I recently met a 55-year-old patient, an athlete his whole life, thoughtful about food and sleep. He wants to feel excellent and live well for a long time. For years, his cholesterol panel had been looking increasingly abnormal, but his doctor had shrugged it off as not yet urgent enough to act on. Eventually, he had to get more advanced cardiac testing, which found significant coronary artery disease. Since learning he had plaque in his arteries, he has struggled to tolerate different lipid-lowering medications and felt frustrated by how little control he seems to have.

I encourage all my patients to keep their own spreadsheets of lab results, since trends tend to tell stories that snapshots miss. Once my patient pulled together his records, a decade of results emerged. Buried in them was a letter after his 2014 annual physical: Your cholesterol panel is abnormal. The recommendation would be to eat healthy, exercise, and sleep, which are all things you are already great at. See you in a year! What followed was a decade in which closer monitoring, a more individualized assessment of risk, targeted lifestyle changes, and medication could have been considered.

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As an elder millennial who attended high school in the 1990s, I remember these classes well. There was one of those infamous demonstrations in which people who had sex were equated to lint-covered pieces of Scotch tape, and another in which we all spent an afternoon “exchanging fluids”—in the form of cups containing a sodium hydroxide solution—at the end of which everyone, save the “abstinent” kids who had kept their cups unadulterated, was revealed to have metaphorical chlamydia. There was the pervasive sense, reinforced by every adult authority figure, that just looking at a penis without protection—for the penis, for your eyeballs, or both—would be enough to get you pregnant and give you AIDS. And the sexism! Oh, the sexism: Boys, we were told, wanted to have sex because they enjoyed it; for girls, on the other hand, sex was something they did because they didn’t respect themselves and just wanted guys to like them.

Clearly, things have changed. This week, I found myself perusing the YouTube offerings of a nonprofit called Fact Forward, a youth health organization in South Carolina which partners with school districts, healthcare providers, and the juvenile justice system to offer sex education classes for young people. The video that caught my eye is called Burn, which tells the story of two teenagers, James and Melissa, who meet at a movie night hosted by a mutual friend. Both have been thoroughly evangelized-to about the importance of using protection (“You last so much longer!” says one of James’s friends), and there are condoms literally everywhere; Melissa, apparently a notorious slut, has been warned by her friends that James is a jerk and a cad, and gifted a box of Trojans specifically for this occasion. But nevertheless, and despite having met five minutes ago, the pair have unprotected sex on their friend’s kitchen counter (rude!), after which James flees into the night, leaving Melissa devastated, even though she was explicitly warned of this exact outcome less than 24 hours ago.

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A parasite called cyclospora that spreads in fecal-contaminated water and food causes—in the words of the Cleveland Clinic—“watery, and sometimes explosive, diarrhea and other stomach problems.”

As you’ve also heard, the United States is having a major cyclosporiasis outbreak, with over 10,000 confirmed and probable cases, centered largely in Michigan and Ohio. (Go Big Ten!) A privately held, California-based produce company called Taylor Farms, which has over $7 billion in annual sales and 25,000 workers, appears to be the center of the outbreak, which is suspected to have started with lettuce imported from Mexico.

Now, naturally, legacy reporters are doing everything they can to connect this outbreak to their favorite colostomy bags: President Trump and his secretary of Health and Human Services, Robert F. Kennedy Jr. “Trump’s CDC cuts fueled a cyclospora perfect storm,” CNN reported on Monday, joining a slew of similar headlines.

But, as is so often the case, the legacy media narrative turns out to be full of watery (and sometimes explosive) reporting. Problems with American food safety, including outbreaks from contaminated meat and produce, long predate the current administration.

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Hegseth announced on Wednesday that service members over age 30 will undergo an annual screening for their testosterone levels. Those who don’t meet the mark could be given the option to take testosterone replacement therapy (TRT).

