6. Commission bids for a cluster RCT comparing the US childhood immunization schedule (minus COVID) vs. Denmark, Sweden’s and other nations.

7. Build a firewall between the data collection and policy making sides of the CDC. The group tracking public statistics should not be setting policy. Too often statistics were fabricated to support policy narratives. There should be a firewall in CDC.

These are 7 starting actions the CDC director must take, and anything less than this will ultimately further undermine the CDC. If the CDC does not get on its knees and beg for forgiveness now, detailing errors and offering a plan to fix them, the next Republican administration will simply end the entire agency.

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At the same time, I would not increase spending at this moment. The current system is so broken that merely increasing science funding would merely mean more waste. The media talks about science like every dollar we spend is valuable. It is not. Let me give two examples.

First, the media is critical of RFK for cancelling hundreds of millions in federal funding for mRNA vaccination and in this case an oral COVID vaccine against KP2.

If any company wants to make an oral COVID vaccine they should raise private funds from investors and do so. The US FDA should make them power their trial for hard endpoints (hospitalization and death) and not accept immunologic surrogates. With these rules, very likely the company would not be able to raise money. Investors would ask: wait a second— how many people are actually hospitalized any more with COVID? What is the chance this pill (a hitherto novel vaccine technology) would work? Will Americans want this product and use it? Likely, it would fail.

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So why should the government continue to fund the company if investors don’t believe in it. In some situations you could argue broader societal good, but in this case, you can’t. Because COVID19 is no longer a novel pathogen, but one of the now 5 circulating cold strains.

Second, I saw a researcher at Columbia complaining that this grant was cancelled.

Again, climate change is, as of 2025, inevitable, as is the growth of Air Conditioning globally. This researcher is asking:

Does climate change —> change the temp—> make it harder to sleep —> bad outcomes

Alternatively he could ask

Does burning energy—> make ACs cheaper—> make it easier to sleep —> improve outcomes

But either way, the question is unanswerable. From a methodological standpoint, I can’t imagine an agreed upon way to investigate it. I bet if you gave it to 25 research teams across the political spectrum, you would get 25 different answers. But if you give it to 25 climate activist researchers, you would get 25 answers that are all bad but very different point estimates.

For that reason, I strongly suspect the researcher will conclude climate change makes sleep worse. I already know the outcome!

Finally, what difference does it make? It’s not like there is some politician on the fence about signing a climate bill, but then “I never knew it will affect my sleep!” The grant has poor value of information.

Science can be scientific but science funding is currently low tier sociology. It is faddish and untested.

Funding low credibility science on politically disputed topics is a cauldron for public distrust.

If scientists want more funding they have to be honest and admit that we are funding some silly ideas right now. Cut bad spending before asking for more money.

1. The brand is damaged. One of the points Jay Bhattacharya made in his confirmation hearing was about the use of medical products derived from aborted embryos. Jay said that there is a large group of Americans who will not accept these product which is a reason to reduce its funding. Whether we like it or not— acceptability among people is a factor in funding. Due to the disastrous Biden vaccine mandates and obfuscation around myocarditis and other safety signals, I fear the brand is damaged for most uses.

2. There are alternatives. MRNA vaccines utilize the cell to create the protein against which immunogenicity is developed. There have been and there are alternative means to do this. In the case of the covid-19 pandemic, it was extremely convenient to use mRNA because by taking advantage of the cells intrinsic ability to create proteins we could go very quickly, which was at a premium because of lockdowns and closure (our bad policy). In other therapeutic arenas, that speed does not have the same salience.

   

3. The long term safety profile is unknown. While this does not apply to uses in populations facing imminent death, it does apply to other infectious uses or in diseases with long survival. I tend to be skeptical of claims of unknown side effects until they are shown with validity. At the same time I know that the current safety program is extremely poor at characterizing safety signals. We do not yet know the long term impact of this technology, and again, if you have a terminal disease, the risks of long-term safety concerns are less important.

4. Uses in cancer are of low pretest probability. With colleagues, we have a paper forth coming looking at the randomized control trials of cancer therapeutic vaccines. Spoiler alert: it is a sea of negative findings. What precisely is a cancer therapeutic vaccine? We take patients who have cancer, whose immune system maybe impaired or senescent, and we inject them with antigens against their tumor. Those antigens can be made with protein derivatives, or they can be given as an MRNA. But the idea is the same to sensitize the body against antigens in the body. These can— and have been— even been bespoke— made for each individual. All of these trials have failed. Provenge came to the US market but the trial has misuse of crossover, so the difference is likely due to docetaxel administration.

