Week of November 17, 2025
Last week, I spent time with several advocates of the "Make America Healthy Again" movement, who are skeptical of healthcare systems and delivery. The experience was both fascinating and troubling, serving as a masterclass in how logical fallacies can masquerade as science and policy discourse.
I witnessed confirmation bias in real-time: data cherry-picked to support predetermined conclusions. I watched groupthink reinforce itself through the "No True Scotsman" fallacy; any "non-aligned" healthcare provider wasn't a "real" health advocate. Most challenging were the internally logical, yet unrealistic and unscalable ideas. The seductive simplicity of "eliminate this policy" or "deregulate that service" overlooks healthcare's chaotic complexity and human behavioral variability.
I left wrestling with a (now) familiar dilemma: how do you meaningfully engage with individuals whose convictions blend religious fervor with selective data interpretation and political validation? Such combinations rarely create space for evidence-based dialogue. Walking away feels like a betrayal of professional integrity. When phrases like "the banality of evil" and "2+2=5" start echoing in your head (or when you find yourself thinking of Gollum corrupted by the Ring of Power), it's easy to question your anchor points on the spectrum of normalcy.
I hope my unease stems from reading too much history and literature. But in a profession built on evidence and nuance, moments of cognitive dissonance feel significant.
https://en.wikipedia.org/wiki/Eichmann_in_Jerusalem#Banality_of_evil
https://en.wikipedia.org/wiki/2_+_2_=_5#George_Orwell
https://en.wikipedia.org/wiki/Addiction_to_power_in_The_Lord_of_the_Rings
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Listen to a Google Notebook LM A.I.-generated podcast of the newsletter with two virtual "hosts."
https://drive.google.com/file/d/1yV08uOFaTa6Zu2sl-3qVZg2tOyoF_cX-/view
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Science and Technology Trends
Stanford researchers utilized novel RNA sequencing technology to establish a clear link between the Epstein-Barr virus (EBV) and systemic lupus erythematosus (SLE), also known as lupus. This research is an excellent example of how layers of technology, experimentation, and population health converge to generate new knowledge. At some level, this is not surprising -- viruses, like EBV, have been linked to numerous autoimmune diseases (including lupus and multiple sclerosis). However, this research quantitatively measures EBV burden and defines a cellular mechanism that drives the autoimmunity. This knowledge is novel, plausible, and a significant step toward improved therapeutic options.
Consumer-friendly article: https://med.stanford.edu/news/all-news/2025/11/lupus-epstein-barr.html
AI summary: https://claude.ai/public/artifacts/89e8fb2d-a077-4cc6-b96a-c5b4a291048f
I was surprised to find social media analysis in the Journal of the American Medical Association (JAMA) this week. The study is a "cross-sectional analysis of 740 high-engagement social media posts across four platforms demonstrating that 80.1% of pharmaceutical promotion content showed characteristics of undisclosed influencer marketing, with only 2.2% containing explicit sponsorship disclosures despite widespread use of promotional language and calls to action. Of the posts promoting medications, 69.1% made efficacy claims, while only 33.4% mentioned risks or adverse effects, potentially undermining informed patient decision-making." While the authors cannot prove that pharma is paying social media influencers, the patterns of endorsements suggest this possibility and highlight another reason to be wary of social media content.
https://jamanetwork.com/journals/jama/fullarticle/2841349?guestAccessKey=4bed78de-86df-4493-855a-2243e743692d&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jama&utm_content=olf-tfl_&utm_term=111325
In my never-ending quest to (prove? Reinforce my confirmation bias?) that coffee is fantastic, I found more articles this week:
JAMA published a paper reporting that caffeinated coffee may be PROTECTIVE against the common recurrent heart rhythm abnormalities atrial fibrillation (AF) and atrial flutter. I was surprised to see this data (this is the antithesis of everything many of us doctor-types assumed), and yet, in a randomized cohort of 200 patients (100 drank coffee, 100 abstained during a 6-month time frame), AF or atrial flutter recurrence was less in the coffee consumption group (47%) than the coffee abstinence group. We shall see if these data hold up over time.
https://jamanetwork.com/journals/jama/fullarticle/2841252?guestAccessKey=e6db3dde-a055-43b6-9736-5f9ab1b625f9&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jama&utm_content=olf-recommended-tfl_&utm_term=111025
AI Summary: https://claude.ai/public/artifacts/ea4c6622-b192-4300-8749-fea8a52235c6
Related: Coffee is probably not as good for you if you add lots of sugar and fat-filled creamers. "[In this review] Higher coffee consumption was associated with lower all-cause mortality. However, the mortality benefits were restricted to black coffee and coffee with low added sugar and saturated fat content."
https://www.sciencedirect.com/science/article/abs/pii/S002231662500286X
Anti-Science Articles of Note
It is the time of year to "girdle your intellectual loins" for medical discussions at the Thanksgiving table. Epidemiologist Jessica Steier offers a well-written primer on discussing mRNA vaccine mechanisms and DNA interaction, immune amnesia from measles infections, liver and kidney detoxification processes, peer review and scientific transparency, and Epidemiological study design (including cohort studies and confounding factors). Her goal is to help keep the dinner table calm while you intellectually jujitsu the crazy uncle with a degree from the Facebook School of Internet Research.
https://theunbiasedscipod.substack.com/p/a-survival-guide-for-thanksgiving
On November 20, 2025, Steier and her science colleagues will be hosting a free (registration required) webinar on Tips for talking science at the Thanksgiving table:
https://us06web.zoom.us/webinar/register/WN_7vwsdjg1TSmcynGlc_bQCg#/registration
Harvard researchers wrote about the counterintuitive world of "placebo science" in last week's Nature. Data across numerous studies that used open-label placebos demonstrated a significant improvement in pain, even when the patient knew they were receiving an inert substance. The ritual of taking medicine, the caring interaction with a clinician, and perhaps just the act of doing something about suffering might be more powerful than we imagined.
