By Joseph Varon at Brownstone dot org.

The recent earthquake in Venezuela brought back memories I have spent nearly 40 years trying not to relive. Watching images of collapsed buildings, frightened families searching desperately for loved ones, rescuers digging through mountains of broken concrete with little more than their hands, and physicians struggling to care for the injured under impossible conditions transported me to another place and another time.

Trauma has an extraordinary memory. It does not matter how many decades have passed or how many lives you have saved since then. Sometimes all it takes is another earthquake, another cloud of dust rising over a broken city, another exhausted physician covered in debris, and suddenly you are no longer watching the evening news. You are there again.

My heart aches for the people of Venezuela because I know, at least in some small measure, what they are living through. I remember the disbelief that follows the shaking, the strange silence that descends after the noise stops, the desperate hope that someone beneath the rubble is still alive, and the emotional exhaustion that follows days spent searching, treating, comforting, and grieving. Long after the television cameras disappear and the headlines move on to another story, survivors continue carrying that day within them. Every earthquake that follows becomes a reminder of the one that changed their lives forever.

Some moments divide life into two chapters. There is the person you were before, and there is the person you become afterward. Most of us never recognize those moments while we are living them. Only years later do we understand that the person who existed before a certain morning never truly returned. For me, that morning was September 19, 1985. It was the day I stopped being merely a young medical intern and began learning lessons that no classroom, no residency, and no textbook could ever teach. The last ordinary evening of my youth began with dinner.

On September 18 1985, three other people and I crossed the street from the Hospital General de Salubridad in Ciudad de México, to a modest Chinese restaurant that had become our refuge during internship. There were two fellow interns, my girlfriend Sara who, more than forty years later, is still my wife, and me. Ironically, we rarely went there for Chinese food. We went for what we affectionately called orejas de Elefante ("elephant ears"), enormous veal Milanese cutlets that extended well beyond the edges of the plate. They were inexpensive, delicious, and large enough to satisfy four perpetually hungry interns who spent far more time inside the hospital than anywhere else.

Like every generation of young physicians before us, we were convinced that nobody had ever worked as hard as we did. Internships have a remarkable way of making young doctors believe that they have discovered exhaustion for the first time in history. We complained about the endless hours, the overwhelming patient load, the lack of sleep, and the fact that we barely had enough time to sit down and eat before another patient needed us. We laughed because sometimes laughter was the only thing that kept us going. Looking back now, I smile at the innocence of those conversations. We believed we understood fatigue. We believed we understood responsibility. We believed we understood stress. We even believed we understood fear. We did not.

The following morning, at exactly 7:19 a.m., the earth decided to teach us otherwise. At seven o'clock I was sitting in a classroom located in the basement of the hospital. Even now, writing those words feels surreal. The basement. The very building that, within minutes, would simply cease to exist. It was another lecture, another ordinary morning in the life of a medical intern. Upstairs, patients were being examined. Nurses were changing shifts. Families were arriving to visit loved ones. The hospital pulsed with the familiar rhythm of medicine. None of us quest...

By Ann Bauer at Brownstone dot org.

Picture it. You're lucky enough to live in the late 19th century. Van Gogh is wandering around the Netherlands painting haystacks and stars. Spiritualism is everywhere: séances, mediums, table-turning, and seers who communicate with the dead. Some dude named PT Barnum is criss-crossing America with this crazy melange of traveling circus and sly hoaxes. There are side shows and peep shows, theatrical extravaganzas in every town. Ragtime is just taking hold.

And for the first time in the history of man, books are available to the everyone with a few ha'penneys to rub together. The print industry has exploded, becoming more systematized, and better at shipping. Suddenly, even ordinary people can read – in their parlors, at saloons and libraries, and after dinner, once the harpsichord recital is done. Novels are everywhere: Charles Dickens, Jane Austen, the Brontë sisters, George Eliot. In France, Victor Hugo. The Russians? They're producing metric tons of pages. Tolstoy, Dostoevsky. People are inhaling these stories, 900 pages at a time.

Academics refer to this period as the "reading revolution." Reading was as much an indulgence as carnivals and music halls. People didn't HAVE to read, they GOT to read. They did it ostentatiously and with zeal. And this habit lasted, in one form or another, until recently when reading for enjoyment started to tank. Blame the Internet and social media and our fractured attention span. Blame Oprah, who in her quest to 'get people reading' promoted one title and focused every English-speaking woman's attention on it, to the exclusion of every other book on the planet.