   

   From our paper (2015 above)

   The pretest probability for cancer therapeutic vaccines is lower than other domains of cancer biology, such as cytotoxic drugs, tyrosine kinase inhibitors, antibody drug conjugates and even cellular therapy. That is not to say that the pretest probability is zero. It never is, and something may succeed against the odds, but the role of funding is to try to improve one’s chances.

5. If this class of product is so transformational and will be so well received by the American people then surely the companies that have already invested billions of dollars, and have hundreds of billions of dollars in cash would invest further in these products. But they are also very interested in these federal subsidies.

   Side note: Some cite these two papers to support mRNA vaccines

This is a phase 1 study without a control arm.

They took pancreas cancer patients with a single resectable panc lession. Did surgery. Had to have path R0 or R1 resection! Gave atezo, gave their bullshit vaccine, then gave FOLFIRNOX.

They present an analysis by biomarker plot in the paper.

No control arm. Some people destined to well already. Restricted to R0 or R1 resection (aka cherry picking) and the intervention was confounded with FOLFIRINOX.

A completely useless study.

At least this is randomized

Problems. Volatile estimates, tons of censored patients, cherry picked 18 month time point.

If this melanoma vaccine is so good, what is it’s response rate in relapsed refractory metastatic disease?

I will bet it fails in large phase 3 without high drop out.

Do you know what would be a silly thing to do: recommend that adults born between 67 and 89 who DO NOT LIVE IN OUTBREAK regions, check their vax card and get an MMR booster. Yet, this is precisely what Slate suggests:

And if you aren’t in a outbreak region, you don’t have to run, but you still ought to do it. Side note: that appears more aggressive than even the current CDC’s website.

CDC

Sweet Jesus, this is a stupid thing to say— especially in this moment. First of all, I fit this demographic perfectly, and off the top of my head, I can’t recall how many doses I received, but I won’t be seeking a medical consultation for this.

The ACIP recommendation to give a 2nd dose to those who have 1 in outbreak settings already is based on lower levels of evidence, but just going out and getting another dose if you live in Manhattan or SF is completely batshit stupid. It’s bad public health advice because it makes the public think public health people are zealots.

The lesson that public health seems unwilling to learn is you have to pick your battles and focus on the interventions with the greatest risk/ benefit ratio. Giving an unvaccinated kid a single dose of MMR near an outbreak region is high yield, scaring Suzie in San Francisco to get her 2nd or possible 3rd dose because she doesn’t want to be antivax is completely pointless.

It alienates people from health care. It leads vaccines to be further polarized. It is the same thing as when liberals saw that Trump did not wear a mask and decided to forcibly mask their 2 year olds, even in speech therapy, because that would show him. Nothing shows anti-vaxers are wrong like recommending unnecessary vaccines to people who have already gotten a lot of unnecessary vaccines (See COVID), the logic goes.

Sometimes, I worry that the core problem in public health is that when you take a field and pay a low wage for decade after decade, anyone with intelligence goes elsewhere. You somehow have selected for a pool of the dumbest people in the country. Toss in political polarization— because the very low wage also selects for far left individuals. (studies in medicine show higher income is associated with higher fractions of Republican voting individuals), and you have ticking time bomb.

When an issue arises, and you need a very smart, shrewd, pragmatic leader, you have dummies talking out their ass trying to ram one size fits all policy down the throat of the public.

The greatest anti-vax tool ever created was allowing public health to be run by idiots.

But nearly no one in the academy was doing anything meaningful about it. They like to talk about it. Say the same things, as they fly to conferences and stay at swanky hotels and fluff themselves (thanks indirects!).

I often wondered if you would do more good taking an airplane full of cash and dumping it out over an impoverished region than letting these scientists waste our time with low credibility and redundant papers.

But the brain rot took hold. DEI was everywhere. A medical student could have four lectures in emergency medicine and one would be on dei and the other would be on the impact of global warming on heat stroke. How to work up chest pain might just be a footnote. It was insane how much of the curriculum became dei. It was also astonishing that you could not question things. If you said anything against the prevailing narrative you would be labeled as “dangerous” and be removed from teaching duties and the like. In fact, if you didn't pledge allegiance to the dogma in mandatory training, you wouldn't be allowed to teach in the first place!

Then, as the study sections deteriorated, filled with mediocre scientists, dei took over grant applications. You had to put underserved minorities or persons of color or some abbreviation soup in there to justify your grant. It doesn't matter if it was completely unrelated to these topics. If you painted your grant with the lens of DEI, you were more likely to be funded.

