Health | The Atlantic

The Best Protein Source Is Hiding in Plain Sight

2026-10-10T08:00:00-04:00

Somehow, America has yet to reach peak protein. Perhaps we never will. Even after David bars have gone viral for being bricks of essentially pure protein and Starbucks has rolled out lattes topped with “protein cold foam,” new and somehow weirder protein-laced products keep hitting shelves. You can now buy protein Honey Nut Cheerios, protein popcorn and PopCorners, protein sodas, protein ranch dressing, and protein chips. (Doritos launched a nacho-cheese-flavored version with 10 grams of protein per one-ounce serving.)

In an era of GLP-1 drugs and peptide stacks and Oura rings and self-optimization, of wellness influencers and looks-maxxers, everybody seems to be doing everything they can to eat as much protein as possible. The magical macronutrient will supposedly make you more muscular, or more toned, or thinner—or something, really anything, just better. Amid the protein frenzy, regular food seemingly doesn’t cut it anymore. Why order a simple flat white when you can instead sip a Dunkin’ Nutty Pumpkin Iced Protein Latte?

[Read: America has entered late-stage protein]

Into the fray, I would suggest a humble alternative: Have some yogurt. Calorie for calorie, Greek yogurt has more protein than Chipotle’s High Protein Low Calorie Bowl, Kraft’s new PowerMac, or yes, a Dunkin’ Nutty Pumpkin Iced Protein Latte. So do some traditional yogurts, as well as other fermented options in the dairy aisle such as skyr and kefir. And that’s if you opt for the full-fat, luscious kind (which I recommend). Nonfat Greek yogurt, which is lower in calories, is roughly as protein-dense as a David bar—with the added benefits of having just two ingredients (milk, culture) and not tasting like plastic.

Yogurt is not only full of protein but also good for your bones, your digestion, and your immune system. Yogurt is an ingredient: Eat it plain or bake with it, use it as the base of a sauce or dip, throw it in a marinade or soup. Sure, some yogurts have added sugars, but so does a Starbucks Iced Banana Protein Cream Matcha. And as far as health fads go, yogurt is typically probiotic. All things considered, yogurt may be the easiest protein of all.

[Read: Let’s not fool ourselves about yogurt]

In spite of everything it has going for it, yogurt has not been the face of the protein craze. Perhaps that’s because yogurt is not splashy or technologically innovative or referred to by a trademarked proper noun. A David bar may taste different and have distinct packaging from an RxBar or a Jacob protein bar made with beef tallow, but all plain yogurt is the same. Though some companies have released “protein-enhanced” yogurt (whatever that means), for the most part yogurt is not optimized by corporate food scientists and focus groups in the way that today’s protein-branded products are. Yogurt has been optimized in the sense that humans have consumed it for thousands of years.

Imagine wellness influencers suggesting that you dollop yogurt into a bowl and sprinkle berries on top without measuring anything. There wouldn’t be any regimen to adopt or wellness plan to pay for. There wouldn’t be any special trademarked protein products for influencers to hawk: The company behind the David bar, for instance, has sponsored Andrew Huberman and, until recently, Peter Attia was its chief science officer. The homemade parfait would all be rather mundane and boring compared with Attia’s rotation of four protein powders or the bodybuilder Chris Bumstead’s breakfast filet mignon. It wouldn’t get any views.

Protein is not just a health fad; it is a business. So is everything else in the world of wellness. Indeed, there’s something about many of these setups—which proffer the perfect low-calorie, high-protein snack to pick up on your way to work every morning; a biometric wristband to wear every night; supplements to consume every day for the rest of your life; a weight-loss drug you will inject every week—that keeps people coming back for more, giving their attention and money and energy to the endless pursuit of betterment.

Health and more broadly self-improvement are, obviously, admirable pursuits. Protein can be a way to achieve either. But obsessing over hitting those goals can become unhealthy, as most obsessions are. Have some yogurt, or don’t. You’ll probably be fine.

What We Really Know About the Russian ‘Plague’ Case

2026-10-06T13:17:40-04:00

In a world on edge still from the last pandemic, rumors of a deadly disease that could have escaped from a lab can cause some understandable distress—however speculative they might be. Late last week, reports emerged that a woman who died in a Siberian hospital may have contracted plague, or even that she had seeded a plague outbreak. The case almost immediately set off rounds of hurried speculation within Russia and abroad; officials have shared few details, inspiring elaborate theories about what killed the woman, who worked in a plague-research facility. The fervor around the case escalated on Sunday, when Axios reported that the State Department was monitoring a “suspected plague outbreak” in Russia.

So far, the evidence that the death was caused by plague or something worse is thin, in part because Russian authorities—who have a poor reputation for transparency about biosecurity—have shared few clarifications. But scientists have a good understanding of how plague works. And if the lab worker did contract plague, that is no cause for international panic.

Here’s what is actually known. Sometime in the past week, a woman who worked at the Irkutsk Anti-Plague Research Institute of Siberia and the Far East, not far from the Mongolian border, died of “pneumonia of an unknown cause,” Rospotrebnadzor, Russia’s agency for consumer protection and public health, said Sunday. Government officials have not confirmed her identity, but Russian media have reported that the woman was Daria Shipilova, a 27- or 28-year-old technician at the lab. A local official said that the hospital where she was treated has been placed under quarantine; local media, meanwhile, reported that several hospitals were under quarantine. And Igor Kobzev, the governor of the Irkutsk region, said in a statement on Friday that other people—local media later reported the number as 200—may have been in contact with a resident who contracted an “especially dangerous infection,” and were placed under medical observation. He did not identify the resident as Shipilova or say that the person had died. The public-health agency told state media that “no micro-organisms linked to her professional activity were identified in the patient’s samples” and that no contacts have experienced “health changes related to infectious pathology.” Meanwhile, an aluminum factory in the same town as the laboratory imposed a mask mandate for its more than 2,000 employees, The Wall Street Journal reported.

Plague might sound medieval, but it’s endemic among animals in many parts of the world today. Although Russia hasn’t reported any plague cases to the WHO since at least 2018, Mongolia has. An average of seven cases are recorded in the United States every year, typically from a flea bite or handling infected animals. More than 80 percent of U.S. cases are the bubonic form of the disease, which presents with swollen, pus-filled lymph nodes. Two other main forms of plague, all caused by the same bacterium, are also occasionally reported around the world: septicemic, which infects the blood, and pneumonic, which infects the lungs. Because the lab worker died of pneumonia, speculation that she’d died from plague centered on this last form.

Pneumonic plague is the sole form of the disease that can transmit between humans, but that doesn’t mean it’s particularly likely to spread. David Wagner, the executive director of Northern Arizona University’s Pathogen and Microbiome Institute, told me that the respiratory droplets that can spread pneumonic plague—not to be confused with the tinier aerosols that can spread diseases such as flu and COVID—are only released during a cough or sneeze and only travel about three to six feet. “You have to be in very close proximity to someone with pneumonic plague to contract it from them,” he said.

Because transmission between humans is relatively difficult, the Russian government’s response to the mystery death from pneumonia—placing 200 people under medical observation—is “really incongruent with what you would expect for plague,” Amesh Adalja, an infectious-disease physician at Johns Hopkins University, told me. Daniel Jernigan, the former director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, told me that response was “above and beyond” what is typically required for plague cases. Perhaps, he said, the Russian authorities acted out of an abundance of caution; per Reuters, a local official recently said that most of the hospital workers who had been placed under quarantine have already been released.

Even if Shipilova did die of plague, fears of a larger outbreak are probably moot by now. Plague has an incubation period of only one to seven days, so anyone Shipilova might have exposed would have come down with symptoms by now, Jernigan said. Russian authorities have said that no one under medical observation has tested positive for plague. Generally speaking, the chances of a large outbreak of plague are slim. “Once you have an accurate diagnosis, it’s readily treated with multiple types of antibiotics, which is why we don’t have massive plague outbreaks and pandemics anymore,” Wagner said.

Very quickly, though, some scientists, security experts, and media outlets began speculating that whatever killed Shipilova was not traditional pneumonic plague, but a dangerous pathogen that had been somehow altered in the lab. The fear is that the pathogen could be resistant to antibiotics or other treatments, making it harder to prevent an outbreak. No evidence so far suggests that’s true or that the Irkutsk lab was modifying plague bacteria to make it more dangerous. Still, the host of unanswered questions surrounding this case has paved the way for conjectures about links to biological weapons and for conspiracy thinking about government collusion and vaccine companies set to profit off a plague pandemic.

Some Russian media outlets reported—and international outlets repeated—that the woman contracted plague after she broke a test tube containing a sample of the disease. (If that was the case, Adalja said, the lab should have followed the standard procedure of prescribing antibiotics immediately after exposure, which has not been reported.) And in the past, the Russian government has worked on bioterrorist agents and hidden the true cause of disease outbreaks. For example, Soviet officials attributed a 1979 anthrax outbreak that killed at least 64 people to contaminated meat. More than a decade later, President Boris Yeltsin admitted that the anthrax had come from a military biological-weapons facility.

The war in Ukraine has increased speculation about planned biological threats. In 2022, the Russian military began refurbishing a Soviet-era laboratory to handle deadly pathogens such as Ebola viruses, The Washington Post reported. “There’s just a standard lack of transparency from the Russian government that adds to the vacuum of information,” Adalja said.

The U.S. government, for its part, has given inconsistent signals about whether it believes that the incident has wider implications. Along with the State Department, the CDC and the Administration for Strategic Preparedness and Response are reportedly working to learn more about the death. But Secretary of State Marco Rubio downplayed the possibility of danger to reporters yesterday, saying, “I don’t think it’s cause for alarm, but it is cause for focus and a cause to just keep an eye on it.” Today, he called on Russia to be more transparent and share more information. President Trump has offered his sympathies to Russia and said that the U.S. will offer help, though he didn’t specify what form that would take. (The White House did not respond to a request for comment.)

The strong public reaction to the death in Siberia can likely be attributed to some surface-level similarities to the early days of the coronavirus pandemic—a mysterious respiratory disease, rumors of a lab leak, an initial response being handled by a secretive government. Still, the experts I spoke with were adamant that pneumonic plague would not be another COVID-19. Plague may not be totally relegated to the history books, but a major outbreak is low on the list of real threats.

When Anesthesia Goes Wrong

2026-10-05T07:30:00-04:00

Photographs by Julia Sellmann

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When Freddy Marquez was 12, he was hit by a motorcycle while biking and smashed his face into the pavement. He healed fast, but as adolescence reshaped his boyish features, the scar started to tug on his upper lip, leaving his mouth ajar. “Mom,” he said, “I’m going to high school. I don’t want to look like this.” So in September 2024, his parents found a surgeon in central Florida, where they live, to do a scar revision.

On the morning of his surgery, Freddy went into the operating room around 9. His mom, Joana Jardin, settled into a waiting-room chair, expecting to drive him home in a few hours. Noon came, then 1 o’clock, then 2, then 3. “Where is my son?” Joana began to ask. “Where is my son?” The staff couldn’t tell her anything, except that she had to wait. She watched as other parents picked up their kids from surgery and left. At 4 o’clock, she realized she was the only one in the waiting room.

When Joana finally got to see Freddy, around 5, he was barely conscious. His eyes were closed, his breaths shallow. He was just sleepy, a nurse reassured her, because he’d gotten Benadryl after a hive-like rash broke out—but not to worry, the monitors tracking his vitals showed nothing else awry. Eventually, Freddy managed to slump into a wheelchair, his eyes still closed. He was sent home.

The next day, Freddy woke up. Then he threw up. He was still drowsy and now irritable. His head hurt. Joana took him to urgent care and later to the ER, where doctors who evaluated him figured he was just recovering from surgery. But in the coming days, his symptoms became stranger and more disturbing. Freddy started losing control of the muscles in his face. He developed tremors. He choked on his saliva. He lost his balance. He felt what he could only describe as electricity coursing through his brain. “Please, Dad, pray for me,” he would cry when the “electricity” struck.

At the hospital where Freddy was finally admitted, doctors ordered two separate MRIs of his brain, and, to keep him still during the scans, they put him under anesthesia. Both times, he took hours to regain consciousness. Both times, he emerged worse than before.

Freddy lost the ability to walk. His body spasmed and twitched as his muscles took on a life of their own. When Joana saw her son in the hospital bed—eyes staring at the ceiling, limbs flailing wildly—she remembers thinking this is how people once believed you could be “possessed by a demon.”

The scans found spots of white in Freddy’s brain—signs of dying and dead neurons—but no explanation as to what had caused them. In the coming weeks, he got better and then worse, worse enough that doctors ordered yet another MRI. His parents begged the hospital not to use anesthesia again. Don’t worry, Joana remembers being told; the doctors can do it safely. They do it all the time. Joana felt that she had no choice but to trust them. As Freddy slid into unconsciousness, she once again started ticking off the hours waiting for him to wake up: 1 p.m., 2, 3, 4. “Where is my son?”

Freddy never woke up. His body went into cardiac arrest, then respiratory failure. He died on December 29, 2024, at age 14.

Julia Sellmann for The Atlantic

Photographs of Freddy Marquez, who died at 14, shortly after routine surgery under anesthesia

Julia Sellmann for The Atlantic

Freddy’s mother, Joana Jardin

Before that final MRI, in one of their last conversations, Freddy had blurted in a half plea, half accusation, “You don’t understand what is happening to me, Mommy.” He was old enough, by then, to have lost faith in his parents’ omniscience but young enough to still yearn for it. His ordeal had revealed to him that the adult world is riddled with unknowns; that the assurances of even doctors in white coats can mean very little. “I promise that I’m going to understand. Until my last breath,” his mother told him. “I’m going to understand.”

And she would, eventually. Joana did not know it then, but Freddy’s death would be linked to dozens of cases of unexplained catastrophic brain damage after routine anesthesia, all in children or young adults. Several, like Freddy, died. Others became permanently disabled.

The mystery of why Freddy died would ultimately collide with one of the greatest unsolved mysteries of medicine: How does anesthesia work in the first place? How is it that anesthesiologists can induce a state that some have called “functionally equivalent to brainstem death”—only to reverse it? This process happens 60,000 times a day in operating rooms across the United States. Yet it remains poorly understood. What happened inside Freddy’s brain, some researchers now think, may be an extreme version of what happens inside any of our brains when we slip into unconsciousness under anesthesia.

This past May, in Germany, I watched a doctor give a talk to her colleagues about two eerily similar cases almost two decades apart. One was Freddy’s. The other was that of a boy in Germany who went under anesthesia for a broken arm in 2006. Like Freddy, Ulrich “Uli” Gabriel Gobin Hernández was 14. Like Freddy, he took hours to wake up and then gradually lost control of his muscles. But unlike Freddy, Uli survived. The woman giving the talk was not Uli’s doctor. She was his mother.

Yaremy Hernández Castillo, who is soft-spoken and modest to a fault, wore a white coat with sensible sneakers as she flicked through slides of her son’s brain scans. Most of her colleagues at the cardiac-rehab hospital where she worked had no idea that she’d spent the past 20 years—outside her job as an internist—trying to decipher his condition. Early on, she had intuited that what happened to her son could be explained only by something still unknown to medical science. “Uli Gabriel, patient zero,” she came to think of him. But in the initial lonely years of her investigation, his doctors doubted her. Her own medical colleagues did too. “Everyone told me it was absurd,” she recalled to me, even as they could muster no better explanation.

These were the facts of Uli’s case: On Saturday, January 14, 2006—a beautiful day to hit the slopes—he went snowboarding near his family’s home in the Bavarian Alps. Uli took a jump way too fast and landed on his right arm; the humerus bone did not withstand the force of impact. He ended up at the local clinic, where Yaremy worked at the time, and where she trusted he was in capable hands. On weekends, the alpine-village clinic treated an influx of skiers with mangled bones.

But as the hours passed and Uli did not wake up from surgery, Yaremy began to worry. When he finally did rouse—confused, vomiting, and talking “like a drunk man”—her instincts both as a mother and as a doctor screamed that something was wrong.

The trauma surgeon came to check on Uli’s arm and declared it perfect—his own job was done. No one else seemed to share Yaremy’s growing alarm at her son’s mysterious neurological symptoms. The word she kept using to describe this period was alone. To get an MRI of Uli’s brain, Yaremy personally arranged for an ambulance to take him to a larger hospital. On the MRI, two ghostly white spots appeared in his basal ganglia.

The death of brain cells in the basal ganglia, which coordinates movements of the body, explained Uli’s symptoms, which progressed to erratic twisting, painful muscle spasms, and involuntary protrusion of the tongue. But what had caused the damage? No one knew. Uli could still walk and talk, albeit with some difficulty, and he remembered everything: the confusion, the pain, the seven dwarfs from Snow White plastered all over his pediatric hospital room, which, as a 14-year-old, he found tragically uncool. He was impatient to get better and to get out; he had tickets to a Foo Fighters show less than two weeks later. But the day of the concert came and went, and Uli remained stuck in the hospital, his symptoms unresolved, their underlying cause still unknown. The tests that doctors ran all came back negative.

Had his anesthesiologist made a mistake? Yaremy couldn’t dismiss the possibility. How does a perfectly healthy kid become so sick from routine anesthesia, other than because of a terrible mistake? Malpractice could give grief a direction and a shape, suggesting a person to blame (a doctor) and a means of redress (a lawsuit). Friends kept telling Yaremy to sue. In the end, she did, filing a lawsuit against Uli’s anesthesiologist, Ludwig Düthorn, a senior colleague whom she regularly passed in the hallways of their clinic. At the very least, she figured, the lawsuit could help uncover what had really happened.

At the clinic, Yaremy began to avoid the ICU, where Düthorn worked, unsure of what to say about the tragedy that had rattled both of their lives. Düthorn, too, was haunted by the case. He replayed the surgery in his mind, searching for any hint of the debacle to come. Uli’s blood pressure had dipped briefly—but that wasn’t uncommon during anesthesia, and would not have been enough to cause this level of brain damage. Düthorn had counteracted the drop with a routine dose of noradrenaline, and that had worked as intended. All of Uli’s other vitals were unremarkable. All of the dosages had been double-checked by a nurse.

Afterward, whenever Düthorn had to anesthetize a healthy young boy, he would think of Uli. “I was personally devastated,” he told me. “I thought, I did the anesthesia. It is my fault. But on the other hand, I could find no mistake.”

Julia Sellmann for The Atlantic

Uli was an active kid, skiing at 3 years old and playing soccer in elementary school.

The death or serious injury of a healthy child from anesthesia is so unusual as to be universally shocking to doctors these days. Anesthesia is known to pose risks to the elderly or ill, but even then it is far safer than it once was.

In the 19th century, as many as one out of 2,500 patients died under chloroform, then a popular anesthetic. But patients were willing to take the risk, because the alternative was pure, visceral horror: During the pre-anesthesia era, hospitals would put their operating rooms in towers, so as to spare other patients from all the screaming.

Like many medical breakthroughs, the discovery of anesthesia was something of an accident. Doctors became aware that ether, a popular party drug at the time, made giddy revelers insensitive to pain. They decided to give it a try in the operating theater: The first public demonstration was carried out on October 16, 1846, when a 21-year-old man under ether had a malformation removed from his neck at Massachusetts General Hospital. (The name anaesthesia, from the Greek for “without sensation,” was suggested by Oliver Wendell Holmes Sr., the eminent doctor and essayist who also gave this magazine its name, in 1857.) At the time, doctors did not understand why ether worked; that it did was good enough.

General anesthesia today is often likened, colloquially, to sleep. But what it does to the brain is stranger and frankly spookier: A patient who is merely asleep would not lie still and take a bone saw to the chest. To render someone so deeply unconscious, anesthesia shuts down multiple distinct functions in the nervous system, making a patient insensate, paralyzed, and unable to form memories. The brain under anesthesia is suppressed to such an extent that Emery Brown, an anesthesiologist at Harvard and MIT, has compared it to coma or brain-stem death.

“The key thing is that it’s reversible,” Brown told me. When anesthetics stop being administered, the patient starts to rouse within minutes. Their consciousness flips back on. The spell breaks. This total reversal has happened millions of times in millions of people, the magic of it now mundane. But Uli had needed hours to find his way back to consciousness, his brain adrift someplace too deep and too dark to return from unscathed.