“The modern battlefield is brutal and unrelenting. It requires and demands maximum psychological and mental readiness. And by addressing these health markers early, we’re keeping you on the leading edge of lethality,” Hegseth said in a video posted to X yesterday titled “The High-T Department of War.”

The move was met with confusion and disdain. Wired called the plan a “junk science fever dream,” The New York Times said Hegseth “sought to cultivate an image as a manosphere-friendly leader,” and in an effort to roast Hegseth, many equated testosterone treatments for service members to “gender-affirming care.” On the other side, the backlash was pinned on “Hegseth Derangement Syndrome”—a play on Trump Derangement Syndrome, in which individuals have an irrational and reflexive hostility to Trump.

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Around him, the intensive care unit at Bridgeport Hospital Milford Campus had erupted into chaos. Nurses and doctors pumped on 26-year-old Conor Hylton’s chest, shouting instructions and working frantically to resuscitate him. A breathing tube protruded from his mouth. Dark, lumpy, blood-clotted vomit stained the sheets and pooled on the floor.

“It’s just a very chaotic scene, as you can imagine,” William recalled. “You just want your child to survive. You start trying to make deals with God.”

Across the hallway, William’s wife, Betsy, sat hunched over a trash can, sick with fear.

Then, at 6:11 a.m., a doctor’s voice cut through the commotion.

“Is his family there?”

The voice came from a large monitor mounted on the wall. There, on-screen, was the physician directing the resuscitation efforts. He was 12 miles away, working from Yale New Haven Health’s headquarters in the tele-ICU hub.

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It’s a branch of medicine that’s often misrepresented in left-leaning outlets as conservative quackery, because it was pioneered by Catholic surgeons as an alternative to in vitro fertilization (IVF), to which the Church is opposed. Just last week, it was characterized in “The New York Times” as “an approach that many medical experts argue may give false hope to couples who have not been able to have children.” But for Maddy, it felt like her only hope.

And it worked. Her daughter was born exactly a year ago tomorrow. (Happy birthday to her!) At the time, Maddy and I spoke a lot about how, even though she sought the treatment because she’s Catholic, it could help so many women who aren’t, for whom IVF isn’t an option. But in her piece today—a response to the “Times” article—Maddy argues that politicizing this treatment could deter people from seeking it. —Freya Sanders

The left-leaning press is wildly suspicious about the medical intervention that allowed me to become a mother.

“A faction of Christian conservatives and MAHA-heads have joined forces to advocate for ‘restorative reproductive medicine,’ ” warns The Cut, explaining that its proponents operate “on the flawed assumption that infertility can be treated with lifestyle modifications like diet, exercise, and cycle charting.”

Meanwhile, The Guardian wonders if it is “the right’s path to limiting IVF.”

And, just last week, The New York Times described it as “an approach that many medical experts argue may give false hope to couples who have not been able to have children.”

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“I’d love to learn that role,” Kidman said, speaking at an event at the University of San Francisco in April. “Loneliness is a big part of our world now, particularly for people in that stage of life. I want to be there.”

At the time, I found this fascinating and not a little bit funny, in the worst and most macabre way. Imagine being terminally ill, slowly losing your functions, your faculties, your dignity, your bladder control—and there at your bedside, fluffing your pillow and slipping ice chips through your pale, parched lips, is the star of Eyes Wide Shut.

But Kidman is not alone in her interest. In an overstressed, understaffed system of care for dying patients, a new and growing cohort of caregivers has emerged who hope to reintroduce some humanity into a process made sterile by corporate influence. It’s not unlike the recent boom in birth doulas, who similarly advocate for expectant mothers.

Researchers who study trends in end-of-life care have noted that death doulas are a fast-growing category in the field, and where numbers are available, they tell a compelling story. Between 2019 and 2024, membership in the National End-of-Life Doula Alliance—a dues-paying organization for death doulas and those who train them—grew from approximately 260 to over 1,600. On social media, posts from death doulas rack up thousands of views; topics range from environmentally friendly funeral practices to what a death rattle really sounds like. The popularity of this content is proof not only that a market exists for the services that death doulas offer, but so too does a hunger for a more expansive cultural conversation around the topic of death itself.