Just for the record. The work from my team has always interested in helping the poor, and I have worked for 5 years in a safety net county hospital. Providing good care to the less fortunate matters to me. But what I hate more than anything is empty rhetoric. (And downright dishonest research… such as claims that white doctors have twice the death rate for black babies and other such ludicrous ideas based on bad science)

Then, like all faddish movements, the pendulum swings back. A growing number of people in America are sick of this rhetoric. And they vote in Trump. Columbia University likely did a poor job of balancing protests, preserving safety, and navigating a difficult situation with diverse views.

The Trump administration wishes to punish Columbia. So they start to cancel grants. But they don't cancel all the grants to Columbia. My guess is they only cancel about 1 in 3 NIH grants. But they don't do it at random. This is the kind of vocabulary in your grant that would get you canceled.

From skimming this grant, my guess is that it's methods are inadequate and poor. It won't be able to give us any information that is accurate or novel. The analytic flexibility is greater than the signal. It certainly won't be able to help these women. And of course they paint the grant with the DEI rhetoric to help them get funded. This was one of the grants that was terminated per Nature.

One Columbia faculty member tells me this, “Lots of PIs in Columbia whose grants did not get cancelled are thankful that they did not use DEI buzzwords in their application”

Once a buzzword, now a liability.

Easy come, easy go.

What's the take home lesson?

The real lesson is we shouldn't be funding grants based on buzzwords. Whatever is in fashion today, will not be in fashion in 5 years. Dei was a powerful dogma. Perhaps the majority of Americans disagreed with its core philosophy. But it was rammed down the throat of faculty, even those in biomedicine, within universities. My guess is many deans felt powerless to stop it. You could be the president of the University and worry about your own job. So they allowed it to infect the system. And now there's the correction.

Going forward, I would suggest not to include these buzzwords in your Grant. I would also not rebrand this. Words like inclusion and belonging are also not going to do well in the future. Write your grant's very matter-of-factly. Just state what you're going to do and stop using this kind of politicized rhetoric.

I also think that we need randomized control trials of NIH funding. Because the only reason the system was allowed to be so co-opted is because the study sections bought into it. But we have no idea if study sections is the best way to give out money. My guess is even lottery would out perform the incompetence, fickleness and capriciousness of study sections.

If grants were given by modified lottery, we never would have fallen down this dei rabbit hole.

Nature claims that the grants that are canceled are disproportionately training grants. But they do not provide evidence of this claim. Yet, I would not be surprised if that is the case because I would guess younger people are more likely to use these buzzwords.

Funding buzzword science was always a dangerous game. Now it appears it has backfired tremendously.

There is an irony here.

It claims plant based oils are better than butter, which is in contrast to MAHA— Make America Healthy Again— which prefers butter, ghee, tallow and olive oil (extra virgin) over sunflower seed, canola, and soybean oil.

The paper is a classic observational study, let me just cut to the 3 big problems.

Problem #1 - they do not actually know how much butter people are eating. Everyone is assumed to use the exact same amount (a pat 5 g) of butter every time they report using it. This means a butter crossaint is the same as butter on toast versus butter in the pan before you saute a chicken. Anyone who cooks will know that this is an idiotic assumption.

They justify this by citing a paper (ref 24) saying their method of conversion has been “validated” but I read that paper, and it is sobering. By validated, they means that food frequency has some weak correlation with another imperfect method of data collection— a 7 day diary. (which PS might also not be accurate) And when I pull the figures in the paper, I found they were even more dishonest. Butter is actually one of the ones where there is the weakest correlation between frequency and amount based on diary. And the true amount consumed is likely EVEN MORE INACCURATE than this, so the real correlation is even worse.

It felt like gaslighting when I checked the reference. They know how stupid their assumption is, and cited a study, perhaps hoping, no one would check it.

Problem #2 - they combine OLIVE oil with these other oils. Of course MAHA has no beef with olive oil. No pun intended. Everyone likes EVOO. I have a particular brand that I like. No one ever equated olive oil with soybean oil.

Related problem, is I see no validation for these oils in the paper. In other words, just as with butter, I could not find strong support that they are accurately measuring intake of these oils.

Problem #3 - People who eat butter are COMPLETELY different than those who use plant oils. They have different exercise patterns and smoking patters, and many other differences. We must remember that much of these survey data occurred in a world afraid of saturated fats so naturally richer, health conscious people avoided them. The data is a mess.