In the months after his accident, Uli’s symptoms became manageable enough for him to return to school. Still, he could be unsteady on his feet. On a walk with friends and their dog one day in 2007, he took a tumble and fractured his collarbone. His mother hoped the bone would heal without surgery, but his erratic limb movements from the damage to his brain kept jostling the broken bone. Surgery became inevitable.

Wary of anesthesia, Yaremy asked his doctor to avoid the type Uli had received for his arm surgery. She had no scientific evidence to cite, but she hoped he would listen to her, as a worried mother and as a fellow doctor. He did not.

This time, Uli did not wake up for days. Yaremy thought he was going to die. She would open his eyelids to check his reflexes. Nothing. When his eyes finally stayed open on their own, Uli was delirious. He screamed whenever an unfamiliar nurse entered his room. He had trouble following conversations. His skin became hypersensitive to touch. He lost more control over his limbs. He would never again be able to play guitar in his band or impress girls with snowboarding tricks. He would never even walk or talk on his own.

Yaremy struggled to care for him at home, and she began to contemplate her life in small-town Germany. She had grown up an ocean away, in the boisterous city of Caracas. At 21, she met a German man at a disco in Venezuela, who became her husband and then Uli’s father, and who persuaded her to move to this tiny ski town, where her new in-laws ran a hotel. When she arrived—with 1-year-old Uli in her arms—she spoke little German. For a long time, she was the only foreigner in town. She missed the warmth of the Venezuelan sun and she missed her large family, who she knew would rally to help her back home.

And so, soon after the disastrous second surgery, Yaremy boarded a plane with Uli, now 17, to Caracas. Her younger child decided to stay in Germany with their father. They all planned to reunite in Venezuela later, but Yaremy knew her marriage was already over, its existing cracks widened by the new challenges of caring for their son.

The move proved, in one way, fortuitous. A few years into living in Caracas, Yaremy encountered the first hint that what had happened to her son had also happened to someone else. When picking up medication for Uli—Botox to relax his clenched muscles—she met another mother doing the same for her own son. The facts of his case sounded awfully familiar: anesthesia, delayed awakening, brain damage, loss of muscle control. The mother told Yaremy about a spate of anesthesia complications in the Venezuelan state of Carabobo in the early 2000s, which were blamed on a contaminated batch of sevoflurane, then a fairly new anesthesia drug in the country. Her son, this mother said, was one such case.

Uli, too, had gotten sevoflurane during both surgeries. The colorless and faintly sweet gas has since become one of the most widely used anesthetics worldwide. But Uli’s surgeries were two years apart and 5,000 miles away in Germany, which had had no reports of contaminated sevoflurane. Yaremy couldn’t see how the incidents in Carabobo could be connected to her son’s. Still, she filed them away in her mind.

Not long after, Yaremy began chasing down a second clue, which emerged as Uli’s malpractice case wound its way through the German legal system. The lawsuit itself was unlikely to succeed, now that Uli had suffered the same complications under a different anesthesiologist, but an expert examining the facts of the case made a crucial observation: The two symmetrical white spots in Uli’s basal ganglia, he said, looked much like the brain damage found in people with inherited mitochondrial disease.

Mitochondria are the tiny structures inside our cells that act as power generators. When they become dysfunctional, cells are first starved of energy; then they die. The most vulnerable cells are the most energy-hungry ones; neurons are particularly susceptible, especially those in the basal ganglia. In children with mitochondrial disease, neuron death can be triggered by physiological stress of any kind: fasting, illness, dehydration, and, yes, anesthesia. Perhaps the fault lay with Uli’s mitochondria too.

In 2013, Yaremy managed to secure an appointment at a leading genetic-disease lab in Houston. She boarded the plane with Uli, convinced that the answer awaited them at their destination. There, specialists ran a series of blood tests on Uli and searched his DNA for mutations that cause mitochondrial disease. “I felt like I was going to see the light,” Yaremy told me over breakfast in May. “But nothing happened.” She sighed, her shoulders tense with disappointment.

The tests found no mutations known to cause mitochondrial disease. Moreover, Uli had never exhibited other symptoms; mitochondrial dysfunction affects numerous parts of the body, including the heart and muscles, and symptoms frequently manifest in childhood. Uli had been a healthy and energetic boy: walking before age 1, skiing at 3. Yaremy wondered if her son’s reaction to sevoflurane could be caused by a novel mitochondrial mutation. Uli remembers hearing the doctor, who did not know he understood English, mention her belief dismissively to his medical students.

Yaremy and Uli returned home to Caracas, where they had been building a new life. Uli enrolled at Venezuela’s largest university; using an eye-tracking device to communicate, he graduated with a degree in modern languages. Yaremy worked her way up to professor of medicine at the same university.

Then, in the mid-2010s, Venezuela’s petroleum-dependent economy cratered. Public hospitals lacked equipment as basic as disposable gloves; inflation soared to more than 1 million percent. Even with her connections, Yaremy began to struggle to obtain Uli’s medications. She decided in 2018 to uproot their lives once again, taking Uli back to Germany, where he could receive more reliable care.

By then, Yaremy was closer to finding the explanation for Uli’s condition than she knew. She already held key pieces of the puzzle. But it would take a second tragedy in her family for her to realize how they fit together.

In June 2020, Yaremy got a call from her younger cousin—and Uli’s godmother—María Fernanda Pozo Castillo, or Mafer. They are close, having grown up together in Caracas. Because Yaremy is the doctor in the family, Mafer told me, everyone bugs her with their ailments. (“Yaremy, I have a headache,” she said, slipping into an imitation.) But she was calling about something much more serious. Her 13-year-old son, Matías, had just had knee surgery after a bike accident in Austin, Texas, and he’d struggled to wake up. He had gotten sevoflurane.

“Mafer, no!” Yaremy said.

Even as she began to relive the cold dread of waiting for Uli to wake up, Yaremy pulled herself into problem-solving mode. “Don’t leave the hospital without an MRI, okay?” she told her cousin. “If the doctor says it’s not necessary, it doesn’t matter. You demand an MRI.”

Mafer remembers that the doctors were reluctant to order a brain scan for her son—he’ll be kicking a ball again in three weeks, they told her. But she kept asking and asking until they acceded. Sure enough, the MRI—which was done without further anesthesia—showed two white lesions in the basal ganglia. “Same places,” Yaremy immediately said when she heard this. “Same places as Uli Gabriel.”

In the coming days, Matías started experiencing involuntary limb movement. He developed muscle contractions, even more severe than his older cousin’s, that left him screaming in pain. The contractions have persisted, even with high doses of muscle relaxant delivered straight to his spinal cord. This past summer, Matías’s pain became so excruciating that he had to be hospitalized in the ICU. His mother cares for him full-time. Before we spoke on the phone, she kept apologizing that she might need to leave at any minute to tend to him.

Yaremy was devastated for her family; so was Uli. “I wouldn’t wish it on anyone,” he told me when we met in the spring, tapping the sentence out letter by letter on a board that he uses to communicate.

Julia Sellmann for The Atlantic

Uli has been unable to walk or talk on his own since his second surgery. He uses eye-tracking devices and letter boards to communicate.

Yet amid her grief, Yaremy’s scientific mind got to work: One kid in her family? Okay, a fluke. But two? It had to be genetic. She thought of Uli’s mitochondrial-DNA test from seven years earlier. The sequencing had found no mutations known to cause disease. But the report did note some “variants of unknown significance,” including one called m.11232T>C, meaning that the 11,232nd letter of his mitochondrial genome had been altered from a T to a C. No one made much of the finding; all of us have variants of unknown significance in our genomes, most of which are of little consequence, like minor typos that do not obscure the meaning of a sentence. But maybe this mutation was, in fact, significant.

Mitochondria carry their own loop of DNA, separate from the chromosomes that make up the rest of our genome, and are inherited through the maternal line. Yaremy’s mother and Mafer’s mother are sisters, so they and their children share the same mitochondrial line.

Could a single typo in their mitochondrial DNA be responsible for all of the catastrophic brain damage in the family? And what was the connection to sevoflurane?

Yaremy now began searching for a scientist to study her family. She suspected that Uli and Matías carried the same mutation, as might other relatives. Two of her mother’s sisters, she realized, had also suffered complications after surgery that now seemed to trace back to anesthesia. Were others at risk too?

She found Julio Montoya, an expert in mitochondrial disease at the University of Zaragoza, in Spain, who saw her email in a waiting room as he was about to undergo emergency surgery for a detached retina. With his one good eye, he read it and replied immediately. He was keen to investigate.

Montoya and his colleague Eduardo Ruiz-Pesini had, it turned out, seen the m.11232T>C mutation before. In 2018, they had found it in a Venezuelan boy at a Barcelona hospital. This patient had become severely ill after surgery to remove his tonsils and adenoids—and deteriorated even further with subsequent rounds of anesthesia in later years. The Spanish team decided, along with Yaremy, to put together a formal research proposal. The boy from the Barcelona hospital would become patient one in their study; Uli became patient two, and Matías patient three.

Over the years, Yaremy had talked with colleagues in Venezuela about Uli so relentlessly that word sometimes came back to her of similar cases: nearly always kids, nearly always after routine surgery. An introvert by nature, Yaremy had to learn to badger anyone and everyone for a useful crumb of information.

She began running down some of these rumors: The wife of the son of a friend knew a neurologist who knew an anesthesiologist who knew of a boy who had fallen ill after surgery on a broken forearm. He became patient four. Patient five was the boy whose mother she’d met picking up Botox in Caracas. A physical therapist told her about a boy who’d had cleft-lip surgery—patient six. An old friend from medical school, an anesthesiologist, had examined a boy who developed symptoms after surgery for a cochlear implant. The friend had once been skeptical of Yaremy’s theory, but now he helped her gather data. This boy became the seventh and final patient in the study.

All of the patients who ended up in the study were boys, but Yaremy heard of girls affected, too. For every patient she managed to track down, she followed other trails that ran cold. Families who’d filed lawsuits were reluctant to talk; others were lacking complete medical records. The allegedly contaminated sevoflurane in Carabobo, Yaremy learned, had been widely discussed among doctors at the time, but news coverage of the events 20 years ago had disappeared from the internet as a result of the regime’s media crackdowns and poor digital recordkeeping. She managed to get hold of one newspaper article—a printout saved by the mother picking up Botox in Caracas. But she was not able to find any other families whose children had died or become disabled in Carabobo.

A haunting pattern appeared in the cases she was able to pull together. All seven patients in the study had received sevoflurane. Most of them could trace their maternal relatives to Carabobo; Yaremy’s own maternal grandmother was from the state. And all seven had the same T-to-C mutation. This mutation is extremely rare, even in Venezuela, but it is an estimated 15 times more prevalent in Carabobo, where it is believed to have originated many, many generations ago. The Spanish researchers hypothesized that this old mutation had taken on new, potentially fatal importance in the era of modern anesthesia.

General anesthesia today is usually achieved through a cocktail of drugs, both inhaled and intravenous. Of these, sevoflurane is one of the most popular, particularly for children. It is easy to administer, quick to work, and not irritating to the airways. But sevoflurane seemed to behave differently—and dangerously—in the presence of the T-to-C mutation.

To prove this, the Spanish researchers would need to collect cells with the mutation and subject them to sevoflurane in a lab. Yaremy volunteered her own. In the fall of 2024, she found a colleague to draw her blood and a lab to biopsy a ribbon of her skin. Her cells soon made it to Spain, where the team got to work.

As the lab experiments were ongoing last summer, tragic news came out of Chile. Five children there had suffered terrible outcomes after routine anesthesia; four were dead, according to an alert from the Chilean Society of Anesthesiology. All five children were Venezuelan.

The news spread within the Venezuelan diaspora. In the past decade, more than half a million Venezuelans have moved to Chile, where they have not always found themselves welcome. Now some of the parents alleged that poor medical care and discrimination had killed their children. They filed lawsuits and demanded justice on social media. In videos the parents shared of their children on Instagram and on TV, they are all bouncy and bright: a 4-year-old girl swinging in gymnastics class, a 2-year-old boy in a Messi jersey kicking a soccer ball.

Chilean investigators were able to collect genetic samples from only three cases—out of what had grown to a total of seven in the country—but all three patients had the same T-to-C mutation. One of the children who died in Chile, Yaremy later learned, was the cousin of a patient in her study. As word of the mutation spread around the world, doctors started reporting cases in the United States, Canada, Colombia, Peru, and Guyana.

“I suffered with each kid, each mother,” Yaremy told me. Even when a child survived, she saw ahead to their “lifetime of complications.” She often thinks about the boy with the cleft lip from her study, who, abandoned by his mother, lives in a poor village in Venezuela with his grandmother. His family can’t afford Botox or other treatments. In videos she has seen, his muscles are always clenched, his limbs unusable.

Back in Spain, the researchers raced to finish the experiments. They ultimately found that cells carrying the mutation were indeed hypersensitive to sevoflurane. This mutation could explain why Uli—and Matías and all the other children—had stayed unconscious for so long after surgery. The study, with Yaremy as a co-author, was the cover story of the June 2026 issue of Anesthesiology, the official journal of the American Society of Anesthesiologists. Accompanying it was an editorial written by two physician-scientists in the U.S., Richard Levy, at Stanford, and Philip Morgan, at Seattle Children’s Hospital.

I had first spoken with Levy a few months earlier, after the ASA issued an alert—following up on the one in Chile—about terrible complications from anesthesia, primarily sevoflurane, in people with maternal Venezuelan ancestry. In our conversation, I asked what seemed like a basic question: How does sevoflurane work? “If you can figure that out, you have a Nobel Prize,” Levy told me. “The reality is, we don’t know.” We don’t know how any inhaled anesthetics work. But this novel mutation out of Venezuela, he and Morgan thought, might hold a clue.

Julia Sellmann for The Atlantic

More than a decade after his injury, Uli became a case study in a scientific paper, co-authored by his mother, about how anesthesia interacts with a rare mitochondrial mutation.

Anesthesia likely taps into something evolutionarily ancient in the body. A one-cell protozoan, a Venus flytrap, and a human are all susceptible to anesthesia—and two of those things don’t even have a brain.

For most of the 20th century, scientists clung to the idea that these drugs perturb the fatty membrane of living cells—a hypothesis based on how the gases behave in olive oil. But by the 1980s, a new dogma began to take hold: Anesthetics bind to proteins on the surface of brain cells, which interrupts their signaling. This is best understood in a drug called propofol, which is a common anesthetic but not an inhaled one; the milky-white liquid is delivered via IV. In an elegant set of experiments in the 2000s, scientists identified propofol’s primary target as a protein called the GABA receptor. Yet the same experiment, when repeated with a common inhaled anesthetic, failed to find an analogous target. Decades later, it remains elusive. Maybe it doesn’t exist.

Today, the general consensus regarding the mechanism of inhaled anesthesia is that the gases bind weakly to many proteins in the brain, which together add up to complete loss of consciousness. Most practicing anesthesiologists don’t think much about this. Sevoflurane works. The proof is in the operating room every day. What more do you need?

But a group of researchers dissatisfied with the conventional wisdom on proteins, including Levy and Morgan, has been slowly building the case for an alternative hypothesis: Actually, it’s the mitochondria.

When these researchers heard about children with a mitochondrial mutation dying from anesthesia, they immediately saw the implications. Scientists have long relied on rare mutations to probe the mysteries of biology. In another Venezuelan state called Zulia, for example, families with a shared mutation for Huntington’s disease have been crucial to our understanding of the condition. Rare mutations are a kind of natural experiment.

Morgan, along with his wife and scientific collaborator, Margaret Sedensky, had once run lab experiments looking for mutations that altered sensitivity to anesthesia—though only in a tiny, transparent worm called Caenorhabditis elegans. When they induced random mutations in the worm, they found that the relevant ones were clustered in the mitochondria. Their findings didn’t make much of an impact among their fellow anesthesiologists, though. “We’re like the comic relief at our big national meeting of 15,000 anesthesiologists,” Sedensky told me. “ ‘Here come the worm doctors.’ ”

But Morgan and Sedensky kept working out the details of their theory. Inhaled anesthetics such as sevoflurane, they now argue, work by inhibiting the mitochondria, inducing a kind of temporary brownout in the brain. The bubbles used to transport brain chemicals become frozen in place, like cars that have run out of gas. They restart as soon as anesthesia is discontinued. But in some hypersensitive patients, the mitochondria could become so impaired that their brain cells die. Morgan had found some of these hypersensitive patients before, but he believes Uli’s mutation could help pinpoint more precisely how anesthesia works on mitochondria. This past summer, cells with the mutation—derived from Yaremy’s blood sample—arrived in the couple’s lab in Seattle.

Understanding how anesthesia works, Levy told me, could enable scientists to design better drugs that precisely target the brain, without lingering side effects. Though modern anesthesia drugs are generally quite safe, they are imperfect. They affect the cardiovascular system; they affect ostensibly unrelated areas of the brain, such as the region that controls nausea. And they have been linked to cognitive decline in the elderly after surgery—though the degree to which the drugs are responsible, as opposed to other factors such as the physical effects of surgery, is still being debated. How much of that can be avoided?

Before her study was published, Yaremy had someone she needed to call: Ludwig Düthorn, Uli’s anesthesiologist after the snowboarding accident. She had not seen Düthorn since testifying against him at the malpractice trial years earlier. She’d lost the suit; legally, he had already been absolved. Personally, she felt she had to apologize.

Düthorn was gratified to know what Yaremy had found, but even now, he told me, he feels a doubt gnawing at him in the operating room. Uli had a silent and novel mutation in his DNA. Could his next 14-year-old patient have a different one?

Cases like Uli’s unsettle everyone they touch. In the 2000s, Rafael Legórburu, then an anesthesiologist in Caracas, treated a young boy who would not wake up after sevoflurane—a case he now suspects was connected to this mutation. The boy suffered profound brain damage. Legórburu still finds it difficult to talk about 20 years later. “I have a scar,” he told me, “for the rest of my life.” Today he lives in Spain, where he practices aesthetic medicine, administering Botox and fillers; he says he’ll never touch sevoflurane again.

Doctors are now revisiting a number of old malpractice cases—some of which resulted in large settlements—that might be explained by the T-to-C mutation. An anesthesiologist whose hospital had settled one such case involving their patient told me they felt relieved, and vindicated. (They spoke with me on the condition of anonymity because they were not authorized by the hospital to speak publicly.) At the same time, they could not entirely shake their sense of responsibility. “It was the worst experience of my life,” they kept telling me.

A group of Venezuelan anesthesiologists—largely based in the U.S.—recently formed the Venezuelan Anesthesia Perioperative Risk society, or VAPOR, to raise awareness of the mutation among health-care workers, and to promote guidelines for screening and treating patients with maternal Venezuelan ancestry. A quarter of Venezuela’s population—8 million people—has left the country in recent years, meaning the mutation is scattered more widely than ever. Yet within Venezuela, no lab is testing for it, and anesthesiologists do not routinely have access to the specialized equipment needed to administer anesthesia without inhaled gases.

Yaremy is working with scientists to continue studying the mutation, about which many questions remain: Do other anesthetic drugs, inhaled or administered via IV, pose a danger? Are children more vulnerable, or have we simply not looked hard enough yet in adults? The oldest known patient to be affected was 31 years old.

In her own life, Yaremy has finally found a measure of stability. She and Uli live in Radolfzell, a bucolic lakeside town in southern Germany, where she works at the cardiac-rehab hospital. It’s calmer than the ICUs where she’s worked in the past. “B-O-R-I-N-G,” Uli joked, tapping out the letters in English. But the calm is welcome after years of upheaval. Uli has his own apartment and a rotating cast of full-time assistants; he works as a translator for medical records. (He is fluent in English, Spanish, and German.) He is a doting uncle to his niece and nephew, the children of his younger sibling, Levi.

The mutation still lurks in their lives. Both times after giving birth, Levi, who uses they/them pronouns, developed an infection in the uterus and needed surgery. Yaremy made sure that they did not get sevoflurane. But what about Levi’s kids, who also have the mutation? What if they’re rushed into emergency surgery on their own? Levi had closely followed the news of the children who died in Chile. “They could have been my kids,” Levi remarked as we parted ways after a family lunch by the lake. The water was a brilliant clear blue that day; so was the sky.

A few days after I left Germany, Yaremy learned about a new suspected case: a 12-year-old boy who’d had trouble waking up after surgery in Caracas. “How can this still be happening?” Uli wrote to me. “I mean what the ****!?”

Julia Sellmann for The Atlantic

Uli and Yaremy now live in the lakeside town of Radolfzell, Germany. Uli works as a translator for medical records.