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It was wonderful news for millions of Americans who want to quit smoking, the biggest cause of avoidable death. Adults overwhelmingly prefer flavored vape products as alternatives to smoking and are far more likely to use fruit-flavored vapes than menthol or tobacco flavored e-cigarettes to kick the habit.

Last month’s decision allows the company Glas to market to adults its Sapphire (blueberry) and Gold (mango) flavors. The device itself is the Fort Knox of vapes. Users must pair their device with an age-verified smartphone via Bluetooth, download an app, upload a selfie and a driver’s license image, and use the device near the paired phone.

But it seems that what’s good for adults is bad for teenagers. The American Lung Association pronounced the FDA’s decision “reckless,” and worried that flavors would lure teens into vaping. The Campaign for Tobacco-Free Kids accused the agency of “risking a resurgence of youth e-cigarette use.” And the American Academy of Pediatrics declared itself “deeply alarmed that these products will end up in the hands of young people.”

But how worried do we actually need to be about youth vaping? The facts are surprisingly reassuring.

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For years, parents were told to delay potentially allergenic foods like eggs or peanuts, especially if allergies ran in the family or if the baby had eczema. The entire conversation around food allergies taught families to think of certain foods as threats first and nourishment second. This was not fringe advice traded among anxious parents online—in 2000, the American Academy of Pediatrics recommended delaying introducing eggs to a child’s diet until age 2 and peanuts until age 3 for “high-risk infants.” Parents who followed this advice were not being neurotic. They were doing what the experts told them to do.

Now the guidance is close to the opposite: Once babies are developmentally ready for solids, parents are told to introduce allergenic foods early and keep them in the diet consistently. This shift was shaped by authoritative studies and has since been reinforced by additional evidence suggesting that early exposure is likely protective rather than dangerous.

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Brad endured months of muscle and nerve testing and MRIs to rule out a spinal cord injury before visiting a clinic in his hometown of Phoenix, Arizona, that specialized in treating a very rare neurological disease. At the end of the appointment, the doctor offered him a hug, and then a diagnosis: amyotrophic lateral sclerosis, or ALS. It may as well have been a death sentence.

ALS, also known as Lou Gehrig’s disease, attacks the nerve cells that allow you to move your muscles, until you can no longer move, speak, swallow, or breathe. Doctors can manage symptoms and slow progression modestly with a handful of approved drugs, but there is no cure. The average life expectancy after diagnosis is two to five years, and there are more than 33,000 Americans living with the disease.

Brad walked to his car in a state of shock. On his drive back to work—he was a technology executive—he stopped at a parking lot, cried, and appealed to God. “I said the most desperate prayer in my life, asking Heavenly Father if this was really ALS,” Brad told me. “I remember getting a very clear answer: Everything is going to be all right.”

Within three years of being diagnosed with ALS, Brad had lost control of his entire body. When it came time to tell their three children—their oldest was in first grade at the time, their youngest was just 1—his wife, Tiffany, sat them down, had them put on oven mitts, and asked them to try to build something with Legos. It was nearly impossible. “That’s what Dad’s ALS is doing to him,” she told them.

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Early menopause did not help. In the last several years, I’ve put on about 20 pounds that I really don’t need. I also don’t seem to have the discipline, motivation, or time to lose them.

Still, that’s not why I went on a GLP-1. I went on a weight-loss drug because a doctor told me it might help ease symptoms I’ve struggled with for basically my entire adult life.

I was diagnosed with my first autoimmune condition—Graves’ disease—at the height of my health, when I was 23. My immune system forgot that my thyroid was a part of my body and attacked it, sending it into an overactive storm that made me very, very sick. My doctor prescribed strong medication and sent me on my merry way. In 1998, there was no discussion of diet or lifestyle or any of what we now know can influence autoimmune conditions. I probably did a lot of things that very slowly made my condition worse.