Conclusion

I wish to make 5 points

• Lumping olive oil with seed oil, having no real clue who ate what, and then seeing massive imbalances in covariates and, yet, nonetheless, proceeding in this analysis is research misconduct. It should lead to disciplinary action, not a JAMA IM paper.

• This paper is not science; It is closer to propaganda. And given the political overtones, it may be considered politically motivated or a form of campaigning. It is like the cloth masking studies that were used in the pandemic to justify absurd policy.

• Some of the authors are NIH funded. We are wasting taxpayer money on this entire body of science. I continue to state most NIH funded work is a waste of money. We steal money from bus drivers and garbage truck workers to do this “science” that is wrong. I would cancel all these grants— sure there is an error rate, but no worse than inferring how much butter you eat in grams from a food frequency questionnaire ;)

  

  Finally, these three authors in particular have done some of the worst science of the last 50 years. Go ahead, pull their papers and see for yourself. It proves how careers are made of bad nutritional epi.

  

• It is no secret that the JAMA IM editors are anti-MAHA, as are most journal editors and they will not see past their own bias: a paper that criticizes a MAHA initiative will be more likely to be published than one that supports it. It is concerning that Journals do not wish to have ideologic diversity. That would have prevented them from accepting this paper.

  In short, this paper is flawed. Proponents of science and those who oppose cuts to NIH are saying that science is politically neutral, a method of finding truth, and bi-partisan. But then they do something like this. Publish an obviously flawed analysis. A twisted and contorted study. On a political topic in a heated moment, and further prove that many NIH funded grants are weaponized for political advancement of one side. What do they think will happen to their funding?

  What do I think about seed oils? Butter? I personally have the following 6 beliefs. As someone who cooks for ~10 hrs a week, this is how I like my food.

Read more

The NIH cuts funding for studies on vaccine hesitancy. Well of course, I think we would all agree that vaccine hesitancy is an important topic, and we need to know more. But that isn’t the question. The question is whether or not what we are funding is helpful.

And let me, at the outset, give you a reason why it might be unhelpful. We all know in medicine there are different doctors and scientists. There are a few who are open minded and curious, who approach issues from all vantages. They are willing to consider that recent rise in vaccine hesitancy is fueled by third party fringe elements, but also willing to consider it was fueled by the misguided covid-19 vaccine campaign and mandate, and the annual booster campaign,

Then there are the ideologues. Vaccine researchers who just repeat bland slogans “they are all safe and effective!” without considering nuance. Ideologues invariably blame third parties— and ignore all the recent errors. Many of the people with grant funding to study this topic are ideologues.

If you want to fund effective research on vaccine hesitancy— you would draw distinctions between important vaccines (measles or polio) and less important ones (covid-19, hep B (on day 1— can it happen later, as in Europe), and even arguably some others).

If you wanted to fund effective research, you would consider which strategy is better to reduce hesitancy— reassure parents that all is fine, and we know these products are safe— or admit what we don’t know— while we have great confidence for some products, for others there is massive uncertainty.

To address these questions, I picked the last few NIH funded vaccine hesitancy papers on Pubmed and decided to see what the hell is the NIH funding. These are consecutive articles, no omissions.

Exhibit 1.

This is a review article published in a low tier journal. It was NIH funded. I read it and learned nothing of value. It repeated empty platitudes favored by ideologues. It had no original data or insights. Verdict: funding should be cut.

Exhibit 2

This paper was low quality survey paper. It asked these derivative and dull questions.

There wasn’t a single sentence in this paper that I found interesting or intriguing. It could not offer pathways for solutions. Verdict: funding should be cut.

Exhibit 3

For a moment, I got my hopes up and thought that they actually ran an experiment to study this and reduce hesitancy, but it is ANOTHER REVIEW article. It literally says NOTHING new. No new ideas— it repeats the same thing you would read in the newspaper every day. It considers no new angles, and offers no new insights. Verdict: funding should be cut.

I did this for 10 more articles and they were all like this. Again, consecutively chosen in reverse chronologic order.

So, should NIH cut the funding? Yes!! We need new ideas and innovative approaches to vaccine hesitancy. We need researchers who are at least willing to consider that one reason it is rising lately is that our covid policy further bred distrust. How can you overcome that if you won’t admit it?

The media keeps whining about what Trump cuts, but their analyses are superficial. I think they are unhelpful. Take a look at the specific grants, you will find many should be cut. Very often you will find that a field needs a reboot.