Joana, Freddy Marquez’s mom, first caught wind of the suspected mutation in the summer of 2025, when she heard on social media about the children who’d died in Chile. She, too, is originally from Venezuela. And she made the connection instantly. Months earlier, when Freddy had been hospitalized, his doctors had ordered a genetic test that turned up a variant of unknown significance. Freddy had the m.11232T>C mutation as well. This information never made it into his chart for the same reason Uli’s mutation wasn’t initially taken seriously: No one understood its importance at the time.

Joana began commenting about Freddy on every related post she could find. One by one, she linked up with others who told similar stories: another mother in Florida, the family of a girl who died in Houston, Yaremy’s cousin Mafer in Austin, and so on. Joana got added to a WhatsApp group for the parents in Chile, which has since evolved into a de facto global support group for parents of children with this rare mutation. Through the group, Joana also learned of Yaremy. They spoke for the first time in February, and recognized in each other a maternal instinct that is both steely and tender. “She was in tears,” Joana told me, “and I was in tears.”

In February, Joana appeared on Instagram Live in a zebra-print shirt to talk about Freddy, alongside other affected mothers. The zebra print was a reference to the old medical adage “When you hear hoofbeats, think horses, not zebras”—meaning: think of the common explanation, not the exotic one. But sometimes, it is zebras. Freddy died because what happened to him lay just outside medical knowledge. His particular mutation is rare, but encounters with the unknown in medicine are not. Joana was asking for some humility, some openness to the possibility of zebras. Since Freddy’s death, she has made advocating for people with rare mitochondrial conditions her life’s mission.

Joana can still picture him: swimming, playing basketball, riding “like crazy” on his bike as Gordito, his Alaskan malamute, raced alongside him. “His flipping dog is now chasing me wherever I go,” she said. And Joana continues to propel herself forward. She’s cold-calling researchers. She’s going to medical conferences. She’s offering up her own cells to study. She is keeping the promise she made to Freddy before he died.

This article appears in the November 2026 print edition with the headline “Going Under.”

Are Mormons Losing Their Distinctiveness?

2026-10-04T08:00:00-04:00

Mormons have sometimes called themselves a “peculiar people,” and statistically, they have been. Compared with Protestants, Catholics, Jews, and Buddhists, Latter-day Saints have higher birth rates, higher marriage rates, and larger families. They also have a relatively high retention rate—meaning that those who are born into the Church of Jesus Christ of Latter-day Saints tend to stay members for life. But recently, all of these long-held patterns have started to shift.

The Church is not facing a crisis, exactly—more of a demographic ravine than a cliff, Jana Riess, a historian who studies the LDS faith, told me. But as of 2024, only about half of young people born into the Church stay in it—down from more than 80 percent in the 1980s. Its marriage rate has fallen 10 percent since 2011, and in the past 40 years, the number of annual recorded births per 1,000 LDS members has dropped from 25 to five, according to an analysis of Church records by the independent data scientist Alex Bass. If Latter-day Saints’ peculiarity was defined in part by their early marriages, their minivans full of kids, and their loyalty to the Church, some of that peculiarity seems to be slipping away.

The LDS Church’s birth-rate and retention problems are far from unique: People in the United States are having fewer babies and leaving religion pretty much across the board. Doug Andersen, a spokesperson for the Church, wrote to me in an email that “official church records show consistent worldwide increases in both membership and participation,” in part because a record number of converts are joining worldwide.

Still, the demographic tilt is enough of a problem that the Church’s new leader, Dallin Oaks, is taking notice. Under the previous Church prophet, mentions of family were fewer and farther between at the Church’s biannual conference. But this year, in his first conference address since becoming prophet, Oaks issued a warning: Although the Church’s marriage and birth rates were better than the U.S. average, they had declined significantly. “We are a family Church,” he said, and quoted from the 1995 “Family Proclamation,” which once hung on the walls of many LDS homes: “God’s commandment for His children to multiply and replenish the earth remains in force.”

In some ways, what’s happening to the LDS now is what happens to any religion that grows beyond a core of strong believers. Over time, the more particular edges of a faith—the meatless Fridays of Catholicism, for instance—can get sanded down until it more closely resembles mainstream American culture and mainline Protestantism, Matthew Bowman, the chair of Mormon Studies at Claremont Graduate University, told me. (The Church now discourages use of the word “Mormon” as a nickname for members of the faith, but the term is still used in proper names, such as Bowman’s title or The Book of Mormon.) To him, the demographic shifts in the LDS indicate that “the long process of assimilation is becoming more noticeable now.”

Compared with individual Protestant denominations, such as Methodism, the LDS looks like it’s doing better at retaining its young people, Justin Dyer, a religion professor at Brigham Young University, told me. But Ryan Burge, a political scientist at Washington University in St. Louis, argues that that’s not the right comparison to make, because even if someone switches from Methodist to Lutheran, they still hold pretty much the same Protestant beliefs. And Protestantism’s retention more generally, at 70 percent, far surpasses the LDS Church’s.

Lower retention may also have more ramifications for the LDS Church than it would for Methodists. Fewer young people means fewer missionaries. And fewer members means that the work of operating churches, which are volunteer-led at the local and regional levels, will fall on fewer people. In the past, the Church’s robust structure for kids (Sunday school, youth programs, regional dances, and sleepaway camps) carried young people into missionary work, which usually equated to lifelong membership, but that formula seems to be failing now, Jana Riess said. (She herself is an LDS member.) “The Church has been great at retention in the past and is doing many of the same things that used to be so successful then. So it’s understandable why leaders would be sort of wringing their hands and saying, ‘Why isn’t this enough?’”

The Church is having a particularly hard time keeping young women. In 2025, fewer than 40 percent of 18-year-old girls stayed in the faith, according to Dyer’s research. Many apostates leave because they are more liberal than the Church on issues such as same-sex marriage, but when Riess interviewed young women for her upcoming book on people who leave the faith, many of them also brought up feeling undervalued by the Church.

In LDS theology, only men can hold what is called the priesthood—the authority given by God to Joseph Smith and passed down through every generation of LDS men—which allows them to bless children and the sick, pass the sacrament, and serve in certain leadership positions. Because of this, essentially, “there is nowhere in the LDS Church where a man reports to a woman on questions of final authority, and there is nowhere in the LDS Church where a woman has final say,” Bowman said. And the 1995 Family Proclamation made clear that a wife’s role is to nurture the children. “It’s a tough position for the Church to be in,” Riess said. “It wants to remain attractive to women in a culture that has moved in a different direction, but also wants to stay pretty much on the same path of emphasizing this very particular configuration of the nuclear family.”

Many women do not mind the Church’s male priesthood, or at least accept it. “I can believe that something’s divine but also fallible at the same time,” Sophie Smith, a graduate student at BYU, told me. She believes that women already have many ways to contribute to the faith and that “whether it’s in this life or the next, it will not be a patriarchal Church.” But LDS leaders do seem to be aware of the Church’s young-women problem: Women can now direct their ward’s Sunday-school program, and recently, the Church lowered the age at which women can serve a mission from 19 to 18.

This decision has led to a record boom in missionary numbers, but it’s also “a way to keep young women in the fold and try to socialize them more deeply in the faith,” Riess said. (One refrain in LDS circles, Bowman said, is: “A missionary’s most important convert is himself or herself.”) Completing a mission at 18 also means that young women can get married sooner: They return around age 20, and “on the LDS checklist, the next check is getting married and having children,” Alyssa Beck, who leads classes for teenage girls at her ward in Los Angeles, told me.

Women who do lean into the Church’s call to motherhood may still struggle to have a big family, though. Smith has noticed those around her having fewer kids, mostly because they can’t afford more. For years, the single-family-home price in the so-called Mormon Corridor—Utah, Idaho, and Arizona—ran below the national average, but since 2020, prices have soared above that threshold, according to Bass’s analysis. “There are still people who are like, I wanna have eight kids, and that’s awesome,” Smith said. But out of necessity—because both parents need to work, and kids are expensive—many don’t.

These younger families may find less than they once did to keep them immersed in the culture of the religion. Between bazaars, choirs, plays, and road shows, congregants might have once been at their chapel four times a week; now many active members come only on Sundays, Bowman said. (And even Sunday services have been shortened from three hours to two.) As the faith has grown internationally, “the cultural apparatus that was built in Utah just wasn’t exportable,” Bowman said, and because the Church tries to keep its practices consistent across the world (whether in Kenya or Utah, every chapel uses the same teachings and Sunday-school curriculum), he believes that Church leadership pared back the social expectations of being a Latter-day Saint. That cultural loosening might be helping the Church grow internationally and simultaneously making it easier for American members to leave. (Andersen, the LDS spokesperson, said that the Church is “encouraged by increased participation of our children, youth, and young adults in the United States in the past decade.”)

For now, the Church seems to be insisting that its future is rooted in family—which will require people to heed the words of the prophet, and multiply and replenish the Earth. To do that, though, young people will need to stick around. Churches across the country, not just the LDS, are trying to figure out that particular puzzle: Recently, many younger Americans have passionately recommitted to religion, but their depth of feeling hasn’t caught on widely—at least not yet. Whether they grew up LDS, Catholic, or Baptist, many Americans seem to want churches to offer some combination of retreat from mainstream U.S. life and assimilation in it. But, as Bowman said, “that is a very, very tricky sweet spot to hit.”

MAHA Gone Mild

2026-09-30T16:45:13-04:00

The Make America Healthy Again movement has always had a split personality. Many of the movement’s leaders are fervent anti-vaccine activists whose views are at odds with scientific evidence and out of step with most Americans. At the same time, MAHA’s tenets include eating more vegetables and getting enough sleep, which is perfectly reasonable advice; it’s just hard to take seriously from people who, like Health Secretary Robert F. Kennedy Jr., wax nostalgic about catching measles.

That duality has been especially stark this month, as the midterms approach and Republicans look to MAHA for an electoral boost. At a conference two weeks ago for Children’s Health Defense, the anti-vaccine organization Kennedy founded, he told the audience that they had a “steadfast friend at the White House.” At a MAHA data summit on Monday, Kennedy previewed his plan to use a database of Americans’ health records to compare rates of autism among vaccinated and unvaccinated people. And yet, the second annual MAHA Summit, which was held yesterday in a hotel ballroom in Washington, D.C., seemed perfectly calibrated to downplay controversy.

Other high-ranking administration officials, including Vice President Vance and Medicaid chief Mehmet Oz, spoke at yesterday’s summit, lending the affair an extra layer of high-profile polish, but the event was mostly an opportunity for its roster of sponsors to tout their products and services. An executive from Walmart—one of the event’s many corporate sponsors—spoke about making food labels simpler and more transparent, though he didn’t say how his company, which sells more groceries than any other retailer, plans to do that. After being lobbed yet another softball question from the moderator, he gushed, “It means a lot for us to be here with MAHA.” Also among the sponsors was Grail, a cancer-screening company, which just last week announced that its controversial early-detection test had been recommended for approval by a Food and Drug Administration panel. Hims & Hers and Gameday Men’s Health—two wellness companies that stand to make serious money if the FDA allows gray-market peptides to be made and prescribed in the United States—also chipped in. Bloomberg reported that companies that forked over $300,000 were allowed to have “meaningful input” on the selection of panelists and topics. (In an email, an HHS spokesperson wrote that the FDA’s decisions “are made through established processes grounded in law, science, and evidence.”)

[Read: America is about to go over a peptide cliff]

The MAHA Summit was “very money-driven,” Mary Holland, who runs Children’s Health Defense and was not on the speaker list for yesterday’s conference, told me outside the ballroom. Kennedy has for years denounced corporate influence over the health agencies he now oversees, but onstage, there was no handwringing about conflicts of interest. Instead, Tony Lyons, the president of the nonprofit MAHA Center, which organized the summit, offered praise for “the investors scaling natural remedies, breakthrough technologies, next-generation devices, and cutting-edge therapies.” (Lyons is also Kennedy’s longtime publisher, and his company, Skyhorse, paid Kennedy $4 million in book advances over the past year.) Corporate convenience seemed to beat out Kennedy’s “eat real food” agenda: The conference swag bags contained two organic snack bars, a packet of electrolyte powder, potato chips fried in grass-fed-beef tallow, and a bag of dehydrated taco filling made from pinto beans and peas, all vaguely MAHA-coded but certainly nowhere to be found on the administration’s inverted food pyramid.

Plenty of Kennedy’s vocally anti-vaccine compatriots were in attendance, if not on the agenda. I spotted Mark Gorton, the president of the MAHA Institute, who, at the Children’s Health Defense conference, declared himself “the boldest anti-vaxxer in the anti-vax conference.” Del Bigtree, Kennedy’s former communications director, who once told me he’d rather his kids catch diseases such as polio and measles than get the shots that prevent them, spent most of his time chatting with his many fans in attendance. He was pleased at how large companies appear to be on board with MAHA, even if the summit steered clear of the issue—vaccines—that brought him and Kennedy together. “It really probably should be called ‘MAHA Food Summit,’” he told me. (An HHS spokesperson wrote that Kennedy “oversees an extraordinarily broad health portfolio and addresses different priorities in different settings.”)

[Read: ‘I genuinely am upset that your kids are vaccinated’]

But lest Bigtree and other anti-vaccine activists have any doubts, Kennedy has repeatedly reassured them that he is on their side. At the Children’s Health Defense conference, he went so far as to read from a manufacturer’s list of possible adverse events from a hepatitis B vaccine. In an appearance on CNN last month, Kennedy again floated a possible connection between autism and vaccines, even though researchers have found no such link.

Since Kennedy’s failed run for president in the 2024 election, he has drawn together an unlikely and seemingly uneasy coalition. Some are hard-core activists, like the guy I spoke with who was wearing a shirt that took aim at fluoride, vaccines, hospital births, aspartame, and root canals. But other attendees at the packed, invite-only event said they were there because they hoped psychedelics might be used to treat depression; because they thought that AI might improve health care; or because they were looking for answers to medical problems their doctors hadn’t been able to solve. They weren’t anti-vaxxers, and they weren’t necessarily big Kennedy fans, as a couple of them confided to me between sessions. But Kennedy and his Republican allies seem to hope they can channel these different levels of frustration with mainstream medicine and keep all of those voters under the MAHA banner. The midterms will be, among so many other things, a test of how far that banner can be stretched.

GLP-1s Are Rewriting the Story of Weight Loss and Mental Health

2026-09-29T13:25:05-04:00

Noom, the popular weight-loss app, prompts its users not only to log their meals and exercise but also to gaze at paintings. The “Mindful Art Break” feature includes images of such works as Claude Monet’s Woman With a Parasol—Madame Monet and Her Son and Franz Marc’s The Bewitched Mill, neither of which seems to have anything to do with body fat. Breath work, meditation, and lessons in cognitive-behavioral-therapy techniques are also available on the app. One user, in a testimonial the company sent me, said that Mindful Art Break helped them “contemplate something other than weight loss.”

Why, then, would a weight-loss company offer such a program? Noom launched a stand-alone emotional-health program called Noom Mood in 2023, the same year it added GLP-1s to its offerings. Then, last year, the company integrated core Mood tools into the flagship app “after seeing major overlap with weight, stress, and self-care needs,” Emily Passer, Noom’s head of communications, told me. Other weight-loss services—especially newer ones that offer GLP-1 medications—are getting into mental health too.

Mental health and weight are, of course, intimately linked. As someone who lost almost 70 pounds by strength training and getting treatment for an eating disorder more than a decade ago, I can certainly attest to the importance of mental-health support during any sort of body change. But Noom and other weight-related companies are leaning into a common strategy to entice customers: To be palatable (and successful), a weight-loss company must now profess care for its customers’ psychological health, not just for their waistline.

Wondr Health, a weight-loss platform that partners with employers, offers information about managing stress and anxiety and says that its program begins with “behavior change.” Weight Watchers, which filed for bankruptcy last year, announced in December its “fully integrated platform for the GLP-1 era,” including features related to behavioral health and community support. Kim Boyd, the company’s chief medical officer, told me that weight loss and mental health shouldn’t be treated as separate pursuits. “It’s all happening in one person, and those things are really, really connected,” she said.

“Mental well-being is a huge trend right now, and I could see how it would be good business to capitalize on it,” A. Janet Tomiyama, the director of UCLA’s Diet, Stigma, and Health Lab, told me. Other industries have done just that in recent years—see Ulta Beauty’s “feel-good” wellness initiatives and Bumble’s “interest badges” for therapy and mindfulness. The messaging is playing to widespread sentiments. In a May 2025 survey, YouGov asked U.S. adults to rank how essential various states of being or behaviors are to overall physical health; 79 percent of respondents said that “having good mental health” is essential. When the National Academy of Sports Medicine asked personal trainers in April what their goals were for their average client, mental clarity and stress relief came in just under weight loss and well ahead of athletic performance.

And yet, mental-health support from a weight-loss company might feel incongruous, in no small part because the tools of weight loss and the drive to lose weight have historically not improved people’s mood. Tomiyama said that in a 2010 study she co-authored, the stress hormone cortisol spiked when women were randomly assigned to start a diet. Plus, Tomiyama said, because many people who diet gain the weight back, they end up feeling as if they’ve failed. “We have scientific, causal evidence that diets ruin people’s mental health,” she said. “So I’m not surprised that these companies are noticing that through their customer base and realizing they have to do something about it.”

Now more than ever, though, dramatic weight loss doesn’t have to involve dieting at all. Instead of cutting calories and fighting against related hunger, people can take a GLP-1 and feel fuller from less food. One small, non-placebo-controlled study on how a GLP-1 called liraglutide affected mood and behavior suggested that the drugs significantly improved depression symptoms. The research is complicated, though: Other studies have found no significant effect on mood, and still others suggest that, at high doses, GLP-1s are linked to depressed mood, possibly because of their dopamine-dampening effects. Anecdotally, some GLP-1 users experience anhedonia. But others feel more optimistic, perhaps because, unlike dieting, the drugs can turn down the dial on so-called food noise.

The social effects of GLP-1s are also less than straightforward. On the one hand, people who are overweight or have obesity face a lot of stigma and can be treated poorly, which is famously not ideal for your mental health. So perhaps GLP-1s can improve mood simply by being an effective way to lose weight. On the other hand, Tomiyama conducted another study that found that people who lose weight through GLP-1s are socially stigmatized even more than people who have never tried to lose weight in the first place, perhaps because of perceptions that GLP-1 users opted for the “easy way out.” People who go off GLP-1s and gain weight back are stigmatized too. Boyd, from Weight Watchers, said that the mental-health-related struggle she observes most from the company’s clients is shame around GLP-1 use being seen as a cheat code. She knows of one woman who was storing her neighbor’s GLP-1 medications in her fridge because the neighbor didn’t want her husband to know she was on them.

It’s no wonder, then, that people who take these drugs might want some extra help for their mental health. In a 2024 survey of 300 GLP-1 users, 75 percent reported that they were interested in behavioral-health support, and 63 percent believed that they would achieve better health outcomes while taking GLP-1s if they also received such support. They might be right. Spencer Nadolsky, an obesity specialist who founded an online medical-weight-management platform that offers both GLP-1s and behavioral and emotional support, told me that psychological support “doesn’t necessarily lead to a lot more weight loss in general, but it improves outcomes in other realms of the weight-loss journey,” including patients’ feelings about the process and their general quality of life.

The cynical view—one I’ve taken myself—is that any gesture toward mental health by an entity selling weight loss (or anything else) is an empty marketing-and-sales tactic. How effective these interventions are at actually supporting customers’ mental health, and whether companies will continue offering them if mental-health support exits the zeitgeist, remains to be seen. But in my experience, weight loss on its own also isn’t enough to meaningfully improve mental health. When I got treatment for my binge-eating disorder, the pounds were coming off because I was eating less and because I was exercising in a way I liked. My mindset and lifestyle seemed to be changing for good because I was talking through the anxiety and depression that drove my bingeing in the first place.

I think back to the times I sat in early-2000s Weight Watchers meetings with my mom, where conversations revolved around the scale—or when a doctor told preteen me to “eat healthier” to lose weight without asking what I even knew or thought about healthy eating, or how difficult it was for me because I had a disorder. It would have been nice to have someone even pretend to care about my feelings. Hopefully, this new concern on the part of the companies will last.