Nature News Article: https://www.nature.com/articles/s41591-025-04047-1
AI Summary: https://claude.ai/public/artifacts/d097e10b-72d7-4614-86ee-6cfacb3288c0
Living with AI.
I could not write a more enticing summary of this article than the author, "A team of researchers at the AI evaluation company Andon Labs put a large language model in charge of controlling a robot vacuum. It didn't take long for the LLM to experience a complete meltdown straight out of a Douglas Adams novel, in what the researchers described as a "doom spiral" including a "catastrophic cascade" and a full-blown existential crisis." Andon Labs is the same AI research team that had an LLM run an in-office vending machine, resulting in some entertaining outcomes (hallucinated Venmo accounts, an attempt to meet up with a snack supplier outside the office, and taking suggestions to stock the vending machine with tungsten cubes).
https://techcrunch.com/2025/11/01/ai-researchers-embodied-an-llm-into-a-robot-and-it-started-channeling-robin-williams/
Andon has a yet-to-be-peer-reviewed Rick and Morty-inspired research protocol for testing LLMs' practical skills - the Butter-Bench test.
https://arxiv.org/pdf/2510.21860v1
McKinsey's latest AI survey reveals that while 88% of organizations now use AI regularly, only one-third have moved beyond pilots to enterprise-wide scaling, with only 6% achieving a meaningful financial impact. Organizations with the most robust results have redesigned entire workflows rather than just adding AI on top of existing processes, invest heavily (over 20% of their digital budgets), and pursue growth and innovation goals beyond simple cost-cutting. Please note McKinsey is in the business of "redesigning workflows" to maximize AI's impact.
Report: https://www.mckinsey.com/capabilities/quantumblack/our-insights/the-state-of-ai#/
AI Summary: https://claude.ai/public/artifacts/9334eae1-4e95-4a8a-9264-888cef42afca
Infographics
The Chemistry of Apples. It is all about the sugar-to-acid ratio.
https://i0.wp.com/www.compoundchem.com/wp-content/uploads/2025/10/The-chemistry-of-apples.png?ssl=1
Things I learned this week
Despite a lifetime of cultural immersion, I was unaware of the history of the bagel and the marketing bravado of Murray Lender, the last CEO of the Lender Bagel brand. The best part of this story is when Kraft Foods bought the Lender's brand in 1984, Murray marked the occasion with a public wedding between "Len, an 8-foot-tall bagel to Kraft's Phyl, a two-legged tub of cream cheese in front of an audience of food brokers and their spouses."
https://dailynutmeg.com/blogs/blog/lenders-bagels-hole-story
You must watch the wedding video. It is a priceless combination of 80s videography, publicity kitsch, and bad dad jokes.
https://youtu.be/PmOcRrfb5lI
I miss the 1980s.
The headline of the week was from a Forbes article demonstrating the fallacy of confusing absolute and relative measures of things. In this instance, if one is losing weight and size due to Ozempic, it is easy to conclude that unchanging body parts are getting bigger. Or, as Forbes titled their article, "Men Are Claiming Ozempic, GLP-1 Meds Are Making Their Genitals Bigger." Many things in life are relative.
https://www.forbes.com/sites/brucelee/2025/06/16/men-are-claiming-ozempic-glp-1-meds-are-making-their-genitals-bigger/
AI art of the week
A visual mashup of topics from the newsletter.
I use ChatGPT to summarize the newsletter, suggest prompts, and generate images with several LLMs.
I've had low-budget 1970s Japanese sci-fi TV on my mind this weekend.
"A single frame from a 1970 Japanese live-action science fiction TV show. The scene depicts a chaotic crossover: four brightly costumed 'Fallacy Fighters' in vinyl jumpsuits confront a massive tartan-patterned kaiju named 'Falasaures Rex,' while beside them, a malfunctioning robot vacuum sidekick—'Robo-San'—spins in a comic frenzy. Robo-San has oversized googly eyes, wobbly plastic arms, and exposed wiring; blinking cardboard status panels behind him flash 'CATASTROPHIC CASCADE' and 'DOOM SPIRAL.' The Scotsman Kaiju points an accusatory foam finger at one Fallacy Fighters. The set is unmistakably low-budget: cardboard skyline, fog-machine smoke, visible fishing-line wires supporting sparks, and over-saturated magenta/cyan tokusatsu lighting. A vending-machine prop labeled 'SNACK MODULE' stands in the corner, stocked with tungsten cubes and nonsense items. The shot has the grainy texture and theatrical staging of classic early-1970s tokusatsu television."
Chat won this week.
Gemini
https://drive.google.com/file/d/1yo41cuRB49pW9GsXhmKstxCFMOjH4oSx/view
Perplexity
https://drive.google.com/file/d/1uERzry3AphUOb98F_wI1YGu890rrMlTi/view
Grok
https://drive.google.com/file/d/1XyasfWSMmJfk0uf0IMRRO2XZkAy5bgXK/view
ChatGPT
https://drive.google.com/file/d/1zMp3aZEYR-w1gb5h-P5258Mvs-4RgAgV/view
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The Pandemic Mitigation Collaborative (PMC) utilizes wastewater viral RNA levels to forecast four-week predictions of COVID-19 rates.
COVID (and other viral illnesses) transmission will rise over the coming weeks as travel and holiday gatherings increase. Get your vaccines.
https://pmc19.com/data/
based upon https://biobot.io/data/
Wastewater Scan offers a multi-organism wastewater dashboard with an excellent visual display of individual treatment plant-level data.
https://data.wastewaterscan.org/
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Clean hands and sharp minds,
Adam
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