Many online are debating whether or not this action works to improve on campus conditions for students, if it targets the administrators who fell short, or unrelated faculty, and many other related questions. Yet, one thing is clear: it is a strong message and will surely make the administrators in question panic, suffer, and seek legal remedy. Even if grants ultimately reinstated, in part or whole, It is a powerful motivation for universities to do better on all future protests, balancing freedom of expression with safety.

Should a similar action be extended to universities which actively worked to constrain academic freedom? Stanford’s faculty senate censured Scott Atlas for saying schools should remain open, lockdowns were barbaric, and kids shouldn’t mask.

Stanford’s medicine chair directed Prof. Eran Bendavid to stop speaking publicly against lockdowns.

Pitt removed Norman Wang from its EP program directorship because he didn’t support race-motivated affirmative action

I am aware of dozens of additional examples of faculty losing teaching roles, being denied promotion, or simply being told to ‘be quiet’ for signing the Great Barrington Declaration, being critical of masking, or lockdowns or vaccine mandates.

In 100% of these cases, the view that was punished was the view that tended to be held by conservatives— though ironically, there is nothing about masking a two year old that makes it a liberal position— it just happened to fall there because of Trump derangement syndrome, i.e. since he was nonchalant about masking, the left had to do it as hard as possible.

How can NIH operationalize this proposal? Right now there is an NIH hotline and submission form for complaints about sexual harassment or fraud in research. These are investigated and grants can be cancelled or pulled. This mechanism should expanded to concerns that faculty were punished or told to remain quiet on policy issues. Universities with high rates of offenses could then have grant funding revoked.

Universities are not going to do the right thing without accountability. They are not going to foster a culture of debate on issues that fall on right/left lines because too many faculty members on the left view the debate itself as ‘violence.’ Small groups of faculty label views they dislike as ‘dangerous misinformation’ even as those views were correct. Many faculty stopped discussing these issues publicly because of retaliation in their jobs. Short of being fired— being denied the opportunity to teach, to present one’s work, to lecture, and being stripped of titles— is unjust retaliation and was conducted by many universities.

Stripping even a handful of institutions of large numbers of federal grants will wake up administrators. They do not yet understand that their conduct is precisely the reason why public trust is in the toilet. A stronger message is needed. I offer this suggestion only because I believe that in the long run, universities would be better off if they foster and encourage debate, and allow faculty to hold a range of ideas. And because I worry that if they don’t do that, they will increasingly become irrelevant.

It is easy to protest to defend your own salary, but I wonder why no one stood up for any of the following 5 topics in the last few years

1. The majority of science is conceptually flawed, does not reproduce, is not useful. Multiple empirical and theoretical analyses show this rate is upwards of 50%. Ioannidis showed with conservative modeling the majority of research is false. Glenn Begley reported Amgen’s experience where only 11%! of published cancer research could replicate in their lab

Not a single American university has sampled their own experiments and sought to replicate them. The NIH has never made reproducibility a cornerstone of funding. No one stood up for reproducible science.

2. Fraud is rarer, and involves willful deception. Its is often overlooked by scientists. To my knowledge, not a single one of these Dana Farber investigators have faced penalty for this. No one stood up for science free of photoshopped figures.

And, if you really wanted to eliminate all fraud you would realize that the only reason we find problems in images is people report the raw data. If we reported the raw data for all experiments, fraud would grow exponentially. Again, no one does that. Which brings me to….

3. When many of us concerned with the veracity of science asked for data sharing the Editor in Chief of NEJM called us “research parasites”— that’s the word used for someone who wants to make sure the published work is correct. Interestingly patients who participate in these studies wrongly assume the data will be shared for maximum good. Instead, because researchers want to hide data, the ICMJE’s proposal for data sharing was defeated. No one stood up for transparent science.

4. These professors were fired for not getting a covid vaccine AFTER they already had covid. Interestingly, many other professors got exemptions, but they did not. It is almost as if the mandate could be used to cull professors with unpopular views with selective exemption. No one stood up for these scientists, or a culture where we don’t fire people with unethical mandates. Aaron ironically was the hospitals medical ethicist.

   

5. Scientists are happy to protest their own funding, but most had nothing to say when schools were closed for 2 years, and people were separated from their dying loved ones. Both of these devastating actions went against science. Easy to stand up for science when it benefits you, harder to when it benefits others.

Stand up for science is not about standing up for scientific claims or processes; it is about standing up to unaccountable funding. Sadly, those days are over. Reform is coming.