Why a Sea-Lion Epidemic Is a Bad Sign for Humans

2026-09-18T11:06:00-04:00

You have likely never heard of synanthropes, though you surely know them. And they know you. Synanthropes, whose name is derived from the Greek for “together with man,” are not our pets or our herds of domesticated animals but something like our oldest frenemies: beings from which we have long sought and failed to decouple ourselves, that now reside within our communities, and that have become an ineluctable part of our lives. They include insects like bedbugs, which have evolved within urban environments to become uncommonly dependent on humans for their survival, as well as house sparrows, seagulls, blackbirds, and pigeons, all of which have adapted themselves to take advantage of cities while evading their dangers. In Singapore, synanthropic river otters have begun rampaging through local markets and aggressively pursuing tourists for food. Black bears are bathing in backyard swimming pools in California.

All of these creatures straddle the human world and the wild. And that can make them uniquely perilous to human health.

In Chile, which has a 4,000-mile-long coastline, the most conspicuous synanthrope is the South American sea lion. About 130,000 of these pinnipeds, which can weigh 660 pounds and resemble giant waterlogged chocolate Labrador retrievers, live in raucous colonies on the water’s edge. On account of their ubiquity, pretty much everyone in Chile has had some kind of run-in with the barking beasts.

“As a Chilean, you can easily see sea lions,” Victor Neira, a veterinary scientist and virologist, told me from his lab at the University of Chile in Santiago. Sea lions have long been habituated to human handouts in Chile, and many of the urban colonies they’ve established are located near fish-processing plants, where the animals gorge on fish guts, bycatch, and other detritus dumped back into the ocean. “They’re not aggressive by nature,” Neira said. “They see people all the time, so they generally just move out of the way for you.” He thought for a second and seemed to change his mind. “That being said, if you mingle with them, they will try to bite you. So usually you have to kind of run or you have to scream.”

Neira has had more than his fair share of sea-lion encounters, because he’s spent the past decade tracking novel viruses in wild and domesticated animal populations across South America to sound the alarm about potential threats to humans. The more blood and fecal samples he and his team collect from seabirds and marine mammals, the more likely they are to detect novel pathogens or viral variants that have just appeared in the region. This sort of epidemiological research is undertaken in countries across the world because scientists now recognize that synanthropes are among the most important vectors transmitting novel pathogens to human populations. The hope is that a network of scientific early-warning systems, like the one Neira and his team have designed, can give humanity a head start in identifying new pathogens and stamping them out before they explode into the next pandemic.

In December 2022, Neira discovered a disturbing anomaly in blood samples he had been routinely collecting from migratory birds in Chile. H5N1—an influenza virus that causes acute respiratory symptoms and death in birds—appeared to be circulating among pelicans, cormorants, and terns. All three species regularly cross paths with other birds and sea creatures, and the viruses they harbor, along their migration routes. Neira was terrified. In the preceding 20-plus years, H5N1 had killed tens of millions of wild birds around the world, and hundreds of millions of poultry had been culled to contain its spread. He girded himself for a devastating avian outbreak. When the viral wave arrived, though, the casualties went much further.

Neira told me that in early January 2023, clusters of dead seabirds began washing up on shore. Later that month, Neira’s team witnessed the first cases of H5N1 among Chile’s sea-lion colonies. After years during which the monthly number of sea lions stranded on land (a measure that marine biologists use to assess disease severity and death counts) never surpassed 100, January 2023 saw a sudden spike to about 250. One month later, that number had doubled, and in June, more than 4,500 stranded sea lions were observed by scientific authorities. Overall, somewhere between 10 and 25 percent of the sea-lion population in the country died in the six months after the first H5N1 case was detected among Chilean seabirds, though Neira estimates that the proportion could be double that. It was a sudden and deeply frightening mass-mortality event, caused by a virus that had gained the ability to infect and kill mammalian hosts as well as avian ones. The corpses were piling up on shore, attracting flies and other scavengers—and risking further spread of the virus. Eventually, Neira said, the Chilean government built halls to house the remains, a sign of the scale of the crisis and its lasting impacts on Chile’s ecosystem.

More epidemics were caused by novel viruses in the past two decades than in all of the 20th century, suggesting that human vulnerability to opportunistic pathogens has shifted dramatically. The H5N1-fueled mass-mortality event among Chilean sea lions is an unsettling illustration of how synanthropes are ratcheting up this risk by bringing novel viruses carried by wild and migratory animals close to humans. H5N1 is still spreading through animals worldwide, including in the United States. More than 1,000 American dairy herds have tested positive for H5N1 over the past two years; cases among poultry and cattle alike may tick up this fall during the seasonal migration of wild birds.

So far, that hasn’t translated into a major human outbreak. Since 2024, only 71 human cases of H5N1 have been reported in the U.S. Two people have died. No evidence indicates that the virus currently infecting cattle can spread between people. It’s a lucky break, given how ubiquitous H5N1 is among hundreds of wild bird species that regularly come in contact with poultry and cattle herds, which are perfectly positioned to infect human populations with opportunistic pathogens. That luck might not hold forever, though. A recent report from the World Health Organization suggests that H5N1 viruses are continuing to mix and match genetic material, and a 2024 study from Scripps Research Institute in San Diego found that the H5N1 variant circulating in U.S. cattle is only a single amino-acid mutation away from being able to efficiently infect humans.

As animal populations continue to come into closer proximity with humans, the threat posed by synanthropic viruses will only grow. Viral pathogens can now be efficiently borne from the most remote places on Earth into the heart of human metropolises. It just takes an animal to bring it from there to here.

This article has been adapted from Dan Werb’s new book, Our Wild Familiars: How Animals Are Adapting to Cities and Reshaping the Natural World.

RFK Jr.’s Brazen Reassurance to Anti-Vaxxers

2026-09-17T19:33:23-04:00

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Since becoming Health and Human Services secretary, Robert F. Kennedy Jr. has repeatedly denied that he opposes vaccines and has toned down some of his more extreme rhetoric on the subject. But in a keynote speech today at a conference for Children’s Health Defense, the anti-vaccine organization he founded, the old Kennedy was back. He complained about safety studies, floated disproven theories about a link between vaccines and autism, and all but declared himself an anti-vaxxer. “You have a strong and steadfast friend at the White House,” he told the crowd.

His choice to take the stage at the conference signaled a shift. Since becoming HHS secretary, Kennedy had distanced himself from Children’s Health Defense as he worked to convince the Senate that he held mainstream-enough views on vaccines. Children’s Health Defense, meanwhile, attempts to convince parents that vaccines are a threat to their children’s well-being. In just the past few days, CHD has used its X account to warn parents against trusting babies with health-care providers who might give them vaccines, claimed that childhood vaccines kill more children than do the diseases they prevent, and alleged that COVID vaccines were designed to cause infertility. The speakers at its conference were a who’s who of the anti-vaccine movement.

Nearly everything the organization promotes runs counter to guidance from the CDC, an agency that Kennedy leads as head of the Department of Health and Human Services. But much of Kennedy’s speech was consistent with CHD’s brand of scaremongering. He suggested that vaccines contribute to chronic disease and disorders such as autism. He bemoaned the fact that more vaccines are recommended for American children now than when he was a child. And he falsely claimed that nothing is known about their safety. “We have no idea what the risk profile is for these products,” he told the crowd.

In one of the more bizarre moments of his address, Kennedy read from the manufacturer’s list of possible adverse events for the vaccine against hepatitis B, a disease that can lead to liver failure. Among those he mentioned was anaphylaxis, an allergic reaction that occurs roughly once for every 1 million doses administered. He ignored the benefits of the vaccine, which has drastically reduced infections and is projected to have prevented millions of deaths. Instead, he implied that the vaccine was merely part of an industry “gold rush.”

The speakers surrounding Kennedy are publicly hostile to vaccination. He was introduced by Mary Holland, the CEO of Children’s Health Defense, who took over the organization after Kennedy’s departure and praised him for taking on “the corrupt medical pharmaceutical complex.” Mark Gorton, the president of a pro-Kennedy think tank called the MAHA Institute, had earlier told the crowd that vaccines are a “public-health nightmare” and that eliminating them would make the country healthier. And then there was Andrew Wakefield, known for his discredited 1998 Lancet paper that alleged a connection between autism and the MMR vaccine. Anti-vaccine activists have spent decades citing Wakefield’s faulty research in an effort to fuel fear of immunizations.

Now is a terrible time for Kennedy to return to public anti-vaccine advocacy. Pennsylvania is in the midst of a deadly measles outbreak. The official count in the state is 731 cases since April and 117 in just the past week; the real number of infections is almost certainly much higher. Four people, two of them infants, have died since mid-August. Much of the suffering has been concentrated among the state’s Amish community, where immunization rates are low, about 25 percent in Lancaster County. Before becoming HHS secretary, Kennedy praised the Amish for declining to get vaccinated, telling a crowd at an Amish country fair in 2021 that, when it comes to vaccines, “it’s so important for us to think more like the Amish think.”

Rather than speaking publicly about how low vaccination rates are the reason that measles is sickening and killing Americans, Kennedy has spent the past month squabbling with Pennsylvania’s governor, Josh Shapiro, over how to define measles-associated deaths. Under Kennedy’s leadership, the CDC has so far declined to list any deaths from Pennsylvania’s ongoing outbreak; this afternoon, while he was onstage, HHS’s official X account called the state government’s demands that the CDC do so “political blackmail.” In his speech at the conference, Kennedy’s only mention of measles was part of a complaint that deaths from the disease “get headlines” while the alleged dangers of vaccines are ignored. (An HHS spokesperson didn’t respond to a question about why Kennedy was appearing at an anti-vaccine conference during a measles outbreak.)

Kennedy reassured the crowd that research into vaccine safety was going on behind the scenes at HHS. “As I said, you have friends in the White House,” he said, “and we are doing this one day at a time.” He claimed that HHS had failed to study vaccine risks and told the audience that he was remedying that. He mentioned making use of the Vaccine Safety Datalink, a collection of Americans’ electronic health records. That database has long been a topic of fascination for Kennedy and other anti-vaccine activists who believe that it might contain hidden evidence that vaccines are harmful.

Kennedy built his reputation on being the country’s most prominent anti-vaccine activist. As HHS secretary, he has often emphasized less controversial issues, such as ultraprocessed foods and artificial dyes. Today, he took to the stage with a message for his longtime allies: He is still one of them.

This Is Your Brain on Short-Form Video

2026-09-16T15:37:46-04:00

Among the many aspects of online life accused of rotting our brains, a certain folk psychology holds that short-form video is an especially egregious driver of the decay. In an interview last month promoting his new film, in which a London couple move their tech-dependent kids to a barn without electricity, Andrew Garfield described himself as addicted to an Instagram feed full of “weird ceramics” and Japanese craftspeople. “I’ve given all of those hours to nothing,” he told Variety. “It’s genuinely enraging because we don’t have as much control over these impulses as we should.” Even Steve Chen, one of the co-founders of YouTube—home to many a recycled TikTok on its Shorts—has said that he’s wary of his kids watching too much short-form video, because of the damage it does to attention. Sometimes, when I emerge from the dark vortex of a scroll gone too long, I worry that my thoughts will permanently become as flighty as my feed.

But here’s the tricky part: Very little research exists on what short-form videos are doing to the human mind. This lack of data gives cover to tech executives, who, when faced with the potentially harmful effects of their products, can cite the difficulty of establishing any one app or feature as the cause of a person’s unraveling. Short-form video in particular is a marker of how far behind cognitive research is, compared with the relentless pace of new technology. What available studies hint at so far is at least worthy of unease, and the not-knowing is only making things worse.

Research on short-form videos and cognition is difficult to conduct. Studies on human subjects tend to be slow and expensive, and academics are wary of spending years investigating apps that could be irrelevant by the time their results are published. Plus, the federal government hasn’t prioritized funding research on potentially addictive behaviors, including gambling and social-media use. The industry could help fill in the gaps by funding or even leading research, especially given that American social-media platforms have exclusive and valuable data. But companies are not particularly motivated to bankroll research that could show detrimental effects of their wildly profitable products. So far, they have largely chosen to keep internal research private.

(Data points do creep out. In 2024, for instance, a sloppily redacted complaint in a lawsuit against TikTok revealed some of the company’s internal research, which allegedly found that compulsive usage of the app “correlates with a slew of negative mental health effects like loss of analytical skills, memory formation, contextual thinking, conversational depth, empathy, and increased anxiety.” At the time, a spokesperson for TikTok argued that the documents were outdated and that the quotes in the complaint had been cherry-picked.)

Complicating things further is the fact that much of the publicly available research on short-form video is flimsy. In a study conducted at China’s Zhejiang University that went viral last month, 56 young adults clicked through a series of short videos (not on social media) as they lay in an MRI machine. Two brain regions involved in executing cognitively demanding tasks were found to be more active when participants swiped away from videos before they were midway through, versus when they stuck around until a video’s end. Prominent social-media accounts, including one for the prediction market Polymarket, promoted the study as more proof that TikTok is making us smooth-brained. One news outlet ran the headline “Instagram Reels & TikTok Make You Dumb & Depressed.” But the study, multiple neuroscientists told me, said nothing about short-form videos, intelligence, or depression—instead, it found that brain areas involved in taking action lit up when a participant chose to take the action of skipping to the next video. Besides, the study lacked controls, equated finishing a video with enjoying it, and never established the baseline that supposedly video-addled brain activity was being compared against. (The study’s corresponding author did not respond to a request for comment.)

Stronger studies are much rarer. But they do point in the same direction as many Americans’ intuition: Increased short-form-video use appears to be associated with poorer impulse control, mental-health outcomes, and attention capacity. Researchers at the University of Bristol concluded last year that the constant context-switching inherent to watching short-form videos may degrade prospective memory: the ability to recall something you had previously intended to do. Caty Enders, a doctoral student at the University of New Mexico, has also found that students who used TikTok at a high volume had more issues with both working memory (the information you need to keep track of what you’re doing in the moment) and episodic memory (a form of long-term memory that stores past personal events, such as what you did for your tenth birthday). A 2024 study conducted at Sigmund Freud University, in Austria, found that participants who reported watching more than four hours of short-form videos a day exhibited neurological activity that indicates cognitive abnormality.

Take all these findings with a grain of salt, however. Even the highest-quality studies on short-form videos tend to be limited in their explanatory power. They’re usually small and preliminary. And Keith Robert Head, a researcher at Capella University who recently published a review article on short-form video and attention, could point me to just four good studies on the topic that had been conducted in the United States. Most of the existing research comes from China, and Enders cautioned me against applying findings across the two countries, given that social-media platforms in the U.S. are subject to much less government control and are capable of accessing more user data and personalizing feeds to a greater degree.

Psychologists and neuroscientists have reasoned that short-form video is probably an especially potent and dangerous type of social media because the constant stream of non sequiturs and bright visuals is so overstimulating, and because there’s no upper limit to how long you can spend scrolling. But no one has established whether the negative effects of short-form video are because of something specific to the medium or the fact that spending hours on TikTok displaces healthy habits such as sleeping—in which case, the videos would be no more inherently harmful than bingeing Friends. Participants in a study Enders conducted on TikTok use and memory spent an average of 133 minutes a day on the app. “If you do anything every day for 133 minutes, it will change you,” Enders said.

Uncertainty around any technology’s effects not only relieves pressure on tech companies to make targeted modifications but also leaves governments to decide policy without sufficient information. Some countries have already instituted blanket social-media bans for minors based on imperfect data—not an ideal basis on which to restrict civil liberties. And everyone else is left with the ambient and unsure sense that the apps they use are terrible for them.

The fact that so many people perceive a problem with short-form video may be reason enough for alarm. Luiz Pessoa, a neuroscientist at the University of Maryland who spoke with me about the shortcomings of the recent viral study, thinks that an attention epidemic is clearly at hand, despite scientists’ limited understanding of it. He and his teenage daughter often watch the highlight reels from Formula 1 races, and when they do, she’s also looking at her phone. “It’s obvious we’re multi-, triple-, quadruple-tasking in ways that at least 20, 30 years ago we weren’t,” he told me. You don’t have to be a neuroscientist to have reason to suspect your brain can be stretched only so thin.

Pennsylvania’s Measles Outbreak Is Enormous

2026-09-16T10:01:44-04:00

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Following America’s recent measles deaths, anti-vaccine activists have cast doubt on the virus as the culprit. They’ve pointed to a victim’s underlying health conditions or, as they did last year in Texas, blamed hospital error. But the two latest measles deaths in Pennsylvania—bringing the state’s total to four since mid-August—have made the United States’ measles crisis undeniable.

Last month, the Pennsylvania Department of Health announced two measles-associated deaths; both cases were later revealed to be infants too young to have been vaccinated. In response, Robert F. Kennedy Jr.—who was an anti-vaccine activist for decades before becoming health secretary—wrote on X that the deaths might have been “altogether fabricated.” (He later acknowledged a coroner’s conclusion that one of the deaths had been caused by measles.) Then, last weekend, an unvaccinated 40-year-old woman died in Jefferson County; immediately, people on Reddit and X insisted that her death wasn’t really caused by measles, because she’d had asthma and chronic obstructive pulmonary disease, both of which can make breathing difficult. Yesterday, state officials revealed that an unvaccinated 18-year-old died from a rare inflammatory condition of the brain and spinal cord that can be triggered by measles. Some commenters online deemed that death suspicious too.

What the armchair epidemiologists miss is that vulnerability to the infection doesn’t make a death less real. The two infants both tested positive for measles. The Lancaster County coroner’s office determined that one infant died of a ruptured spleen; however, when I spoke with that child’s parents, they told me that the mother had been extremely ill with the disease when she gave birth, the baby was not breathing when he was born, and they believed measles had killed their son. The other infant was born with a rare neurological condition, but the coroner found that measles was ultimately the cause of death. Greg Furlong, the Jefferson County coroner who investigated the 40-year-old woman’s death, told me that although the woman had conditions that made her vulnerable to measles, and was on supplemental oxygen, she was active before she contracted the virus. She cooked for her family and cleaned the house. Measles killed her in about a week. “If she wouldn’t have got the measles, would she still be alive today? I say yes,” Furlong, a Republican who is also the mayor of Summerville, said.

[Read: The measles-stricken mother who lost her newborn son]

Four deaths in roughly four weeks suggest that the state is in the midst of an enormous outbreak. The Pennsylvania health department lists total cases at 693, with 99 in the past week. But considering that measles kills about one to three of every 1,000 children it infects, the actual number is likely much larger. Milder cases are going unreported. Many who fall ill, particularly in the Amish community, aren’t getting tested; the Amish parents of the infant who died with a ruptured spleen told me that their 13 living children had all caught the virus, but they never got swabbed.

These deaths are occurring after three unvaccinated people, including two young girls, died of measles in Texas and New Mexico last year. Those were the first measles deaths in the country in a decade. The last time the United States experienced four measles deaths in a calendar year was in 1992, at the tail end of a years-long outbreak that killed more than 100 Americans. That resurgence led to a recommendation that children receive two doses of the measles, mumps, and rubella vaccine, and prompted a nationwide push to increase vaccination rates. It worked, and measles was declared eliminated in the United States in 2000. But overall kindergarten vaccination rates started declining during the coronavirus pandemic, and some areas, including Lancaster County, have fallen well below the 95 percent needed to maintain herd immunity.

Now, in the face of a new increase in measles deaths, Kennedy appears more interested in scoring political points than boosting national vaccination rates. He has accused Pennsylvania’s governor, Josh Shapiro, of “the weaponization of infectious disease fears for political gain”; Shapiro, in turn, charged Kennedy with “playing games with public health” after the CDC declined to update its measles statistics to include the deaths in his state. Kennedy’s stated reason for the omission is that the agency is “applying a consistent national standard.” But the delay marks a shift in policy: Last year, the CDC counted both Texas girls’ deaths and the death of the adult in New Mexico after the states announced them. (In a post on X, Kennedy wrote that the National Center for Health Statistics will determine if measles is the true cause of the deaths in Pennsylvania after examining death records; a spokesperson for the Department of Health and Human Services did not respond to questions about that investigation. In a statement, Pennsylvania’s health department said that its investigation had determined that all four deaths met the criteria for measles-associated fatalities.)