But the real culprit, if you ask me, is politics. When identity and partisanship become your defining feature, when you adhere to rigid ideas and philosophies – and fear anything that challenges your beliefs – reading becomes dangerous. All those random ideas floating around? Problems that have no easy answers? Bah! Who needs that?

So here's where we are: reading for enjoyment has fallen by 40% in the past 20 years. And despite bullshit feel-good essays about how we're not really reading less, it just seems that way – and online influencers who hawk the classics without a single specific detail about plot, theme, or character – literacy in every single cohort is falling off a cliff. Publishing is becoming narrower, more ideological, and preachy. The books that face out in shop windows reinforce pat answers instead of asking hard questions. And the world seems smaller, because it is.

Séances, circuses, live music, theater, art…they're all on the decline. Instead we have performative costumed protests and Netflix shows that are contractually bound to restate their plot three to four times for the benefit of distracted viewers.

And original stories, with unique characters built word-by-word and impossible quests and existential messages? These days, you cannot give them away. To wit: my friend Christina Dalcher, author of Vox and Master Class, has a new novel called Lexecution that I have read and loved. She is offering it in sections – for FREE – on X (a work that would cost ~$27 in hardcover) and takeup has been less than pale.

LEX, as Christina calls it, is about a future (present?) British society where speech crimes are policed by drone. Authoritarian rule outlaws gendered words, adjectives that imply degrees of quality (it's unkind to say, for instance, that a person is beautiful or smart, because it might injure those who are not), and all anti-government rhetoric. Children are enlisted, through the public schools, to report their parents for what they say. Re-education of offenders becomes a growth industry. Saira Rao, anyone?

Turns out LEX hit too close to real life, plus Christina was being punished – predictably – for counter-narrative things she'd said. First her agent and then a series of publishers backed out of negotiations to publish. Hence, she is putting this cutting and very real ...

By Joseph Marine at Brownstone dot org.

A few months ago, I was one of several candidates under consideration for Director of the Centers for Disease Control and Prevention (CDC). While I did not make the final cut, I was honored to be considered for such an important position. The administration has nominated a highly qualified team to lead the CDC and I wish them well. The experience gave me the opportunity to reflect on what reforms I would like to see at the CDC as it faces a pivot point in the history of medicine and public health. Here are six themes that I see as most important and urgent.

1. Develop a new ethical framework for public health practice. Too often during the pandemic, policies were justified by the intended effects with little attention paid to the means used to reach those ends. The Hippocratic Oath and its modern derivatives have served as that ethical framework for medical practice for over 2,000 years and they have made the health professions (until recently) one of the most trusted institutions in our society. Public health practice needs its own version and should adopt many of its principles, including:

Respect for individual rights: The US just celebrated the 250 Anniversary of the adoption of the Declaration of Independence. America is the "Land of the Free and Home of the Brave." Public health practice in the US must be consistent with our legal framework, traditions, and Constitution, including the Bill of Rights.

Subsidiarity: Problems are solved best by those closest to the problem. This idea has already been espoused by the CDC in its new priorities statement. The US is a vast and diverse country with over 50 state and territorial jurisdictions, each with its own constitution and separate police powers. A "one-size-fits-all" public health policy dictated by Washington or Atlanta will rarely be successful. While some public health leaders lamented lack of uniformity in the Covid pandemic response, federalism served us well and allowed states with less restrictive pandemic policies to lead the country away from the worst of other states' policies. The current US measles outbreaks have also demonstrated that local public health officials with local knowledge are better able to gain the trust of communities affected by outbreaks to bring them under control.

Non-maleficence: Avoiding harm is a basic Hippocratic principle in medicine which was largely ignored during the pandemic. Former NIH Director Francis Collins has belatedly acknowledged that US pandemic leaders paid little or no attention to the massive collateral damage caused by policies focused exclusively on preventing every possible Covid infection. "First, do no harm" is a dictum which should apply to public health practice as well as medicine.

Consideration of expertise of others: Public health is also public policy, not just science. A public health program must include expertise in economics, childhood development, psychology, and other fields which are not part of formal public health training. Dr. Fauci famously disclaimed responsibility for understanding the economic and social consequences of pandemic policies as being outside his field of concern. This attitude is not acceptable in medicine or surgery, where practitioners are expected to fully understand the consequences of the treatments that they recommend. It should not be acceptable in public health practice.