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Bartlett, whose biceps suggest he spends a lot of time at the gym and whose X profile describes him as an “entrepreneur” (such a beautifully elastic word; are we not all entrepreneurs?) climbed K2 ran an ultramarathon swam the English Channel had “a couple of glasses of wine.”

The results were horrific. As Bartlett explained to a fellow entrepreneur:

I got worse sleep that night, and then because I got worse sleep that night, I ate more poorly the next day. . . . I podcasted worse. I didn’t go to the gym that day or the day after because I felt really bad. . . . I could track all of this on my Whoop.

Hold on a second there, buddy.

Your what?

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She had assumed that when she was ready, her body would be too. No one in two decades of annual visits had ever explained that the most consequential decisions about her capacity to bear children were being made by her ovaries on a calendar she could not see, while her doctor took her blood pressure and refilled her birth control.

She is the patient I see several times a month. She is the most preventable tragedy in American medicine.

I am board certified in both obstetrics and gynecology, and reproductive endocrinology. There’s a fertility crisis happening right now in America—and a furious debate about who is to blame. The alleged culprits include housing, smartphones, and capitalism. One group is getting off lightly: ob-gyns.

In July, the Centers for Disease Control and Prevention (CDC) reported that the U.S. fertility rate had fallen to fewer than 1.6 children per woman—the lowest figure in our history—despite a 2025 survey of American Gen-Z women that found that nearly three-quarters intended to become mothers. American women are not opting out of building a family. They are running out of time.

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When Cissy, a former forensic nurse, asked Iris what else she could do for her before leaving for work, the answer never changed: “Can you put a pillow over my head so I can die? Please make my suffering stop.”

Depression was not new to the Dekkers. Omar has a history of it, as do other members of his family. But Iris’s was different. Her symptoms were psychological and physical—a condition called functional neurological disorder, associated with severe psychological distress and depression. It often presents with symptoms like paralysis, seizures, and chronic pain, and was once referred to in medical psychology as hysteria. Iris had spent more than two years in a wheelchair after a seizure left her unable to walk.

Cissy described the look in her daughter’s eyes as “empty,” and her father called it a “black hole of depression.”

The symptoms began early in Iris’s adolescence. In 2019, at the age of 13, she began complaining of constant pain in her back, head, and stomach. At first, she pushed through it at school, during shifts at a bakery, while babysitting, and playing tennis, relying on a combination of painkillers and antidepressants, counseling at school, and cognitive behavioral therapy.

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Romano won’t be swimming in a sanctioned competition. Instead, she is racing in the very first Enhanced Games, created to reveal what more than 40 world-class athletes in swimming, track, and weightlifting can achieve if they are encouraged to use drugs that would otherwise destroy their reputations and end their careers.

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I’ve been covering women’s sexual health for 20-plus years, almost as long as pharma has been trying to create such a drug—one that triggers desire, arousal, and orgasm (or at least two out of the three). Now, a new documentary, The Pink Pill: Sex, Drugs & Who Has Control, streaming on Paramount+ (a division of our parent company), asserts there is a female answer to Viagra. It’s called Addyi, and the film treats the story of its bumpy road to approval by the U.S. Food and Drug Administration (FDA) in 2015 as a major front in the ongoing fight for female sexual pleasure and bodily autonomy.

You’ve heard of Viagra and its many spin-offs. So why have you never heard of Addyi? The film has an answer: sexism. “Just think to yourself: What if the pill had been blue?” Cindy Eckert, the co-founder and CEO of Sprout Pharmaceuticals, whose sole product is Addyi, tells viewers. Her point is both literal and metaphorical—Viagra has long been known as “the little blue pill.” And the film uncritically adopts this framing.