Tomorrow, Kennedy is scheduled to be the keynote speaker at the annual conference for Children’s Health Defense, the anti-vaccine organization that he founded before becoming health secretary. Children’s Health Defense has a long history of ginning up fears about the vaccine for measles, mumps, and rubella while downplaying the seriousness of the diseases. Kennedy does, too. In July 2021, Kennedy told attendees at an Amish country fair in Pennsylvania, “The cure for measles is chicken soup and vitamin A.” In fact, no known cure for measles exists; vitamin A has shown some promise in people with severe vitamin A deficiency, which is exceedingly rare in the United States. Since becoming health secretary, he has stated publicly that vaccination is “the most effective way to prevent measles infection,” but as I’ve reported, he also undercut that message by telling the father of a girl who died in West Texas that “you don’t know what’s in the vaccine anymore.” Kennedy has been a stronger advocate for measles itself, which he’s falsely credited with boosting resistance to cancer and cardiac disease, than he has for the vaccine that prevents it.

[Read: What RFK Jr. told grieving Texas families about the measles vaccine]

As cases and deaths rise, the reality becomes harder to ignore: Measles, a disease the country seemingly overcame 30 years ago, is once again killing Americans.

The AI Pandemic Isn’t On Its Way

2026-09-11T13:12:58-04:00

Last month, a team of scientists published a high-profile paper describing how they’d taught an AI model to help produce brand-new, deadly viruses. The AI—a “genome-language model” trained on DNA sequences—had designed multiple new genomes that scientists then synthesized into functional viruses. And some of those viruses were capable of killing bacteria in a dish.

News of AI-made viruses went over poorly. The loudest reaction to the study (which had been released as a preprint about a year ago) was fear. Now that AI can design viruses that go after bacteria, perhaps someone could use the technology to manufacture pathogens that harm people—sparking a major outbreak, even a devastating pandemic. This potential threat evoked some of the same concerns that politicians, researchers, and tech leaders (including Bill Gates) have raised. And these fears are only gaining traction: On Thursday, Anthropic released a report that sparked a round of doom-laden headlines, detailing several instances in which the company banned accounts that were using its LLM, Claude, for what could have been reputable research efforts—or efforts to develop biological weapons.

AI, which has repeatedly proved itself capable of exceeding user expectations and bypassing guardrails, is a formidable force; many fears about its potential biological threat stem from its relentless pace of development and the possibility that it could make independent breakthroughs, exceeding researchers’ own understanding, especially if AIs eventually achieve recursive self-improvement—that is, models designing newer and smarter models. Kevin Esvelt, a biologist at MIT and a co-founder of Secure Bio, a biosecurity nonprofit, told me that although he thinks the probability of an AI-driven pandemic remains quite low, the consequences of such a catastrophe would be so large that “it’s very important that we drive that probability down as low as we can.”

But many other biologists, especially infectious-disease experts and virologists, told me that the threat of a pandemic need not loom particularly large on the list of AI-made threats. To the scientists most familiar with the minutiae of growing, modifying, and testing viruses in a lab, and the havoc they can wreak in the real world, the viruses that have already arisen through evolution, or will soon enough, still present much more immediate perils. In other words, humans should be investing aggressively in pandemic preparation, but not because of AI.

To be clear, viruses made with the help of AI could pose some threat. The experts I spoke with agreed that, in the wrong hands, AI could be used to speed infectious destruction, to a degree. To create the bacterium-killing virus, scientists led by a group at Stanford University and the Arc Institute fed the AI model, called Evo, only viral genomes that attack bacteria. Those genomes are much simpler and smaller than ones coding for viruses that go after humans. In theory, though, with a similar technique, researchers could train AI on the genomes of viruses that infect humans, with the aim of manufacturing novel pathogens. Or perhaps—as some people worry is likelier, easier, and more dangerous—users could ask AI to adjust specific traits of viruses known to cause disease, until those pathogens can skirt available vaccines.

Scientists have long been able to manipulate viral genetics without AI. This kind of “gain of function” research has stirred its own political and scientific controversy—especially in discussions about the origins of COVID-19—and the Trump administration has restricted federal funding for it. But current AI models have the capacity to “put a supreme battery in the back of the things that people were already doing,” Brandon Ogbunu, an evolutionary biologist and infectious-diseases modeler at Yale University, told me. Tom Inglesby, the director of the Johns Hopkins Center for Health Security, worries about bad actors using AI to surmount some of the limits of their own technical expertise. Ideally, models powerful enough to suggest new viral genomes should be subject to strict, formal review, Inglesby said; perhaps they could even be limited to training on only certain types of benign data. (For instance, the team that built Evo trained it only on viruses that kill bacteria, and withheld any data about viruses that can harm more complex life forms, including humans.) Esvelt advocates for restricting access to certain models entirely.

Other researchers, however, including the virologists I spoke with, pointed out that another set of safeguards is already in place: how little we humans—the creators and users of AI—understand about pathogenic viruses. For AI to map out more effective pathogens, people must be able to feed it data on what makes viruses highly transmissible, dangerous, and able to circumvent immune safeguards.

But these concepts are complex and murky enough that the chasm AI would need to cross is wide; researchers lack much of the basic knowledge they’d need to train an AI properly on such topics. “Right now, the data is junk going in,” Seema Lakdawala, a virologist at Emory University, told me. Generations of virologists have not come up with firm answers to key questions about what makes certain viruses better at causing diseases than others, or why some people are more susceptible to particular infections than others. Even expert virologists may struggle to ask AI the best prompts to guide it in useful directions.

In her own research on viral transmission, Lakdawala hasn’t found LLMs such as Claude and ChatGPT particularly helpful or correct, she told me, even when she’s asked them questions far simpler than “How do I make a pandemic virus?” (for example, basic questions about the flu-virus genome). Brian Hie, the lead researcher on the team that designed Evo, told me he’s also unconvinced “that AI would even be the method of choice for someone trying to make a dangerous pathogen.” It does not know enough about pathogens, because we don’t know enough about pathogens.

Esvelt, at MIT, argues that AI might not need to understand viruses perfectly, or even that well, to stumble across a dangerous iteration of one. AIs might also improve rapidly enough to make more sense of the existing data than human researchers ever have. But no matter how good AIs get, they so far have no way to build and test new pathogens, Gigi Gronvall, a health-security expert at the Johns Hopkins Bloomberg School of Public Health, told me. Even a very motivated human—whether they wanted to spark a pandemic for a government or terrorist organization, or for their own ends—would still have to pick through AI-generated possibilities, successfully synthesize them, assess them for enhanced (or at least sufficient) transmissibility and virulence, produce a sufficient quantity to do serious damage, and then release that payload of new virus into the world. All of that requires substantial skill in the lab, as well as expensive equipment and lab animals. It’s not impossible, but it certainly isn’t easy, either.

The practice of building new viruses in a laboratory is fickle: “Even if I give two experienced scientists the same protocol, they’re going to do it differently, and the results could come out differently,” Linsey Marr, a viral-transmission researcher at Virginia Tech, told me. Tinkering with viruses the old-fashioned way has also taught researchers that many hypotheses about what should make a virus more contagious or dangerous don’t pan out. Researchers cannot simply tune up a virus’s transmissibility or virulence like a dial; such changes can come with serious costs, including rendering the entire pathogen nonfunctional—incapable of infecting or hurting a person at all.

Evolution is already a master at tinkering with life forms and building upon their most successful—or dangerous—traits. Viruses are constantly trying out new versions of themselves and aren’t limited by human expectations about what “dangerous” agents of disease look like. Evolving pathogens also need no assistance from malevolent actors to start epidemics; in nature, where species constantly mingle, new outbreaks begin all the time. And nature has an elegant way of dealing with mistakes: Unviable iterations of life simply never come to exist at all. As good as AI is getting, “I can’t look anyone in the eye and say that process is any more harmful than what nature is already operating,” Ogbunu, the Yale evolutionary biologist, said.

The virologists I spoke with did agree that AI models should be monitored and regulated, but were wary of limitations that would hinder AI’s ability to speed the development of new vaccines, shore up viral surveillance, boost epidemiological modeling, or otherwise benefit public-health and infectious-disease research. (Even the types of bacterium-killing viruses that caused such an uproar could be deployed against antibiotic-resistant infections.)

Worries about killer viruses are already interfering with such lines of research. Among the examples of potential threats in Anthropic’s report were gain-of-function work on chikungunya virus and research about how flu viruses adapt to mammals—projects that could have been malicious or, in theory, could improve therapeutics or outbreak detection, respectively. (The company said in the report that it couldn’t confirm whether the queries represented the pursuit of knowledge for the public good or attempts at bioterrorism, and had erred on the side of caution.) Lakdawala and Marr told me that, recently, when they have asked Claude or ChatGPT about, say, genetic quirks in the flu-virus genome or using UV light to inactivate viruses, the AI flagged or halted their conversations. “It happens to me almost daily,” Marr said. (An OpenAI spokesperson wrote over email that “today’s models are specifically trained to withhold biological information that could enable harm” and that researchers “pursuing legitimate biological and life sciences work” can apply to its Trusted Access programs, which require proof of identification. Anthropic did not respond to a request for comment.)

Lakdawala and Marr are now trying to develop their own framework to help AI models distinguish legitimate scientific pursuits from nefarious ones. Both say that it’s difficult: What would the criteria be? Who would be the final arbiters of those criteria and of ambiguous cases? And none of those guardrails would address the most extreme concerns about viruses created by AI—that a self-improving intelligence might eventually be able to deliberately design, manufacture, and release a pathogen. For now, though, AI is still a tool. We’re still in charge of the questions we ask it, the data we feed it, and the fate of any virus that it might suggest we create.

The Los Angeles Rams Are Trying to Defeat Time

2026-09-10T15:27:07-04:00

Usually, when the San Francisco 49ers and the Los Angeles Rams play, it’s a relatively short commute. But this evening, the teams will kick off the NFL’s first-ever regular-season game in Australia.

The two teams have taken diametrically opposite approaches to preventing the 8,000-mile journey from disorienting their stars. The 49ers boarded their 16-hour flight to Melbourne nine days ago and have spent the intervening time training, watching Aussie rules football, and winning the majority of local support. The Rams landed yesterday, just 24 hours before the game. They’re betting on being in Australia so briefly that players’ brains and bodies won’t notice the difference. That makes the game the most high-profile test of jet-lag-evasion techniques in American sports history.

Anyone who has hurled across several time zones in one go knows how wide-awake and helplessly sleepy you can feel at inappropriate hours upon landing—a major inconvenience for professional football players, whose career depends on how they perform during one very specific period. Circadian rhythms can also affect performance in less obvious ways. Compounds that encourage inflammation, for instance, spike at night, when the body is doing less and can direct more energy toward fighting infection. A new time zone throws that optimal function off tilt and can cause stomach issues, cognitive impairment, headaches, and mood changes.

Teams at a circadian disadvantage tend to play worse. One study that analyzed every NFL game from 1970 to 2011 with a kickoff after 8 p.m. ET found that West Coast teams did better than oddsmakers expected in two out of every three games, regardless of whether they were home or away. Head coaches are also more likely to make the risky call to attempt an offensive play on a fourth down during evening games when they travel west compared with any other direction.

Because the consequences of jet lag are well established, the real question is how to avoid them. In 2021, 26 sleep researchers and clinicians articulated their best answer in the journal Sports Medicine. Among other recommendations, they noted that fully recovering from jet lag takes one day for each time zone crossed. The 49ers seem to have followed that model by leaving more than a week ahead of the game. (Melbourne is 17 hours ahead of California, but for body-clock purposes, that’s the same as being seven hours behind.) Kyle Shanahan, the 49ers’ head coach, told reporters last month that he would have loved to have just shown up in Australia the day before but that the experts he’d spoken with had all recommended arriving earlier. “I was a little bit on the fence,” he said. “Science wasn’t.”

The Rams, by contrast, are attempting to not switch their body clock at all. They have spent the past few weeks practicing in the late afternoon, which aligns with Friday’s mid-morning kickoff in Melbourne. Their head coach, Sean McVay, said at a Sunday press conference that the team will “have kind of a rhythm” when they land. “We’ve tested it out with some guys, and we feel like it’s been positive,” he added. The strategy is not without precedent: In 1994, Allen Johnson, an American hurdler, decided to live as if he were on East Coast time when competing in European tournaments. His coaching team strongly disagreed, but he won four world championships and Olympic gold. Last year, the Rams arrived in London the day before a game against a strong Jacksonville Jaguars team and won.

Jamie Zeitzer, a circadian physiologist and a co-director of Stanford’s Center for Sleep and Circadian Sciences, described the Rams’ strategy to me as “high risk, high reward.” If the Rams really feel as though they’re playing in the afternoon, they might have a slight advantage over opponents who feel as though they’re playing in the morning. During the late afternoon, circadian rhythms prompt optimal muscle strength and coordination, and core body temperature peaks, increasing alertness with it. Plus, a week might not be long enough for the 49ers to stop suffering the effects of their travel. Some people just take longer to recover, and a long-haul flight, jet lag, hotel life, and unfamiliar foods can lead to days of poor sleep, Zeitzer said. The 49ers have spent their September experiencing time as a pliable, erratic force. Shanahan told reporters that he was “a little confused” in a recent press conference, during which he also struggled to identify the day of the week. (It was Monday.)

Still, Zeitzer thinks the Rams have chosen the worse jet-lag strategy. If the players are to get any rest at all, their 24-hour stretch in Melbourne before game time needs to be carefully managed. From his experience consulting with professional teams, adults are hard to control. Meeta Singh, a doctor who has served as a sleep consultant for multiple NFL teams, thinks that players simply won’t be able to sleep. Singh is one of the co-authors of the Sports Medicine recommendations, which suggest that athletes maintain a “reduced exercise schedule” and do hand-eye-coordination drills in the 72 hours after a long-haul flight. The Rams won’t even be in Australia for 72 hours.

Sleep became a major metric for all sorts of professional sports teams after the NBA distributed more than 2,000 Oura rings to its players during the depths of the coronavirus pandemic. “Once you can show a coach numbers, sleep stops being a soft topic and becomes something they can manage, like training load or nutrition,” Singh told me. Many NFL teams now have a sleep specialist and a performance-science team working on circumventing jet lag. To prep players for time shifts before they depart, 14 NFL teams, including the 49ers, have installed in their training facilities lighting systems designed to mold circadian rhythms. The system, called BrainLit, mimics daylight according to a “recipe” that each team specifies, Kyle Harris, the CEO of the company, told me. On the 49ers’ flight to Melbourne—on the world’s largest and most expensive passenger airliner, with lie-flat seats that extend to seven feet—each player received his own sleep guidelines. Tom Clark, a sports scientist who advises NFL teams with international games, told me that many teams establish each player’s chronotype, or natural preference to sleep and wake at certain hours, and use that information to prescribe optimal sleep habits.

Roger Goodell, the commissioner of the NFL, eventually wants 16 international games to take place each season. By the time Super Bowl LXI rolls around this February, teams will have played in Rio de Janeiro, London, Paris, Madrid, Munich, and Mexico City. For future seasons, the league is considering adding games in the United Arab Emirates and Japan; Goodell insists that an NFL team will be based outside the U.S. in his lifetime.

Perhaps such a punishing schedule will settle debates once and for all about how to handle jet lag. Whatever the marginal impact of sleep strategy, though (and some games are decided on the margins), usually “the better team will win even if they’re playing on the moon,” Clark said. And the Rams are this year’s Super Bowl favorites.

Medicine Needs to Get Serious About AI

2026-09-08T12:54:01-04:00

For as long as ChatGPT has existed, Americans have been asking it, “Could that funny little spot on my toe be cancer?” And as AI has advanced over the past few years, doctors have begun to use specialized models to ask much the same questions in clinics. In the face of these developments, professional medical societies have presented a unified front: Doctors must always have the final say in clinical care.

We disagree. As the medical societies allow, physicians’ enhancing their work with AI tools may be a perfectly good way to deliver medicine. (One of us—Khosla—has in fact invested in a primary-care start-up, co-founded by his son, in which doctors supervise AI assistants.) But for Americans to get the best health care possible, we need to be willing to experiment with models that put AI in control.

This notion has caused a stir in the medical community. When we published a commentary in the Journal of the American Medical Association last month arguing that AI-only care could soon become superior to care provided by human physicians, the CEO of the American Medical Association denounced us as undermining the patient-doctor relationship. The organization’s position was unchanged: AI should be relegated to a supporting role in clinical care. It’s an argument that ignores the available evidence and could hold untold numbers of Americans back from better health.

Much of modern medicine—including managing hypertension, determining the right treatment for many cancers, and addressing chemotherapy side effects—is largely algorithmic. A physician needs to ask a patient targeted questions, determine possible diagnoses, order tests to identify the correct one, offer a treatment plan, and adjust it depending on how the patient responds. That series of actions is steered by detailed guidelines from professional societies.

Yet doctors—despite the best of intentions—make plenty of mistakes when following those steps. Studies indicate that up to 15 percent of American patients are misdiagnosed each year, leading to tens of thousands of preventable deaths. That’s why health-care providers have software that notifies them if they, say, prescribe a deadly dose of a drug. Any software that could practice medicine autonomously would be similarly specialized: not generic ChatGPT, but a model trained in medical knowledge with the appropriate guardrails to minimize risks and mistakes. Such a model could check for drug interactions more consistently and comprehensively than physicians. And it would be able to check in with patients much more frequently than human health-care providers do.

Some AI models have already proved adept at such tasks. In one study published last year, expert physicians judged Google’s Articulate Medical Intelligence Explorer—a highly trained AI model for medical diagnosis and reasoning—as significantly better than human doctors at getting actors playing patients to open up. The “patients” revealed more about their complaints, along with their medical, family, and medication history, all of which can be crucial for an accurate diagnosis. In a 2023 study, patients with type 2 diabetes were randomized to have their insulin dose adjusted by physicians or autonomous AI. The machines got patients to a stable dose faster than human physicians, and their patients took their insulin more reliably and had less distress related to their diabetes.

What about the physician-AI hybrids that medical associations are backing? Research on them is sparse, and more is needed. A 2025 review of 52 studies concluded that, on balance, such hybrids “neither outperformed medical AI alone nor surpassed the best of clinicians.” In at least a few of those studies, human-AI hybrids outperformed AI alone. But in those hybrid teams, the AI controlled the final clinical decision—the opposite of what the AMA and others have in mind.

Medical organizations are not entirely closed-minded to the possibility of change. For example, last week the American College of Physicians published a position paper that allowed that “fully autonomous AI is possible,” but cautioned that its use should be infrequent and “limited to low-risk, low-complexity decisions, and always allow for bringing a clinician into the loop.” John Whyte, the CEO of the AMA, told The Atlantic that he was “disappointed” in the quality of the analysis in our JAMA commentary last month. He questioned the design of the studies we reviewed, many of which involved simulated situations with actors or a retrospective review of existing cases rather than real clinical outcomes, and did not follow patients for years or decades. We agree that longer-term, real-world studies are necessary; hopefully, once advanced AI medical tools have existed for more than a handful of years, results will begin to arrive. Whyte was enthusiastic about further study of physicians controlling AI tools, but only cautiously open to further exploration of autonomous AI in medicine, arguing that the latter would need to be highly regulated.

Reasons exist, of course, to be skeptical of AI-driven medical care. In nine of the 51 studies we reviewed, human physicians outperformed the machines. But some of these tested older AI models or general-use AI models that weren’t trained on medical information and specific guardrails for patient care. Prominent physicians have also argued that real-life doctors are harried by 15-minute appointments and administrative burdens such as prior authorization. That is certainly true, but it is also irrelevant to many of the experiments we reviewed, which examined relatively hassle-free simulations of medical appointments.

One of the most common objections to an AI-doctor future is that robots lack the human connection that patients need to build trust. The American College of Physicians’ recent position paper, for example, cited AI’s inability to make eye contact. But consider that doctors, too, can be robotic. In a Gallup survey conducted late last year, 21 percent of respondents said they had turned to AI because they had previously felt dismissed by a health-care provider. In the 2025 study of Google’s AMIE, patient actors reported that the AI was more emotionally supportive than the physicians were. In a systematic review of 15 studies comparing AI chatbots with physicians, 13 found that AI had significantly higher perceived empathy.

Like human physicians, AI is not and never will be perfect. But isn’t the possibility of reducing fatalities caused by physician error—even by just a little—worth exploring? Instead of writing off a possible source of progress, the medical community should help answer the key questions raised by AI: How should researchers devise ethical, real-world situations to test autonomous AI models? How should governments and professional organizations regulate them? And how should medical education be reformed so that human doctors can continue to do what they uniquely can?