Use of least restrictive means to accomplish public health goals. This is already an acknowledged principle of public health policy, but it was ignored during the pandemic in favor of a misguided "precautionary principle" and "swiss cheese-layered protection" approach that promoted maximalist policies in almost all circumstances. Restraint needs to be reapplied.

Rejecting fear-based messaging. We recognize that manipulating patients through fear is unethical in the practice of medicine. It should be also in the practice of public health. Fear brings out the worst in h...

By Brownstone Institute at Brownstone dot org.

Conventional political philosophy has a blindspot over what turns out to be a crucial concept: the precise nature of the legal relationship between the human person and the regime under which he lives. In the US, we call this citizenship but how precisely is that different from the old-world notion of being a subject to a sovereign?

Confusion over this issue led the majority in the Supreme Court decision in Trump vs. Barbara to overrule an executive order that challenged automatic birthright citizenship. Only a few years back, anyone who would have challenged this idea would have been considered some kind of civic heretic, despite how rare this legal right is in the world.

Justice Clarence Thomas's dissenting opinion was more than a passing disagreement. He penned a treatise of monumental importance to our time. He has completely reframed the distinctly American idea of citizenship as a two-way agreement between the person and the political community. It is not conferred by birth alone but also requires domicile, which means allegiance and the forsaking of other political loyalties.

Thomas's mighty dissent, extracted in full at this link, is really for the ages and teaches this generation something substantial about our history. The purpose of the 14th Amendment was to admit blacks as full members of the polity. "Blacks were entitled to citizenship because they were Americans," Thomas explains.

"They had no other homeland, owed no allegiance to any foreign power, and were subject to no other authority. They 'fought and bled in the same battles,' 'gained and gloried in the same victories,' and were 'liable to be called upon to defend [America] in time of war' alongside every other citizen. The Citizenship Clause thus guaranteed them the 'dignity and glory of American citizenship," so as to ensure that they would never be treated as second class under the law."

They were not considered citizens simply because they were born here. This distinction has more significance than first appears. Thomas then explains the difference between the feudal concept of subjection vs. the free society's understanding of citizenship. There is mighty meaning here, one that is central to the uniquely American understanding of the relationship between the people and the government – a topic that reaches to the core of who we are and what the Founders were attempting to do.

The majority in this case plainly reinvented a feudal concept that the Founders pledged their fortunes, lives, and sacred honor to overthrow. Did they know or understand what they were doing? Not likely.

The emergence of birthright citizenship turns the entire history of its head and introduces a notion concerning individuals and the state that is contrary to the entire American idea. For the majority of the court to do this – probably without understanding the implications – on the 250th anniversary of the Founding only adds to the insult.

He concludes: "The Court's interpretation is not only contrary to the original meaning of the Fourteenth Amendment, it produces grotesque results. While foreigners who wish to immigrate lawfully must sometimes wait for many years, a child born here to a birth tourist is automatically a citizen." He warns "the Court has made a mistake that will seriously affect the country's future."

Thomas's full opinion is extracted here. Please circulate.

By Margaret Hampton at Brownstone dot org.

Healthcare in the United States is in a death spiral. Costs continue to rise, chronic diseases consume 90% of healthcare spending, and millions of Americans feel trapped in a system that often limits choice. Patients increasingly want insurance for a broader spectrum of care — from functional/integrative medicine, to preventive, and more holistic approaches — yet insurers frequently fail to recognize these services due to a lack of billing codes. The result is a healthcare environment where innovation is constrained, patient autonomy is reduced, and effective alternatives to conventional medicine remain invisible to insurers and financially inaccessible to most patients.

Two forces could fundamentally change the US landscape. ABC codes for non-allopathic caregivers and Health Savings Accounts (HSAs). Together, they provide a powerful framework for health freedom and empower Americans to make personalized healthcare decisions.

Healthcare systems (insurers and other payers) only reimburse what is coded and billable. The lack of codes for all healthcare options started in 1983 when the US Department of Health and Human Services (HHS) and the American Medical Association (AMA) agreed that HHS would only use the AMAs codes to process Medicare and Medicaid claims.

In 2002, HHS mandated use of the AMA's codes for filing electronic claims. ABC codes were mentioned as an option but not adopted and the AMA currently has a monopoly on billing codes.