The story it tells is one of feminist triumph over sexist regulators who put unreasonable demands on the company because they took the sexual needs of women less seriously than those of men. Never mind the drug’s lackluster performance and concerning side effects. Bias was at the root, and Eckert was determined to expose it. “Not on my fucking watch,” she tells the camera.

Yet there is another narrative to the Addyi story that isn’t about sexism but about which drugs get approved and why. While Sprout did recognize a legitimate need, it also leveraged a public lobbying campaign to influence an agency that is supposed to be driven by science.

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Perhaps you’ve seen the headlines. “Perimenopause is having a millennial moment. Here are 7 ways to cope,” says The Washington Post. Or perhaps you’ve seen Apple TV’s glossy drama Your Friends & Neighbors, which is back for its second season; the female protagonist Mel is explicitly perimenopausal, and in the first season, she keyed a car for no apparent reason. She’s played by Amanda Peet, who talks about being perimenopausal in real life (“God knows I’ve wanted to key a lot of cars in the last three years,” she’s said.) In fact, it sometimes feels like every celebrity interview with a forty- or fiftysomething woman requires her to open up about what’s going on with her hormones. Drew Barrymore joked on CBS Mornings that when she found out how long perimenopause can last, she thought she’d “never make it 10 years like this.” Katherine Heigl told Business Insider that “whoever designed it so that women would be going through perimenopause while raising teenagers should be sent a strongly worded letter.”

At the same time, influencers who talk about perimenopause seem to have cropped up out of nowhere with something to sell you, causing people online to wonder where this all came from. It’s trickled down from Instagram to tchotchke shops, which sell fridge magnets that say “Perimenopause Is Hot.” You can buy a T-shirt that proclaims “Perimenopause Made Me Do It!” My mom, who is 48, started uncontrollably shaking her leg at night a few years ago. “It’s perimenopause,” she told me when I complained about how annoying it was.

But what exactly is perimenopause—and why are we all talking about it all of a sudden?

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This had been the case for most of my life. From childhood on, I struggled to make friends, which took a toll on my self-worth. By adolescence, my mental health had deteriorated, and I spent close to a year cycling through multiple psychiatric hospitalizations, outpatient programs, and group homes for depression and self-harm. At age 15, I was groomed online by a much older man, culminating in a traumatic sexual assault. Immediately afterward I tried to end my life, then spent a year in a youth residential treatment center in Utah.

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The term “peptide” picks out a broad category. Peptides are small versions of proteins, or segments of proteins. Our bodies make a variety of peptides to send signals between cells, regulating everything from blood pressure to wound healing, and from sleep cycles to fat storage. Peptide drugs can interact directly with these signaling pathways. GLP-1s, the weight-loss drugs such as Ozempic, are peptides that alter hunger signaling. Insulin is a peptide drug that duplicates a natural peptide needed to extract energy from food. Both, of course, are regulated by the Food and Drug Administration (FDA). Other promising drugs are slowly making their way through the pipeline.

These are not controversial, nor are the powdered collagen peptides sold in Whole Foods and other health food stores. The latter are regulated by the FDA as supplements—a category they fall into because they are derived from cattle and fish and are considered a component of food. They may not necessarily do anything, but they’re considered safe enough, as are peptides sold in skin creams and approved as cosmetics.

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These questions are meant to tell us about a person’s risks. But no one taught me to ask a question that now seems embarrassingly obvious, given that we spend about 90 percent of our time indoors: What kind of environment are you living in?

We are trained to think of health as something that happens largely inside the body. Organs malfunction, hormones shift, and cells mutate. We search for pathology in blood and on scans. Sometimes that is exactly where the answer is, but not always.

What enters the lungs matters—hence the typical “Do you smoke?” question. But many of us spend almost all of our time breathing the air of homes, offices, schools, hospitals, barracks, dormitories, and apartment buildings. We assume these spaces are neutral backdrops to our lives, when in fact they are active participants.

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