Hundreds of years ago, doctors believed that disease was caused by an imbalance of “humors” in the body. Even after Louis Pasteur proved that bacteria caused infection and Joseph Lister introduced sterile surgical techniques, physicians cut patients to have them bleed out what ailed them, not bothering to clean the knife or their hands. But medicine progresses. Humans have learned from our past mistakes and created new drugs, procedures, and treatments to massively lengthen lifespan and improve quality of life.

Today need not be any different. Doctors have been presented with a powerful tool that has the potential to improve care for millions of people. It’s their duty not to stand in the way.

Cereal Has Strayed Too Far

2026-09-08T12:44:15-04:00

Breakfast-cereal boxes are a window into both the politics of food and American culture. As a particularly timely example, since Robert F. Kennedy Jr. took office last year as secretary of health and human services, he has called for the removal of artificial dyes from breakfast cereals. On Fox News in 2024, he lamented that the bright colors in Froot Loops are “literally poisoning our kids.” (How exactly these dyes interact with human health is complicated.)

Cereal companies responded right away. General Mills announced last month that it had transitioned its entire U.S. portfolio of cereals—including Trix and Lucky Charms—to all-natural dyes made from fruits, veggies, and spices. Kellogg had previously announced plans to do the same by the end of 2027. Target stopped selling any cereals with artificial colors earlier this year.

For the Make America Healthy Again movement, the removal of artificial dyes is a big win. But cereal still comes with a major concern for many consumers. Nearly all ready-to-eat breakfast cereals sold in the United States—and especially those marketed to children—are presweetened.

The initial loading of breakfast cereals with sugar has been attributed to a single person: Jim Rex, a heating-equipment salesman who lived in Pennsylvania in the early 20th century. As the story goes, Rex was appalled by the spoonfuls of sugar his kids added to their breakfast cereals and set out to create a version that would not induce such behavior. His brilliant contribution: a glossy honey coating on puffed wheat, a cereal he named Ranger Joe Wheat Honnies in 1939.

It didn’t take long for Rex’s strategy to backfire. By 1949, Post had launched Sugar Crisp. Kellogg introduced Sugar Pops in 1951, Sugar Frosted Flakes in 1952, and Froot Loops in 1963, each among the company’s all-time best sellers. General Mills launched Sugar Smiles in 1953. The next year, the company added sugar and artificial colors to its Kix cereal, thus creating Trix.

In 1950, such presweetened cereals represented just 5 percent of all cereals sold, but by the mid-1970s, kids accounted for almost 40 percent of all cereal consumption. In 2014, the Environmental Working Group estimated that kids could ingest about nine pounds of sugar a year just by eating a serving of cereal every day.

Advocates for children’s health have long complained about the high sugar content of breakfast cereals. In the early 1970s, Congress held hearings to highlight cereal’s inadequate nutritional quality. Cereal companies objected, arguing, correctly, that grains are nutritious. But they also responded by trying to make their products appear less sugary.

They began by removing the S-word from cereal names, and some substituted honey for sugar on the theory that people perceive honey as more wholesome and nutritious. In the 1990s, companies hit on another clever strategy: If they used multiple sugar types, they could list grains first on a product’s ingredients but sprinkle sugars throughout the list. Cereals looked healthier, but when Consumer Reports compared the sugars in 27 breakfast cereals in 2008, it found that many were still 50 percent sugar by weight. Rumors circulated that federal agencies were working to set nutrition standards for foods advertised on television programs aimed at children younger than 12, which would likely spell trouble for sugary cereals.

In 2009, General Mills pledged to reduce sugar in its most popular kids’ cereals—most of which had at least 12 grams a serving—to single digits. Its pledge would apply to 10 cereals, including some of its most popular, such as Lucky Charms and Cocoa Puffs. The results were mixed. By 2012, General Mills had reached the single-digit goal for Cinnamon Toast Crunch, Cookie Crisp, and more. Some of this success was due to decreased serving size. And the best General Mills could do for Lucky Charms was 10 grams of sugar in a three-quarters-cup serving—which the company found to be the minimum sweet spot for kids’ acceptance. The project had encountered a harsh reality: Kids like sugar, and companies remove it at their peril.

Sugary cereal is not just a consumer concern; it is also a matter of government nutrition policy. Since 1980, the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has limited the sugars in cereals it will cover to six grams an ounce, about half of the amount in typical cereals aimed at kids. WIC can be a lucrative business for cereals that qualify, so the limit has induced companies to take two actions. The first is to formulate new cereals with less sugar specifically for the WIC market. In 2006, for example, General Mills introduced a new kid-targeted cereal, Dora the Explorer, “lightly sweetened cinnamon corn puffs,” with six grams of sugar in a 27-gram serving—an amount that meets the WIC standards.

The second is to petition to change how sugar in cereals is counted. When the six-gram rule went into effect, in the early 1980s, Kellogg immediately objected. Its Bran Flakes met the WIC standards, but Raisin Bran did not; it contained 12 grams of sugar an ounce, seven from the raisins. Kellogg argued that raisins are healthy and pointed out that WIC was encouraging women to add raisins to their diet to increase their iron intake. For decades, despite Kellogg’s persistent efforts, the U.S. Department of Agriculture did not budge. But times change. In 2024, USDA issued its third comprehensive update to the WIC food package since 1975. The agency retained the six-gram limit but specified that it applied only to added, not total, sugars. It said the policy change was justified to align with listing “added sugars” on food labels and with the government publication Dietary Guidelines for Americans, and to create a “more permissive standard for products containing naturally occurring sugars.”

The distinction between natural and added sugars has continued under Kennedy. The new dietary guidelines, released in January, declare that no amount of added sugar is recommended for healthy eating. At a press conference announcing the new guidelines, Kennedy told reporters, “Today, our government declares war on added sugar.”

Current breakfast cereals have less sugar than they did years ago, but it’s hard to remove completely. Some amount of sugar is still needed to mask the bitter taste of added vitamins. Sugar also helps cereal flakes, puffs, and Os hold their shape in milk. Less sugar is better for kids’ health, but more is better for structural integrity—and taste.

For a truly healthy cereal, look to a time before Jim Rex. The most nutritious option will have one ingredient: wheat or oats. Even if you add your own teaspoon of sugar, it will be only four grams.

This article has been adapted from Marion Nestle and Lisa Sutherland’s new book, Sugar Coated.

The Dark Side of Mindfulness

2026-09-04T09:00:00-04:00

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In 2004, Willoughby Britton, then a doctoral candidate in clinical psychology at the University of Arizona, began recruiting participants for a study that, she felt sure, would show meditation improves sleep.

Britton, a meditation teacher, was so devoted to the practice that she saw herself as a “double agent,” someone who uses science to promote meditation. Although she had grown up in a nonpracticing Episcopalian home, she’d become deeply invested in Buddhist teachings. She read meditation books in her spare time and at one point considered becoming a Buddhist nun. She was confident that meditation improved most things, including sleep; it had already improved much about her own life.

For her study, Britton split 26 participants into two groups: one that would go through an eight-week-long meditation class, and one that would serve as a control group. She brought them all into a lab to sleep overnight while sensors measured their brain waves, muscle activity, and eye movements.

But when she reviewed the results, she was dismayed to find they were the opposite of what she had predicted. The participants in the meditation group slept more fitfully, with more frequent awakenings, than those who didn’t meditate. They spent more time in “Stage 1,” the lightest sleep phase, from which people are easily roused. “Graph after graph after graph, no matter how you looked at it—number of awakenings, number of micro arousals, number of Stage 1 minutes,” Britton told me, the amount of meditation that the subjects practiced was directly correlated with worse sleep quality.

Britton wasn’t sure what had happened. Had she done something wrong? Designed the study poorly? Was the result a fluke, a random finding that didn’t mean much? Or perhaps meditators just need less sleep. At the time, promoting meditation was more important to her than scientific ethics, and she worried that publishing the results would mean “harming the dharma”—criticizing the teachings of the Buddha. So she didn’t.

On a meditation retreat not long after this, she was chatting about her study with a meditation teacher when the teacher said, “I don’t know why all you psychologists try to make meditation into a relaxation technique. Everyone knows if you meditate enough, you stop sleeping.”

On some level, Britton must have known this. At that point, she had spent years both meditating and studying the brain. Because most kinds of meditation aim to enhance concentration, the practice can act like a stimulant. And just as chemical stimulants such as caffeine and Adderall can interfere with sleep, so, too, can excessive meditation.

What else, she wondered, did meditation teachers know that they weren’t telling people? Gradually, starting with that sleep study, the tiers of thought propping up Britton’s worldview—that Buddhism is a cure-all, and that meditation was always beneficial, and could never cause harm—would collapse. Over time, she would find that meditation, a multibillion-dollar industry that is promoted as a treatment for anxiety, chronic pain, alcohol abuse, addiction, and many other ailments, can sometimes, for some people, cause severe and lasting side effects: depression, anxiety, even acute psychosis. Losing the belief system that had been foundational to her life would lead her to produce a trailblazing body of research about the adverse effects of meditation, and then to found a clinical practice geared toward helping the people—a lot of them, as it turns out—who believe that meditation has harmed them.

Britton has straight blond hair, blue eyes, and a muted affect. When you say something to her, she pauses, as if considering whether or not to smile. A colleague once suggested to her that she might be autistic. “And I’m like, ‘Okay,’” she told me one day recently.

She grew up on a farm in Massachusetts with parents who believed that a person should find a problem that isn’t being solved and embrace it as their niche. Her father’s niche was fermenting waste from local businesses and selling it as compost.

Britton was, by her own description, a weird kid who spent a lot of time by herself. She was always asking strange questions like “What is looking out of my eyes?”

One day during the summer break after her junior year at Colgate University, where she was majoring in neuroscience, Britton went over to the house of her best friend, Sarah, a champion athlete at Dartmouth, and discovered her lying lifeless on the bed, a hunting rifle on the floor and a splatter of blood on the wall. Overwhelmed by the pressure of competitive sports, Sarah had taken her own life.

After Sarah’s death, Britton developed symptoms of PTSD. She grew afraid of crossing the street and of driving. She didn’t like opening doors, because she feared she might find a dead body behind them. At one point, while killing rats at her bench in the National Institutes of Health lab where she worked between college and graduate school, she watched the blood drain from their eyes and wondered aloud to a colleague, “Where does it go?” “In the freezer,” the colleague responded. But Britton wasn’t asking about the rat’s body, but its life force. Where did that go?

She was reluctant to take medication, so her father sent her the book A Path With Heart, by the famous meditation teacher Jack Kornfield. She appreciated Kornfield’s explanation for why humans are so prone to rumination—“over and over we feel the familiar tug of thoughts and reactions that take us away from the present moment,” he writes—and that he offered a way out via meditation. She began meditating for half an hour to an hour each day.

In graduate school, Britton initially focused her research on the neuroscience of near-death experiences, but for her dissertation she pivoted to studying meditation, which had been so steadying for her personally.

Meditation was, even then, having a moment. In 2005, the filmmaker David Lynch established a foundation that aimed to promote Transcendental Meditation in colleges and schools. Soon, tech CEOs were flocking to mindfulness summits to learn about “wisdom in the workplace” or “conscious leadership,” and a mindfulness class for Google employees regularly had a long waiting list. High-powered celebs including Oprah and Arianna Huffington credited meditation for centering them amid their empire building. LeBron James partnered with Calm, a multibillion-dollar meditation-and-sleep app. Today, according to one study, about half of all Americans have tried meditation, and about a fifth meditate regularly.

Meditation’s popularity is well-founded. Although the practice has long been supported by the more woo-woo corners of the wellness industry, as well as by Eastern philosophy, an accumulating body of scientific research has suggested that it has all kinds of measurable benefits. Major studies show that meditation can alleviate anxiety and depression—at least about as well as the antidepressant Lexapro can, but without the cost and with fewer side effects. Even short periods of meditation have shown notable effects on the brain: Several studies have found that eight weeks of meditation training can reduce reactivity in the amygdala, the emotion center of the brain, and another showed that meditation could help activate brain regions involved in attention, memory, and perspective-taking in people with social-anxiety disorder. Other reputable studies have linked meditation to positive mood; improved immune function; reduced chronic inflammation; less back pain; lower blood pressure; enhanced self-awareness; better attention spans; greater compassion; and even reduced feelings of loneliness in older adults.

Beyond the scientific evidence, Britton believes that meditation became popular because it’s a health hack that people can do independently, without relying on expensive medical care. The practice suggests that “underneath all of your thinking is some beautiful, basic state” just waiting to be discovered, she said. It probably helps, she added, that meditation is “this ancient thing from Asia and therefore seems more legit or real or something.”

In graduate school, Britton became a serious meditator in the Western insight tradition, which includes sitting and focusing on an “anchor,” such as one’s breath, sometimes for hours at a time. Britton describes it as an austere practice intended to “train the mind.” She molded her life around ancient Buddhist principles. When colleagues remarked on her plain appearance, she said, “Why would I adorn myself?”

Soon, Britton immersed herself in Tibetan studies. Instead of reading novels at night, she’d read dharma books. Her belief at this time, she said, was that “getting enlightened is the most helpful thing you could do for the world.” She considered dropping out of academia to move to a monastery in Asia, which would have meant renouncing her former life, taking a vow of celibacy, and living under a new name.

But she stayed in the United States and continued her academic work, while also training to teach mindfulness-based stress reduction (MBSR), a secular meditation program developed in the ’70s by a molecular biologist named Jon Kabat-Zinn, and a related course called mindfulness-based cognitive therapy. These classes promise to help everyday people with their stress, low moods, and chronic pain; alongside daily meditation practice, they typically include some non-Buddhist teachings from psychology and literature.

Britton moved to Rhode Island to begin her clinical residency at Brown University’s Warren Alpert Medical School. She didn’t know anyone, and, working 12-hour days, she felt intimidated by the cutthroat Ivy League academic life. To fill the time she had to herself, she started meditating for three hours a day.

One night, after meditating on her balcony for an hour, she went back inside and noticed that her house felt like someone else’s home. A picture of her with two friends looked like a picture of three people she happened to know.

Britton decided to take a walk, and as she strolled the streets of Providence, she felt like a bird sitting on her own shoulder, watching herself. She walked into a creperie where she noticed two people arguing. When they both turned and glared at her, she thought, Oh my God, I forgot that I am a person.

What Britton was experiencing is called dissociation, a state that can occasionally be evolutionarily useful—it can help people push through a task when faced with overwhelming terrors. But according to Britton and other researchers, it can happen to extreme meditators too. Britton told me that extensive meditation can prompt the prefrontal cortex to essentially shut off the brain’s emotional centers, causing feelings to seem blunted. And without the typical emotions that we project onto objects, familiar things—our hands, our homes—can start to look foreign. Heleen Slagter, a cognitive neuroscientist at the Vrije Universiteit Amsterdam who studies meditation, says that part of the way the brain gives rise to our sense of self is by predicting how we will interact with the world in the future. If you spend enough time zeroing in on the present moment, as one aims to do during meditation, Slagter says, your sense of the future can start to recede—and with it your sense of self. This can produce dissociation.

Britton began dissociating a few times a week. She had trouble driving because she couldn’t sense where her body began and ended. She’d watch a sappy commercial and suddenly notice her face was wet, not realizing she had shed tears. She felt porous, like other people’s states of mind were her own, a fact that became especially disturbing when she was treating suicidal patients. The dissociation continued for six or seven years, sometimes happening during meditation, but other times at random.

When she told meditation teachers about the dissociation, she said they told her she had entered a new stage of enlightenment—that she was “riding the ox backward.” She had “seen the truth of no-self,” they said, and this was a good thing. They told her to keep meditating, which made the dissociation worse. Somehow, Britton got through her postdoc, but she wasn’t entirely functional. She didn’t date anyone for a decade.

Lauren Lancaster for The Atlantic

Willoughby Britton at home in Vermont. Now retired from Brown University, she runs an organization that counsels people who have had distressing experiences during or after meditation, such as insomnia, anxiety, depression—even psychosis.

Even before she started dissociating, another layer of Britton’s worldview began to crumble after she moved to Rhode Island and was working at an inpatient psychiatric hospital as part of her residency. One day, someone came in from a meditation-retreat center in a state of florid psychosis. Three months later, another psychotic meditator came in, from the same retreat center. That’s weird, Britton thought. Do they know each other? They did not.

It’s well known that psychedelics such as LSD can spark psychotic breaks, but meditation can produce altered states of consciousness almost as powerful as those induced by psychedelics. The brain likes and expects a certain amount of input; go long enough without doing anything and the neurons might start to fire spontaneously, producing, say, flashes of light or made-up memories. Inuit people in the Arctic Circle have been known to experience a type of hysteria known as piblokto, which might be brought on by the sensory deprivation of long winters. No one seems to know why, exactly, psychedelics and meditation can both occasionally prompt psychosis, but it might have to do with the fact that both can have the effect of “rewiring your brain,” which can be a positive thing but can also mean your brain just doesn’t work the way it used to. It might become more easily influenced, for example, or impart grave significance on unimportant events.

At this point in her research, Britton’s studies were still mostly focused on the benefits of meditation, such as on how it can be helpful for depressed people and substance-abusing teens. But now, when she spoke about her studies at conferences, she’d sometimes briefly mention some of the potential adverse effects of meditation. Afterward, people would corner her in the halls or in the bathroom and tell her they’d had negative experiences with meditation—everything from increased depression to psychotic breaks.

She started to wonder whether the unintended effects of meditation might extend beyond a few anecdotes and her own experience with dissociation. Centuries ago, meditation was practiced mostly by monks and other spiritual seekers in East Asia and India; it wasn’t something ordinary people did, Pierce Salguero, a historian of Buddhism and medicine at Penn State Abington and the editor of the book Meditation Sickness, told me. The point of meditation was never merely to relax or just “clear your mind” but to wholly rearrange one’s relationship to one’s thoughts. This might make sense for a Buddhist monk pursuing the great unbinding, but not for a random Brooklynite who just wants to be more productive at work. The “no-self” teachings of Buddhism can be at odds with the goals of Westerners, who are generally aiming to be their best selves, not to disconnect from themselves.

Britton began to perceive that the research on mindfulness contained a giant lacuna: its potential risks. Meditation researchers, she felt, tended not to find adverse effects among their study participants because they didn’t ask their participants about them. What’s more, many meditation studies are funded by pro-meditation organizations, and some study participants might feel pressured to say that their mental health improved after meditating. There’s no such thing as a placebo for meditation, which complicates studying its effects. When Britton looked for past studies on the risks of meditation, she found mostly isolated case reports and small studies—one of which found that two of 27 long-term meditators had had “profound adverse effects,” including confusion, depression, and severe shaking.

Britton still believed in many of the potential benefits of meditation, but she began to rethink her role as a booster for it. “It just seemed like the world does not need another meditation researcher who’s going to promote meditation,” Britton told me. “We’re like Starbucks—there’s one on every corner.” Assessing the extent and severity of possible negative effects of meditation, she decided, would be her version of a problem to solve—her niche. In 2007, she began interviewing meditators for what would become the first comprehensive study of meditation’s adverse effects.

In 2010, Britton met a religious-studies scholar named Jared Lindahl at a conference. At that point, Britton had been meditating so much that she saw stars even with her eyes open—usually either one blue star or one white star—a phenomenon that Buddhists call nimitta. Lindahl had written his dissertation on visual light experiences of this sort. Meeting him, Britton said, “was having somebody understand a part of my experience that no one else had understood.” They wrote a paper about meditation-induced light experiences together, began meditating together, and, eventually, fell in love. The year she met Lindahl, she also finally published the sleep study she’d conducted in Arizona—the one showing that too much meditation can keep people awake.

Lindahl joined her on the meditation-challenges project, for which they conducted interviews about various types of adverse effects experienced and witnessed by 60 meditators and 32 meditation teachers—a smallish sample that is nevertheless rather large for qualitative studies such as this one. They finally published their first study, called “The Varieties of Contemplative Experience,” in 2017, nearly 10 years after they started it.

The most common adverse effects, reported by 82 percent of the meditators (which, importantly, included only people who had experienced an adverse effect of any kind), were “fear, anxiety, panic, or paranoia.” Second-most common were “changes in motivation or goal,” experienced by 78 percent. (Britton later talked with one meditator who sat on her couch for two years, unable to do much of anything, though most of the motivational effects reported were less dramatic.) Smaller numbers reported experiencing delusions, hallucinations, physical pain, rage, and suicidality. The effects lasted for a median duration of one to three years, and the majority of the sample indicated “moderate to severe” impairment in at least one area.