In 2003, HHS provided an exception to test ABC codes as a standard for two years. Alaska Medicaid successfully paid for over 2 million ABC-coded claims filed electronically. Yet government reviewers of the exception data advised HHS in 2005 not to adopt ABC codes. The cost savings of using non-physician practitioners and functional/integrative care remained invisible due to this decision, and our healthcare spending has continued to skyrocket. Chronic disease drives nearly 90% of healthcare expenditures, yet our healthcare system remains largely structured around acute-care treatment.

As a result, patients frequently experience long wait times and expensive interventions only after disease has advanced. Integrative and alternative practitioners offer a different approach — one centered on prevention and addressing root causes rather than managing symptoms alone.

By intervening earlier and promoting healing, they can improve outcomes while reducing the need for costly medical interventions. Existing studies of nurse practitioner and advanced practice nurse care demonstrate cost reductions ranging from approximately 6% to over 30% compared with physician-led care while maintaining similar outcomes in many settings. ABC Codes provide a mechanism to identify, document, and measure those lower-cost care pathways across a much broader healthcare workforce.

X12, the standard for all electronic transactions, created the ability for ABC Codes to be transmitted within certain healthcare electronic transaction standards.

In practical terms this makes it possible to use ABC codes in electronic claims without HHS approval. This establishes a broader, more inclusive healthcare coding framework capable of documenting services that have historically been invisible to traditional reimbursement systems.

By providing standardized codes for a much wider range of healthcare services, practitioners and payers gain the ability to track outcomes, analyze utilization, and understand the real-world impact of therapies that patients are already using every day. The data from ABC coded claims can uncover how to create a more affordable healthcare system.

ABC Codes will help us to solve the chronic disease crisis. Conditions such as diabetes, obesity, autoimmune disorders, cardiovascular disease, anxiety, depression, and chronic pain are not being resolved using conventional medicine. They require sustained lifestyle support, prevention strategies, nutritional counseling, beh...

By Clayton J. Baker, MD at Brownstone dot org.

As the United States turns 250 years old, the Declaration of Independence is being quoted almost everywhere, both in lavish celebration of the glory of America as a nation, and in praise of the nearly unlimited freedom that Americans supposedly enjoy.

Curiously, the quotations used for these purposes come almost exclusively from the first two or three sentences of the Declaration. True, those opening lines are brilliant and profound. Who can resist words like these:

We hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness…

Consider however, that this celebratory and self-congratulatory use of the Declaration completely ignores the last 1,100 or so words of the 1,300 word document. As a born and bred patriotic American, I wanted to know why this is so. I began by rereading the entire Declaration. It raised a lot of questions.

For example, why does no one seem to reference this statement?

Whenever any Form of Government becomes destructive of these Ends, it is the Right of the People to alter or to abolish it, and to institute new Government.

Why doesn't anyone remind us that

… when a long Train of Abuses and Usurpations, pursuing invariably the same Object, evinces a Design to reduce them under absolute Despotism, it is their Right, it is their Duty, to throw off such Government, and to provide new Guards for their future Security.

I believe a careful rereading of the entire Declaration of Independence reveals why it is so selectively and incompletely referenced today. It is a sobering realization: if one thoroughly reviews the entire Declaration within the context of modern American politics, the parallels are unmistakable. It becomes obvious that the United States Government is itself guilty of "a long Train of Abuses and Usurpations" at least as tyrannical as the British Crown's actions a quarter millennium ago.

As such, the right and duty of patriotic Americans is made clear in the words of the Declaration of Independence itself – especially in the portions that we never seem to hear.

The majority of the Declaration of Independence consists of a detailed description of the "long Train of Abuses and Usurpations" that the Founders accused the British Crown of committing, followed by an account of the unsuccessful appeals for justice that the American colonists made to the British.

After its much-quoted opening flourish, the Declaration begins its litany of the Crown's abuses. It includes a lengthy description of the Crown's manipulation of the legislative process for the benefit of the British government and to the detriment of the American people:

He has refused his Assent to Laws, the most wholesome and necessary for the public Good

He has forbidden his Governors to pass Laws of immediate and pressing Importance, unless suspended in their Operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them

He has refused to pass other Laws…unless those People would relinquish the Right of Representation in the Legislature

He has dissolved Representative Houses repeatedly

Serious as those offenses are, one wonders how the Founders would have reacted to the legislative malfeasance of our modern American government. In the interest of time I will stop at three:

The routine passage into law of 1,000-page bills that nobody reads, loaded with endless hidden riders that the public would never accept as stand-alone legislation (e.g., every "omnibus" bill ever written)

The routine creation of laws that blatantly contradict the Constitution, stripping citizens of their fundamental rights (e.g., the Patriot Act, the PREP Act, and many more)

The frequent creation of laws granting legal shields to corporations and denying citizens legal recourse for harms they suffer (e.g., the 1986 National Chi...