Although the study suggests that what’s most likely to cause problems is intensive meditation—sitting in silence in a retreat hall for hours or days on end—28 percent of the meditators had issues arise from their everyday non-retreat practice, and 25 percent of those in the study were meditating less than an hour each day.

Being an experienced or even expert meditator didn’t necessarily protect people. “I was like, ‘You’ve written a bunch of dharma books. How come you never mentioned this?’” she told me she asked one of the teachers. “And he’s like, ‘Well, it’s not good advertising.’” Notably, much of Britton’s sample of people harmed by meditation had graduate degrees; Britton believes that this is because high achievers tend to try to “ace” meditation, by, say, ignoring any internal sense that something might be wrong. (This struck me as similar to the endurance it takes to earn a Ph.D.: Power through years of pain and tedium for the promise of a big payoff at the end.)

As a study, “The Varieties of Contemplative Experience” had some inherent limitations. Because it recruited people who had had negative experiences, the study could conclude nothing about their prevalence. The study also couldn’t definitively prove causality—for instance, it’s possible that the meditators’ symptoms happened after meditation, but for unrelated reasons. Some Buddhists would also say that experiencing negative emotions or other bad effects is supposed to be part of the practice. But by and large, the study was well received and widely cited in the field. It acknowledged its own limitations and, if anything, respect has grown for it over time.

In part that’s because subsequent studies, some of which Britton was involved with and some not—and some of which were conducted in part by the most well-known academic boosters of meditation—have provided sturdy evidence that some percentage of meditators do experience negative effects from it, ranging from mild to severe. The frequency of bad effects found varies, but most studies, and most experts I talked with, estimate that about 10 percent of all meditators experience them, with the prevalence being considerably higher in certain situations. Richard Sears, a clinical psychologist and Zen master who’s been practicing meditation for some 40 years, has said that he thinks Britton’s research is important. “Something is happening” to these meditators who have bad experiences, “and we should be aware of it. This is opening up a conversation.”

Britton and Lindahl went on to publish many other studies on meditation’s dark aspects, including delusion-like ideation and feeling bolts of electricity traveling through the body. One study subject grew paranoid at a meditation retreat, left, and on the way home believed that street signs were delivering secret messages just to her; another became convinced that she needed to save the world from a “black Tantric plot” contrived by retreat-center staffers, threw water in her meditation teacher’s face and slapped the center’s director; a third began experiencing “messianic visions” about the “need to sacrifice myself in some way for the benefit of saving mankind” and was convinced that meditation teachers were communicating with him in secret code; a fourth reported that meditation awakened an “energy” inside him with “a will of its own” that once almost compelled him to jump from a balcony because it “wanted to lift up and fly.” None of these people had previously experienced any psychosis or been treated for mental illness.

Different types of meditation seem to have different adverse effects on the people who experience them. In one of Britton’s studies, a “noting” practice—labeling thoughts or body sensations—was more likely to trigger anxiety, whereas focusing on an anchor such as one’s breath was more likely to prompt a depressive episode. Overall, Britton has found that about one in 10 people who have meditated, even once, had an adverse effect that lasted more than a month—a rate that, were meditation a drug, would qualify as “very common” under the standard classification used for adverse drug reactions. More frequent meditation tends to increase negative effects, Britton said.

The body of evidence that Britton and Lindahl have amassed showing that meditation can sometimes cause harm is now bolstered by others’ research. A Clemson University study found that mindfulness can paradoxically increase distress. (Cultivating a hopeful outlook was more effective than mindfulness at shoring up workers’ resilience and well-being.) A 2020 study found that 3 to 7 percent of schoolteachers and university students in the U.K. who took a mindfulness class reported “unpleasant experiences”—including anxiety, distressing memories, obsessive thoughts, and physical pain; another study found that a quarter of meditators experienced “unwanted effects” such as panic attacks, nausea, headaches, dizziness, insomnia, and dissociation, though most of these effects were transitory. A German research group studying more than 1,300 regular meditators around the world found that 13 percent experienced adverse effects, including a small number who experienced “very severe effects with lasting consequences” or “extremely severe effects” that were life-threatening or required hospitalization. Yet another large survey found that a quarter of meditators, and a higher percentage of nonreligious meditators, had a “particularly unpleasant meditation-related experience.”

To some extent, this is to be expected. It would be odd if a single treatment, billed as the solution for dozens of mental and physical problems, alleviated all of these ailments without any side effects. In medicine, “if it’s not doing any harm, then it’s probably also not helping,” Nicholas Van Dam, a psychologist at the University of Melbourne who has co-authored papers with Britton, told me. Along with a team of researchers in Australia, Van Dam found that about 9 percent of meditators in their survey reported a functional impairment arising from a meditation-related problem, including sleep changes and a sense of disconnection from others. Van Dam’s team suggested that people should be warned that meditation is contraindicated for certain groups, just as certain medications should not be given to some people. Miguel Farias, an experimental psychologist at Coventry and Oxford Universities who specializes in the science of meditation, told me that the early literature on cognitive behavioral therapy, from the ’70s and ’80s, recommended against meditating during a depressive episode. “Physical activity is a wonderful antidote to depression,” Farias said. But “meditation makes you physically be more passive.” In a systematic review, Farias and his co-authors found that adverse events among all meditators were “not uncommon,” appearing in 65 percent of the studies reviewed; the most prevalent symptoms were anxiety and depression.

Some of the side effects these researchers are finding may be attributable to the fact that, in the years since Eastern traditions of meditation were introduced to the West in the 19th century, this once primarily religious ritual has expanded far beyond its original intent; its more sweeping remit may have consequences that the practice’s original Buddhist context might have prevented. But as Salguero and others pointed out, early Buddhist texts cautioned that “meditation sickness” plagued even the devout contemplatives of earlier eras: In one eighth-century Chinese writing, the Buddha warns of 50 “demonic states” in which meditators could become trapped, including hallucinations, sorrow, anxiety, suicidal thoughts, and possession by ghosts.

While working on my most recent book, about personality change, I wanted desperately to change one thing about myself in particular: to bring down my stratospheric level of neuroticism, the personality trait associated with anxiety and depression. When I Googled how to reduce depression and anxiety, the first drug-free thing that came up was meditation.

So I signed up for an online mindfulness-based-stress-reduction class—the kind of meditation that Britton also once taught, and which now has hundreds of classes and instructors to choose from around the country.

I found some of the class’s Buddhist teachings, though watered down for newbies, very helpful, and by the end of the eight-week class, a test revealed that my neuroticism score had, indeed, ticked down. This surprised me because I’m bad at meditating, so I would spend entire 45-minute sessions reviewing my to-do list, my worries, and other earthly matters.

What annoyed me the most, though, was the way the meditation teachers talked, which tended toward New Age–isms in passive voice. “There’s a subtle striving in what you shared,” one of the teachers responded when I asked a question about how to make “mindful walking” more restorative. “Maybe you want for it to be relaxing and not challenging. But that’s not the reason we practice. We practice for the sake of practicing and to meet with whatever is arising.”

This is what Britton calls a “thought-terminating cliché”: a profound-seeming phrase deployed by people in power to quash debate—or, as Britton put it, a way for teachers to politely convey “Shut the fuck up and do what I say.”

But many Buddhists and meditation teachers would agree with my instructor: Feeling, and observing, discomfort is part of the point. In keeping with this, a good number of the meditators whom Britton has interviewed told her that when they had brought up their symptoms with meditation teachers, the teachers dismissed them, saying things like “It gets worse before it gets better” and “What you resist persists.”Their teachers would suggest that all negative experiences are inherently growth opportunities, or that perhaps the person was meditating incorrectly. The mentality seemed to be “Try our product and if you don’t like it, then you did it wrong,” Britton said.

This attitude tracks with what I heard from a few experienced meditators who suffered acute distress while meditating. One man told me that after a long retreat, when he began experiencing spasms that would seize up half his face, his meditation teacher just told him to relax more. Two other experienced meditators I talked with, Terran Palmer-Angell and Carmen Maria Alvarez, also told me that some fellow meditators at a long retreat they attended, organized by the Center for Contemplative Research, had experienced psychotic breaks or developed tics, including one man who would rotate his head around compulsively. The teacher and one of the center’s co-founders, B. Alan Wallace, they said, told them that it was just “an involuntary movement” and nothing to be concerned about.

Palmer-Angell and Alvarez emphasized that their experiences reflected this specific retreat, and not meditation in general. Eva Natanya, the center’s other co-founder, told me that “no one has been diagnosed with a psychotic break by a psychiatrist” at the retreat since its founding, in 2020. However, she said that some “individuals develop physical tics” because of a “burst of energy” while meditating. She said these tics are sometimes referred to as “involuntary movements,” and that initially, meditators might be encouraged to “let it go and go back to meditating because that energy will work itself out by itself.” She added that she herself worked with the person with the compulsive head rotations by “asking questions and listening.” She said the center has multiple forms of support available, including meetings with herself and Wallace, psychological counseling, appointments with doctors, and physiotherapy.

Britton remembers peddling a version of this logic as an MBSR teacher herself. “I was trying to tell people ‘Nothing is good or bad, but thinking makes it so,’” channeling Hamlet and Stoic philosophy. For a while, this idea seemed radical, and constructively life-changing: The secret to a good life is to just be okay with whatever! But then her own meditation practice started to make her think “like, Okay, but wait; I don’t feel like I exist now.”That didn’t seem like a good thing, no matter how you thought about it.

Lauren Lancaster for The Atlantic

Having moved away from Buddhism, Britton now finds her own kind of tranquility in the natural world, taking care of her plants and chopping wood.

After Britton and Lindahl published the “Varieties” study, the phone in their lab started ringing. People experiencing psychosis, dissociation, tics, and other problems after meditating were asking for help. The meditators felt confused and ashamed, like they had damaged themselves. Traditional psychotherapists, they said, didn’t understand what they were going through—and neither did anyone else. How can you hurt yourself meditating?

The surge in outreach prompted Britton to open what she called Cheetah House—a play on citta, the Sanskrit word for “consciousness”—and develop it into a full-fledged nonprofit aimed at helping people who have had difficult meditation experiences. Based at first out of her house in Providence, it now serves 200 people a month, entirely over Zoom.

The Cheetah House program consists mostly of talks with experts, sessions with a “care team” member, and support groups with other meditators who have had distressing experiences. The program is priced on a sliding scale; most people pay $50 a session with a care-team member, and $100 or more for a session with Britton herself.

Many of Cheetah House’s clients have (relatively) manageable problems such as anxiety and insomnia, but Britton told me that, once or twice a month, she gets a call from someone whose family member has had a psychotic break triggered by meditation. Far more rarely, people have killed themselves after intensive meditation retreats. “When people say that I’m fearmongering,” Britton told me, “my response is, ‘We haven’t even gotten into the suicides yet.’” She recently decided to start a support group for the parents of meditators who experienced severe psychiatric symptoms after 13 families, four of whose children had already died, expressed interest.

Between half and three-quarters of Cheetah House’s clientele began having symptoms after a meditation retreat, Britton told me. People often go on retreats to try to deepen their practice or to “relax”—but these are generally not relaxing affairs. Many retreats involve waking up at dawn, eating very little, and sitting perfectly still while focusing on one’s breath for hours on end. Several days of this, Britton said, can cause neurons to become more sensitive, such that minor stimuli, like the ticking of a clock or the sound of another person’s breath, can start to feel overwhelming—as can emotions such as rage and grief. Kieran Fox, a psychiatrist at UC San Francisco and an experienced meditator, told me that retreats are “some of the hardest things I’ve ever done in my entire life. And that’s including med school.”

Among the Cheetah House clients I interviewed, retreats were a common trigger for adverse effects. One meditator, Dan Millstein, told me that after a 10-day retreat, he spent years feeling emotionally shut down and disconnected, like he was “living behind a glass wall or a veil.” Another man, Billy, who asked that I not use his last name, had been meditating regularly for a decade when a seven-day silent retreat ratcheted up his physical and mental anxiety: Shivering relentlessly, he started feeling better when he stopped meditating.

About 15 years ago, a woman who asked to remain anonymous was on her second 10-day silent retreat when she began feeling a twitch in her face that developed into an urge to roll her head around. She felt like electricity was shooting through her body. She would shake uncontrollably and at times writhe on the floor. Eventually, she was hospitalized for psychosis. She was later diagnosed with complex PTSD, and although she’s learned how to manage those symptoms, she told me that she still experiences involuntary muscle movements today. Another woman, Rebecca Fischer, told me that, more than 12 years after a retreat she attended, she still has chronic pain in her legs and back.

A good number of Cheetah House’s clients do suffer ill effects outside of retreats. In the days after meditating at home with an app, a client named Susan Small told me she was driving when “my whole sense of myself disappeared,” and she went on to experience “waves of terror” for months. A man named Eoin told me that after eight days of doing 30-minute audio meditations on his own every morning, he started feeling like a “nervous wreck,” on the edge of psychosis, and like he didn’t really know who he was, a phenomenon called depersonalization.

These people and other clients said they appreciated hearing from fellow meditators with similar experiences, and that Cheetah House helped them feel less like a “misfit toy,” as Millstein put it. They’d had a hard time finding support elsewhere, in part because one of the most common recommendations for emotional distress is to try meditating. Many of her clients, Britton said, seem relieved when she tells them it’s okay if they want to stop.

One recent New Year’s Eve, Britton hosted what she jokingly called a “parallel play” party—a kind of get-together for introverts where everyone works on a craft so they don’t have to talk much. She made margaritas, and friends and colleagues brought over magazines to cut up for collages. A few hours in, someone held up an article from the magazine Psychotherapy Networker and said, “Hey, is this about you?”

The story was, indeed, about Cheetah House, and Britton waited until everyone left to read it. One quote in particular stopped her cold:

“There should be a trigger warning for the Cheetah House website,” says renowned Buddhist teacher and clinical psychologist Jack Kornfield. “Too much of it is misleading information and over-the-top fearmongering.”

This was the Jack Kornfield, the mindfulness guru who wrote A Path With Heart, the book that had launched Britton’s journey into Buddhism. He was like a father figure and a mentor to her. Jack Kornfield thought she was fearmongering. Now all she could think was “Thanks, Dad.” She spent a week in bed after that. (Kornfield declined to comment.)

As she continued with her research, Britton gradually started to feel iced out of the Buddhist circles that had once comprised her entire personal and professional networks. She said a Buddhist organization sent her a threatening letter after she interviewed members of their community. One time, after she gave a talk about adverse effects at a conference, Britton said a prominent meditation researcher cornered her outside and yelled, “I don’t believe you!” (The researcher denies saying this.)

Invitations to conferences started to dry up—and when she did receive them, she said, it would turn out to be an invite to debate whether meditation-related challenges even existed—“just an insult to everyone that I’ve interviewed,” she said.

“If you want to build a bridge, you can’t just be like, A bridge is gonna be so cool. You have to think about where could it possibly fail,” Britton told me. “And it’s so unpopular to be that person.” Her former postdoc, Roman Palitsky, told me that Britton suffered for pointing out the problems with the bridge. “Nobody was doing meditation difficulties before her, not seriously anyway,” he said. “And I think large parts of the meditation world kind of turned on her.”

Some of this criticism can be chalked up to differing interpretations of the science, and of how best to treat stubborn afflictions such as anxiety and depression when all of the remedies have potential downsides. “Is it better for an anxious person to be meditating or on Lexapro?” is not an easily answerable question. Fox, the UCSF psychiatrist, told me that some of the neuroscientific effects that Britton attributes to meditation, such as increased activity in the insula, can also be interpreted as a sign of better “autonomic awareness”—basically, being more attuned to the inner workings of your body—rather than a sign of trauma or panic.

But some of the criticism seems to emanate from a reflexive defensiveness on the part of meditation’s promoters, who—perhaps understandably, given the abundant benefits that have shown to be associated with the practice—don’t want to tarnish the reputation of a good thing.

I’ve noticed that people are apt to defend meditation with a zeal I haven’t witnessed since evangelical youth group in my teens. You don’t enjoy meditation? Good, you’re not supposed to enjoy it. You say it doesn’t work for you? Well, you’re just not doing it right. The answer to every problem with meditation seems to be more meditation.

This touchiness can extend to meditation researchers, most of whom are meditators themselves; academic meetings Britton attended would sometimes kick off with a meditation. Nicholas Van Dam, the University of Melbourne psychologist, told me that meditation communities tend to carry a sense that “if you say anything bad, you’re negating the good.” Farias mentioned that after he included a chapter about meditation’s risks in his book The Buddha Pill, some of his friends “were very, very annoyed,” and a couple of them told him that “we could not be publicly seen as associates.”

Some pro-meditation researchers are more evenhanded—recognizing the value of Britton’s findings even if they quibble with aspects of them. Eric Loucks, the director of the Mindfulness Center at Brown, pointed out that a person can have a challenging experience during meditation and still find their overall meditation practice to be beneficial. He also noted that several studies have found mindfulness-based interventions to have fewer side effects than pharmacological treatments, including Lexapro. Still, he called Britton “innovative” and “courageous,” and said her work influenced not only his own views and scholarship—including updates to the standard MBSR curriculum, which the Mindfulness Center now maintains—but also mindfulness research as a whole. “Just looking for the good stuff,” he said, is not his goal. “We really want to know the truth.”

But several meditation teachers I interviewed did seem protective of the practice. Carol Greco, a psychologist at the University of Pittsburgh and an MBSR teacher, once co-authored a paper that aimed to “dispel the notion” that anxiety, pain, and psychosis “are adverse events due to mindfulness meditation.” She seemed chagrined that I was working on this story, writing in an email, “I would rather talk with you about how meditation can be helpful.” When Britton’s studies began coming out, she said, it “brought a heightened awareness of the potential of trauma in a person’s background and how we can create a safe environment.” But her “heart hurt” because “it felt like it was making mindfulness and meditation seem like it’s really dangerous and really bad.” She told me that in her two decades as a meditation teacher she’s never seen a serious adverse event like psychosis or dissociation.

A few of the scholars I interviewed who defended meditation acknowledged some of Britton’s findings, at least implicitly. Richard Davidson, a University of Wisconsin at Madison professor of psychiatry and psychology who is a well-known mindfulness researcher, told me that, as far as relaxation techniques go, meditation is fairly benign. He believes that for most people there’s a greater risk of harm from not meditating than there is from meditating, because the physical and emotional benefits of the practice are so robust, and he’s co-authored studies supporting that claim. But, he added, people with serious psychiatric disorders should meditate only under the guidance of a mental-health professional who also happens to be a meditator—advice that would probably come as news to the many thousands of people who meditate by using apps at home.

The Buddhist scholar and teacher Gil Fronsdal told me that although he doesn’t think meditation causes adverse effects, retreats may exacerbate preexisting psychological problems. (Britton said adverse effects can crop up even for people without prior mental-health conditions.) Fronsdal recalled one meditator who gradually lost touch with reality after a monthlong retreat: She stalked Fronsdal’s wife, became homeless, and spent hours in a medical-law library researching how it was that Fronsdal had managed to exchange his wife’s spine for hers. Having schizophrenic people on meditation retreats has been “one of my most challenging situations as a teacher,” he told me. He said that people with psychosis shouldn’t go on meditation retreats, and neither should people who are “hyper-anxious”—a quality that described me when I sat for a daylong MBSR retreat for my book.

The substantial and sometimes hostile pushback against her work has made Britton hypervigilant. Maybe excessively so: To my eye, she sometimes detects criticism where there isn’t any. When I asked her to describe what it was like working at Brown’s largely pro-meditation research group while publishing study after study finding that meditation can be risky, she wouldn’t say much more than that the situation could be “tense.” (Loucks, the Mindfulness Center’s director, denied that there was tension.) “When it comes to somebody choosing their religion or your friendship,” she told me at one point, “they will choose their religion every time.”

Starting in the early 2020s, Britton and Lindahl struggled to find funding to continue studying the downsides of meditation; they said an organization once rejected their proposal for a grant on “transformative experiences” for being too critical of religion. She says that when they submitted papers to academic journals, the peer-review comments for the papers focusing on the risks of meditation were “six times longer” than for those focusing on the benefits.