By David Gortler, Pharm. D at Brownstone dot org.

Most Americans think nothing of referring to our nation's birthday as "the Fourth of July." But I learned the hard way not to do that in my Army Reserve Officer Training Corps (ROTC) days in college.

I'll never forget one of the times Sgt. Thayer, a regular Army soldier, decided to randomly quiz our ROTC squad on military regulation and history while we were in formation, following an early-morning inspection. One of the questions was:

"What American holiday do we celebrate in July?"

"The Fourth of July, Sergeant."

Sgt. Thayer's response?

"GET ON THE GROUND! COUNT THEM OUT!"

Then he called on another cadet. Same question, same answer, more pushups.

This pattern repeated several times until one of the putatively better-educated members of the squad, whose family had an extended and extensive military past, finally answered: "Independence Day."

I suppose I'd never really given it due consideration until then.

I learned plenty from being a cadet, but the appropriate labeling of this historically significant event is one lesson I think all Americans should also commit to as we prepare to celebrate the 250th anniversary of our Founding Fathers' declaration of Colonial independence from Great Britain.

America was founded on a set of beliefs and convictions—what Thomas Jefferson described as self-evident truths (actually, Jefferson originally wrote "sacred and undeniable" which was revised to the more secular "self-evident") that were proclaimed in the 1776 Declaration of Independence and then protected by the Bill of Rights and the Constitution.

The Declaration established the first modern country founded on principles of individual freedoms. It also led to the selection of America's government leaders by the people, rather than through an inherited bloodline of kings and nobles.

Can you imagine what your life would have been like if Great Britain ruled over us?

Why is the American holiday reduced to its calendar date by seemingly everyone? Can you recall the last time anyone wished you a Happy Independence Day versus a curt "Happy Fourth?" That kind of labeling debases the magnitude of what the day represents. And the problem seems to get worse with every passing year.

Nobody refers to Christmas Day as "the 25th of December." Nobody greets you on New Year's Day with "Happy January first." Calling it "Independence Day" honors the foundational designation and the values of liberty and freedom that the holiday represents.

Calling the holiday "Independence Day" connects the event directly to its historical significance. It's become necessary because a shocking number of young people are clueless about what the "4th of July" is supposed to represent—let alone the importance of the Committee of Five or the location of Valley Forge. They do not know who the Founding Fathers were or what they accomplished. According to the above-linked video, most Americans can't even spell "independence."

Public schools and teachers' unions have failed to educate American students on the fundamentals of civics. Leftist universities tend to focus their lenses on far-left Colonial/ anti-Founder indoctrination to students on America's failures rather than its successes. And putting John Trumbull's famous painting of the Declaration of Independence signing on the back of the two-dollar bill apparently wasn't enough. Perhaps a verbal grassroots renaissance using the proper convention will at least audibly point American citizens in the right direction.

Independence Day is unlike the adjacently occurring Memorial Day, which was intended as a somber day meant to valorize those who died in wars to protect our liberties. Many Americans unfortunately see Memorial Day as nothing more than a long weekend for vacations, barbecues, and other leisurely indulgences. Even outspoken "progressive" Democratic members of Congress endlessly lecturing Americans about our Constitution and fairness pathetically fail to compreh...

By Alan Cassels at Brownstone dot org.

I had a very good laugh a while back. A few actually. So many, they are worth sharing.

T'was in May of this year when the storied New England Journal of Medicine published a study about a new and novel influenza vaccine, designed to conquer the seasonal flu. Lucky for us, this new bit of medical innovation was made from the same sort of whizbang mRNA technology that went into the Covid vaccines produced by Pfizer and Moderna.

Yippee. Clearly this new jab is designed for those who didn't get the joke last time when a big corporation came looking for us carrying a syringe full of what-the-heck-is-that?

But I digress. Even the premise of this vaccine study is like the setup to a stand-up routine, where you know that stuff is going to get weird fast. Soon you find some in the audience are busting a gut as others are looking befuddled and scratching their heads over which the joke flew.

For starters, the biggest warning sign of any study is its size. A big study almost always means a small effect. Yup. In this case, to show some sort of effect they had to cadge together a group of over 40,000 people over 50, randomly injecting them with the trivalent mRNA-1010 or a "different licensed standard-dose flu shot" and following them for about 6 months.

We're all in the dark about what "mRNA 1010" is but rest assured that this "investigational messenger RNA (mRNA)-based vaccine encodes hemagglutinin glycoproteins from World Health Organization-recommended influenza strains." That should make everyone start feeling all warm and fuzzy, thanking their lucky stars that the WHO is all over this.

Speaking of which, the backstory of the annual flu campaign, often led by the big infectious disease brains in Geneva, is typically marked by hefty amounts of flu-mongering and vaccine salesmanship. There's science and there's marketing but when we're talking the good old flu, the twain shall never meet.

For the most concise breakdown of the study, we can turn to the good folks at ICAN (the Informed Consent Action Network) who sent a letter to FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) and cut to the chase:

Moderna's new mRNA flu vaccine, mFlusiva was a joke, especially if you take "the science" behind it seriously.

Of the 40,000 people in this trial, those who got "Mal-flusiva" (do I get bonus points for coining the first nickname for this mRNA miracle?) reduced their absolute influenza risk by 0.8%. That's right, it might help 8 people out of 1,000. Meanwhile 6.4% of recipients (64 out of 1,000) suffered severe reactions (pain, fatigue, weakness, headaches), at rates which were five times the rate of the standard flu shot.

But did it prevent deaths from the flu?

No, fool. It caused them. In the "Phase 3 Immunogenicity trial" of the new vaccine, five patients died (versus one in the standard shot group). Hard to put lipstick on that one.

What about cardiac risks? Ah, you have a good memory, grasshopper. Events such as fatal cardiac arrest and congestive cardiac failure—similar to what was documented in the Covid mRNA vaccine technology– was also a feature here.

What about cancer? Also, good catch. As to that issue, ICAN blithely noted the "growing body of peer-reviewed scientific literature that identifies potential biologically plausible oncogenic or tumor-promoting mechanisms and purported preliminary population-level cancer signals." A little verbose, but ICAN's suggestion is sound. Let me translate its substance: "Wouldn't it be better to find out if these vaccines cause cancer before injecting them into everyone, instead of after?"

Oh Prudence, you're such a stickler. Doing so would kill this new vaccine in its tracks so the committee, predictably, shot Prudence in the foot. Clearly these "peripheral" issues identified by ICAN can be dealt with after it gets on the market and used by everyone. Funny indeed.

Here's the penultimate laugh: we tend to push flu vaccines on the ...

By Russ Gonnering at Brownstone dot org.

When I was a first-year medical student, I happened across The Citadel, a novel published in 1937 by A.J. Cronin, himself a physician. The following is from the review on Amazon:

The Citadel follows the life of Andrew Manson, a young and idealistic Scottish doctor, as he navigates the challenges of practicing medicine across interwar Wales and England. Based on Cronin's own experiences as a physician, The Citadel boldly confronts traditional medical ethics and has been noted as one of the inspirations for the formation of the National Health Service. The Citadel has been adapted into several successful film, radio, and television productions around the world, including the Oscar-nominated 1938 film starring Ralph Donat, Rosalind Russell, Ralph Richardson, and Rex Harrison.

From the Wikipedia entry:

Cronin once stated in an interview, 'I have written in The Citadel all I feel about the medical profession, its injustices, its hide-bound unscientific stubbornness, its humbug …The horrors and inequities detailed in the story I have personally witnessed. This is not an attack against individuals, but against a system.'

Reading this novel had a profound impact on me, and that impact has lasted up until today, more than 50 years later.

Medical school always had its own set of peculiar struggles, as does everything. Certainly, Basic Training in the military is an eye-opener. What makes medical school unique is the profound contrast of the reality with the ideal. Like many students, perhaps most, I entered medicine with a deep sense of the magnitude of what I was doing. It had a "spiritual" element, almost as though I was entering a religious order and now would be taking on the mantle of responsibility that was more than just a job. I had read the Oath of Hippocrates and could sense the heavy responsibility that had been felt by the ancients and the duty that this road would take.

It would serve no purpose to recount those years in detail. Suffice it to say that, like those of Andrew Manson, the protagonist in The Citadel, my experiences were intense. They ranged from the utter heights to the deepest depths. The mettle of my character was refined and amalgamated in ways difficult to fully understand, even now. I graduated having many of the same feelings described by Cronin in the interview referenced above. I was conscious of my own mortality. I understood what it was like to make mistakes, but over all of it I had a firm desire to really make a difference in a system that was filled with obstacles.

The worst aspects of medical education have improved significantly since the time I spent there. The 40-bed wards are gone. Attending physicians take a more active role in the care of patients. Medical students and resident physicians no longer spend an exhausting 80 hours or more a week in patient care. There are multiple safety measures in place for patients and those caring for them. Up until Covid, I thought that we had made real progress in things.

But those are the externals. Has the internal moral compass really changed? Yes, it has in many individuals, but what about collectively in our profession? Consider those who told their patients, "I would sooner watch you die than give you hydroxychloroquine." Has their moral compass changed? What about the medical leaders who allowed patients to die without allowing them to try ivermectin, despite the pleas of their family? Did their moral compass change? Or those who treated the unvaccinated as lepers? What about the medical ethicists who advocated denying care to those unvacinated?

How about the late-night comic on this YouTube clip who advocated a similar policy? Or those in the audience of that comic who thought this was outrageously hysterical? True, he was not a healthcare professional, but the problems we see run very deep in our society as evidenced by the audience response.

Now it is known that the premise upon which those people based ...

By Christopher Dreisbach at Brownstone dot org.

Five years is a significant milestone in any chronic illness. People can endure extraordinary physical pain, financial hardship, and emotional suffering if they that believe recovery is just around the corner. Hope often carries them through.

But after five years, hope itself begins to erode.

Savings have been exhausted. Careers have been interrupted or lost. Retirement plans have disappeared. Marriages have been strained by the relentless burden of chronic illness and caregiving. Medical appointments that once promised answers begin to feel repetitive and futile.

Gradually, the realization sets in that life may never return to what it once was. Temporary hardship becomes permanent reality. When physical suffering is compounded by financial ruin, social isolation, and the loss of future expectations, despair can become overwhelming.

For thousands of Americans permanently harmed during the Covid-19 vaccine rollout, that five-year milestone is arriving now.

Over the past several months, a disturbing number of Covid-19 vaccine-injured individuals have either taken their own lives or survived suicide attempts. As a board member of React19, a nonprofit dedicated to supporting those injured by the Covid-19 vaccines, I have come to know many of these stories personally. These are not statistics. They are husbands, wives, mothers, fathers, sons, and daughters who believed that if they persevered long enough, help would eventually arrive.

For many, it never did.

What made their suffering especially devastating was not only the physical injury itself, but years spent feeling invisible. Many lost careers, homes, and financial security. Others depleted retirement savings or accumulated overwhelming medical debt. Almost all experienced some combination of disbelief, dismissal, and isolation. After years of being told their injuries were unlikely, unrelated, or simply impossible, many began to question whether anyone in authority would ever acknowledge what had happened.

Against that backdrop, the Senate Permanent Subcommittee on Investigations' recent interim report, Failure to Warn: How Federal Health Agencies Downplayed and Hid Myocarditis and Other Adverse Events Associated with the Covid-19 Vaccines, represents an important turning point.

Drawing on internal government records and documents obtained through the Freedom of Information Act, the report concludes that federal health officials delayed acknowledging vaccine safety signals, withheld important information from the public, failed to respond fully to Congressional oversight, and repeatedly placed concerns about preserving public confidence above full transparency.

For the vaccine-injured community, that public acknowledgment matters. For the first time, many who were dismissed for years can point to official government findings confirming that safety concerns existed, were recognized internally, and were not fully communicated to the public.

Yet transparency alone is not enough.

A report that documents misconduct but produces no consequences may satisfy historians, but it offers little comfort to those whose lives were permanently altered by the conduct it describes. Facts matter. Investigations matter. But they matter most when they lead to accountability.

Fortunately, Senator Ron Johnson (R-WI), the chairman of the Subcommittee, has made clear that this report is not the end of his work—it is the beginning.

Throughout the pandemic and the years that followed, Senator Johnson has courageously pressed federal agencies for answers, demanded documents, convened hearings, and, perhaps most importantly, gave Covid-19 vaccine-injured Americans an opportunity to tell their stories publicly. His message has remained remarkably consistent: transparency is essential, but transparency must ultimately be followed by accountability.

That accountability cannot stop with institutions.

Too often, government failures are blamed on agencies, dep...