Equanimity is a cornerstone of Buddhist thought; Britton herself had repeated the words to rooms full of meditation students many times: “Nothing is good or bad, but thinking makes it so.” But she was starting to think that, actually, some things are good and other things are bad. Sure, you can just accept everything, but sometimes you shouldn’t. She had made a big contribution to the field; it seemed to me like she was feeling done with Brown, with academia, with living in Rhode Island, with all of it.

When Britton first met Lindahl, he persuaded her to start taking one day off a week, something she had not done in two decades. Then it was two days. Then she stopped teaching in the summers. Soon, they were scouting for a plot of land in Vermont they could move to. They now live in an off-the-grid cabin in the woods, where a botanical drawing greets visitors on a wall by the entryway. What is the human soul, the caption reads, but a claw pointing back to the forest?

Britton is consulting on a research project with her former postdoc, Palitsky, who is now at Emory University and running a much larger, longitudinal study of meditation-related challenges. This summer, both she and Lindahl officially left Brown. They’re enjoying exploring “other sections of the bookstore,” as she put it. Running Cheetah House takes up the bulk of her time now.

Britton stopped meditating in 2017, around the time she published the “Varieties” study, and she “began to have a less romantic and more nuanced view of Buddhism.” Now she finds her own kind of tranquility in the natural world, taking care of her plants and chopping wood.

It’s important to emphasize that neither Britton’s research nor her work with Cheetah House clients has turned her against meditation per se; it’s just attuned her to the importance of doing it safely. Meditating for longer than about 30 minutes a day tends to be associated with more negative side effects, she said, and certain types of meditation can be a poor fit for certain people. (For instance, some anxious people shouldn’t do a “body scan” type of meditation, because they are already too focused on their body.) People considering extended meditation retreats should try meditating for a few hours at home first, to be sure they can tolerate long stretches. And those who experience challenges with their meditation practice should consider changing the kind of meditation they’re doing, modifying their practice, or just not meditating. “Treat meditation like any other relationship,” she said. “If you feel like shit with that person, maybe it’s time to break up.”

Spending so much time with Britton made me want to revisit my own adventures in Buddhism and what I had found valuable about it. Mostly, I found old notes about how much I hated meditating: “This is the part of the book where I’m not having a lot of fun”; “I would literally rather give birth than do nothing for 45 minutes”; “I’m just an anxious immigrant who fears you can mindful yourself onto a park bench.”

But I also came across some teachings that I did appreciate, and which I’m going to oversimplify here because I’m not a Buddhist. Among them: The Buddha taught that people should pursue a “middle way” between decadent indulgence and rigid austerity—to not live mindlessly, but to not be so ascetic as to immiserate yourself. “Avoiding these two extremes,” one sutta reads, “the Realized One understood the middle way of practice.” Maybe he was onto something.

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How ‘Somatics’ Became the Solution to Modern Life

2026-09-03T07:00:00-04:00

When clients go to Sybil Ottenstein for therapy, they tend to arrive with answers. Many of them have seen shrinks before. They can tell her which events from their past were formative, and point to the ripple effects in their current life. They’re like detectives, she told me, with all the dots connected on their corkboard of evidence. Intellectually, they’ve cracked the case. The problem is that they don’t feel any better.

That’s why they’re seeking something different from Ottenstein: somatic psychotherapy. Traditional talk therapy could be seen as a top-down approach. You identify problems in your thinking, your habits, or your life, and hope that by working through them, you can resolve physical manifestations of emotional issues—the chest palpitations of anxiety, the stomachache of stress. Somatic therapy, by contrast, works from the bottom up. Ottenstein typically starts her sessions by asking clients to slow down and pay attention to corporeal sensations: “What does it feel like in your chest? In your throat?” As they talk, she encourages them to stay in their body, to let themselves feel whatever is coming up. People cry. They yawn. They scream. They stretch. They dance.

The word somatic, according to Merriam-Webster, merely means “of, relating to, or affecting the body.” But recently, it’s been popping up everywhere, appended to a variety of practices that involve tuning in to physical symptoms in order to ameliorate psychological ones. Somatic therapists like Ottenstein have noticed a significant bump in interest; one of the major somatic-therapy training programs reported that its applicants more than doubled from 2020 to 2023. Other practitioners offer somatic dance, somatic yoga, somatic workouts. (The terms seem a touch redundant.)

[Read: How did healing ourselves get so exhausting?]

On Instagram, hundreds of thousands of posts appear with the hashtag #somatic. A “somatic exercise” trainer who goes by the “Workout Witch” (nearly 2 million followers) teaches small, repetitive movements meant to discharge negative feelings—curl your head down for “sorrow/despair,” pull your right ear for “overwhelm”—and promises that “trauma can be released from your hips.” All over my feed, fit young women are humming, hitting their sternum, pinching their nose bridge, and bouncing their knees all the way to inner peace.

[Read: These Millennials can’t get out of their head]

Much of the time, as with many other wellness ventures, someone stands to make money. At one somatic-workout class I attended, where a staffer told me that the goal was to “move stagnant energy out,” the lobby featured a gift-shop corner with jewelry, T-shirts, and $65 “body gloss” from a brand called Oui the People. But clearly, plenty of Americans are willing to pay for the promise of a psychic cleanse. Practitioners refer to “stuck energy,” to “trapped emotions,” to “resetting” a nervous system caught in fight-or-flight mode. “We have all these ways of just storing that gunk inside,” Ottenstein told me. I pictured, uncomfortably, a thick, black goo running through my veins.

Somatics—the whole roomy umbrella of practices—might seem like an odd fit for the information age, when people are more accustomed to finding answers on the internet than within themselves. But that could be precisely the draw for thinkers and analyzers who are tired of ruminating in anxious circles, who spend their days in front of a laptop and nights scrolling an iPhone. For millennia, people have yearned to break out of the confines of their bodies; they’ve searched—through religion, spirituality, drugs—for transcendence. Now, for some, the existential quest is inverted: Instead of seeking to escape their prison of flesh and bones, they want to reinhabit it.

The origin of somatics is difficult to pinpoint, though it’s certainly not recent. Some credit Wilhelm Reich, a student of Freud’s, who theorized in the early 1900s that patients held tension in their bodies—“muscular armor”—as a subconscious defense against trauma, leading to aches, pains, and inflammation. But it wasn’t until the 1970s that the field began to formalize, developed in part by the American philosophy professor Thomas Hanna, who defined somatics as the study of “the body as perceived from within.” That same decade, a UC Berkeley biophysics doctoral student, Peter Levine, developed “somatic experiencing”: a therapeutic method based on the idea that people, like other animals, react to trauma with a flight, fight, or freeze response, powered by a burst of adrenaline. After the source of danger is gone, Levine argued, they have pent-up “survival energy” to unleash: They need to physically shake it off. He pointed to videos of impalas, quaking and buckling after surviving a cheetah attack. When humans go through something upsetting, Ottenstein told me, “we go to work the next day.”

This idea—that trauma is held in the body, and thus must be physically remedied—was once fairly niche. In recent years, though, it has been jolted into prominence. The psychiatrist Bessel van der Kolk’s book The Body Keeps the Score, which argues for somatic treatments of PTSD, was first released in 2014 and was not an immediate hit. In 2021, it reached the No. 1 spot on the New York Times best-seller list for paperback nonfiction. And although it has been accused of resting on shaky science, it has continued to dominate the charts for years.

Van der Kolk wrote about violent assaults, wartime atrocities, severe childhood abuse—circumstances that many readers hadn’t directly experienced. Yet The Body Keeps the Score seemed to resonate anyway. When it gained momentum, lots of Americans had spent the previous year safe in their homes, baking bread and taking Zoom calls. (“When people say the pandemic has been a collective trauma,” van der Kolk told The Atlantic that year, “I say, absolutely not.”) Most had also, however, been detached from the rich sensory experience of interacting with the external world. Now here was a book about people who’d felt estranged from their own body—and then, through simple movement, play, and touch, found their way back to their surroundings, and to themselves.

[Read: The self-help that no one needs right now]

In the years since, most people have emerged from pandemic isolation. Yet the share of Americans who say they frequently experience stress, which has been rising for decades, has continued its upward trend. Talk therapy remains popular, but it’s not always affordable or accessible—and much of the time, it doesn’t take physical symptoms into account. Meanwhile, many medical doctors don’t consider psychological causes of physical ailments. Stress in particular is “like this mythical creature,” Aditi Nerurkar, a physician at Harvard Medical School, told me. “And we don’t have a lot of time. We have to focus on your hemoglobin. Did you get a mammogram? Did you get a pap smear? What is your cholesterol?”

No wonder, then, that somatics is a flourishing industry. Many Americans already distrust medical institutions; maybe they want to bypass the dismissive doctor, or the therapist who wants to rehash every daddy issue but can’t seem to fix anything. So they turn to this strange constellation of New Age–y courses, TikTok sages, and licensed counselors. Some offerings target people with capital-T Trauma; others claim to be for just about anyone. Many present themselves as alternatives to more traditional paths to mental well-being. The question is whether they can really help the frazzled masses.

Somatics does get a lot of things right. Plenty of bodily sensations are, at root, psychological. Some communication does need to happen between the brain and the rest of the body. That’s how you know to respond to danger: The amygdala triggers the nervous system to increase your heart rate, deliver more blood to muscles, and release a flood of adrenaline. When I spoke with Nerurkar, she rattled off an incomplete list of physical symptoms that might result from stress: headaches, dizziness, nausea, vision changes. When she was in residency training, she said, she experienced what felt like a “stampede of wild horses” across her chest and was convinced that she had a heart problem—until her doctors, having conducted a battery of tests, recommended that she seriously consider chilling out.

And many components of somatic practice have evidence to back them up. Interoception, or awareness of one’s own physical signals, really can be important for well-being—perhaps because it increases people’s sense of attunement with their body, connection with the present moment, or agency over otherwise vague and inscrutable sensations. Mindfulness meditation, which involves interoception, has been shown to decrease stress and anxiety and even reduce physical pain. Yoga and breathing exercises can decrease amygdala activation and lead to better concentration, memory, and executive function.

But the somatics packaging of these techniques is alluring partly because of the emotional liberation it promises. Somaticists tend to describe a clear path: identify a physical signal, connect it to its psychic cause, then let it go. If the nervous system overactivates, surely you can just reset it. If the body holds trauma, surely the body can relinquish it.

These were always just metaphors, though, and imperfect ones. The amygdala doesn’t have a reboot button. There is no viscous gunk of emotional pain to flush out. The Body Keeps the Score has been somewhat debunked; critics have argued that van der Kolk incorrectly described certain studies, and that he seems to have made up others entirely. (Responding to the writer Emi Nietfeld’s critique in Mother Jones, van der Kolk said that at times he drew on unpublished data.) Trauma experts have pushed back on his wholesale condemnation of talk therapy, which can be, according to a mountain of evidence, very helpful for treating PTSD. There’s also something ironic in how certain somaticists—ostensibly advocates for the mind-body connection—talk as if the two are separated by a nearly unbridgeable gap: the physical burden of trauma unreachable through thinking or conversation, and perhaps not even accessible to conscious awareness.

[Read: Why we’re still talking about the ‘trauma plot’]

So somatics isn’t a miracle cure. And it’s probably right to be skeptical of influencers who seek to collect on people’s need to feel at home in their body. But that doesn’t mean somatics can’t be helpful. Much of it, after all, turns out to be pretty straightforward. Movement is good, generally. Breathing is good. Stepping away from your screen—stretching your limbs, remembering you are real and tangible and mortal—is good.

When I signed up for that somatic-exercise class, I expected that I might leave rolling my eyes, but I secretly hoped I’d walk out lighter, more alive and connected to myself and the world. What I found was something in between. The actual workout couldn’t have been more basic: It consisted largely of squats, jumping jacks, crunches, some yoga—downward dog, child’s pose. Occasionally the instructor would remind us to check in with our bodies: “What are you being invited into? And I don’t mean the burpee.” Or: “Let the chin enter the conversation.” Otherwise it hardly seemed uniquely somatic, or uniquely anything.

Then again, I had the post-workout endorphin glow. I’d left my apartment and shut my phone in a locker. An hour later, I exited the studio somewhat baffled. But walking out onto a busy Manhattan street, I felt a little more conscious of the sun on my cheek, the solidness of the ground pushing against my feet. This was silly, I thought. And also: Maybe I’ll come back.

When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic

The Truth About American Food Safety

2026-09-02T10:27:57-04:00

The phrase When it rains, it pours isn’t one you like to see applied to outbreaks of foodborne illness, yet here we are. The summer started with a diarrhea-causing parasite called Cyclospora cayetanensis, which infested iceberg lettuce. Then came news of Shiga toxin–producing bacteria in organic frozen berries, and a Salmonella outbreak linked to Whole Foods guacamole that eventually got traced to tainted jalapeños. (Pico de gallo, salsa fresca, and a variety of spicy dips have also been implicated.) Ricotta-style cheese was recalled for Listeria. Both Salmonella and E. coli were found in products from the aptly named Everything Sprouts. And 10,000 cases of lightly fried tofu were flagged for potential contamination with printing ink.

This flood of food-contamination events comes at just the time when our systems to prevent such outbreaks may be hobbled. Since last year, three cyclospora-research projects at the Department of Agriculture have lost either their funding or staffing, the CDC team that tracks the parasite’s genetics has nearly disappeared, and experienced government employees responsible for food safety have left their job or been fired.

The bureaucracy is crumbling, and the produce aisle is a mess. But let’s be fair: The status quo on foodborne illness was never very good. According to 2019 estimates from the CDC, Americans suffer (sometimes unaware) through at least 9.9 million bouts of foodborne illness each year; more than 50,000 people end up in the hospital, and about 1,000 die. Depending on how you measure outbreak numbers—whether by FDA investigations into foodborne illnesses, for instance, or by the number of food-product recalls—the 2026 statistics have been pretty much in line with recent history. How quickly we forget the Salmonella-dusted cucumbers of summer 2024 that sickened more than 500 souls. Or the cantaloupes that killed half a dozen people in 2023. Occasional salad-based catastrophes have been the norm for many years. Food-safety experts say that something on the order of 150 million meals of leafy greens are served in this country every day. Now as always, a very small proportion of them will make you ill.

But one of this summer’s outbreaks does suggest that our “very small proportion” might be growing into a slightly larger very small proportion. Although the jalapeño and berry outbreaks have had many doleful precedents of their size and scope, the cyclospora summer stands alone. Annual cases of its associated diarrheal disease, called cyclosporiasis, have been slowly increasing over time, from hundreds in the 2010s to a few thousand in the early 2020s. (This is, in part, due to faster diagnosis: One used to have to find the parasite’s oocysts under a microscope; now the fragments of its DNA can be identified in a rapid-PCR screening test.) This year, though, the CDC has confirmed 17,180 cases of the illness, and many thousands more suspected cases still need to be examined. State-level agencies have tallied more than 30,000 infections. “It’s just absolutely crazy,” Kalmia Kniel, an expert in microbial food safety at the University of Delaware and a former president of the International Association for Food Protection, told me. “It is completely overwhelming and insane that this happened.” I suppose it’s nice to know the sense of overwhelm afflicts experts too.

No one seems to know exactly how or why this year’s cyclosporiasis caseload got so big. The largest group of cases, which has been centered in the upper Midwest, has been linked to iceberg lettuce grown in Mexico. Kniel suspects that in Michigan, the parasite may have worked its way from the feces of the first infected people into the local water supply, spawning a secondary, local outbreak. Michael Osterholm, who runs the University of Minnesota’s Center for Infectious Disease Research and Policy and previously spent 15 years as the state’s head epidemiologist, told me that he’s seen no evidence to support the secondary-outbreak theory. Either way, some mystery remains as to how the parasite got into the food supply in Mexico. Taylor Farms, which recalled its iceberg lettuce in July, is “one of the leading produce companies in terms of food safety,” Kniel said. And yet here we are.

Perhaps the government could be doing more to resolve some of this uncertainty. On this point, though, expert opinions vary widely. Kniel said that, at least at first, the FDA and the CDC appeared to be posting information about the cyclospora situation more slowly than they had in past years. Steven Mandernach, the executive director of the Association of Food and Drug Officials and a former food-safety official in Iowa, told me that as far as he can tell, information has been coming out just as efficiently as ever. Osterholm believes that the sky is falling. “We have hit an all-time low, in my 50 years in public health, in our capacity to identify and respond to foodborne outbreaks,” he said, adding that the government’s slow response time on the cyclospora outbreak was nothing less than “public-health malpractice.” In an emailed statement, Grace Davis Jamison, a Department of Health and Human Services spokesperson, wrote, “Claims that HHS has lacked transparency overlook the extensive information FDA and CDC have shared as investigations progress including timely updates that help the public understand potential risks and make informed decisions.” She also said that no FDA investigators had been lost to staffing changes, and that the CDC laboratory that supports foodborne-outbreak investigations was likewise “unaffected.”

Perhaps this disagreement can be squared by acknowledging the failings of the past. The system has long been underfunded while needed changes were delayed, Barbara Kowalcyk, the director of George Washington University’s Institute for Food Safety and Nutrition Security, told me. The recent departures of experienced personnel, to retirements and layoffs, have made things only worse. “We had one hand tied behind our back before this administration happened, and now we have both hands tied,” she said. (How exactly this might translate into disease outbreaks in years ahead remains unclear.)

History suggests that few new investments in food safety come before a tragic outbreak of disease. “It was the 1993 Jack in the Box outbreak that really changed things at USDA,” Kowalcyk said, referring to the undercooked, contaminated hamburgers that killed four children who had eaten at the fast-food chain. A 2006 outbreak of E. coli in bagged spinach, which caused hundreds of illnesses and $200 million in lost spinach sales, helped inspire the passage of the Food Safety Modernization Act. Now we have the cyclospora summer. “I think that this is going to drive another paradigm shift,” Kowalcyk said.

Cyclosporiasis is, by the grace of God, a relatively gentle and self-limiting disease. Many people recover on their own within a few weeks. And for all of the tens of thousands of cases that have been registered in recent months (and the many more infections that were never diagnosed), just two deaths have been reported. Their loss is a tragedy; the economic devastation caused by falling lettuce prices, and the fact that many consumers have spent months in fear of eating leafy greens, is a shame. But given that this summer’s cyclospora plague stands among the largest foodborne-illness outbreaks in the nation’s history, these outcomes seem modest.

Consider this a solace and a warning: Our summer of contamination could have been much worse.

The Backlash Against Polyester Has Gone Too Far

2026-09-01T17:00:00-04:00

Lately, the men of the internet who are obsessed with self-optimization have found a new fixation: their underwear. Many standard pairs use polyester or spandex, or sometimes both. What are they doing to the environment and their bodies, wearing clothes that shed all of those microplastics and leach forever chemicals? They want the underwear of their ancestors—underwear made from natural fibers. On Reddit forums such as r/PlasticFreeLiving and r/SustainableFashion, people trade strategies for breaking up with polyester boxer briefs: “Any recs or leads to find linen cloth for making my own underwear?” one exasperated user wondered. Another wanted recommendations for all-natural underwear that would also be formfitting. He knew about organic cotton and hemp, he explained, but the problem was, they chafed.

Seemingly everyone is interested in natural fibers. Whitney Crutchfield, who teaches textile development at the Fashion Institute of Technology, told me that she first noticed natural-fiber mania brewing among her sustainability-minded students. Then, a year or two ago, she sensed the discourse shifting to regular consumers. Across the internet, people are purging their closets of synthetics, swearing allegiance to only natural fibers from now on. The enthusiasm seems to cut across gender, culture, and politics. “I need my workout clothes to show my nasty sweat!” the fashion journalist Liana Satenstein wrote last year, praising the emergence of a new generation of natural-fiber workout wear amid posts about French pedicures and vintage Prada thongs. “Make all clothes natural fibers again,” posted Carnivore Aurelius, an anonymous wellness influencer who sells “beef collagen peptides.”

Natural fibers are indeed pretty great. Silk, wool, hemp, linen, cotton, and the like—all of which come directly from either plants or animals—don’t carry the baggage of their artificial competitors. They don’t shed microplastics. They’re generally understood to be biodegradable. And although the research is far from settled, synthetics have been linked to adverse hormonal effects. When I visited the website for a natural-underwear brand, a pop-up asked me what I looked for in my underwear: “Fertility health” and “supporting low T” were among the options.

Natural fibers have also become an easy way to gauge the quality of a garment. Cotton, wool, and linen generally cost more than polyester and acrylic do, and they can look and feel luxurious in a way that many synthetics don’t. The reason finding a decent sweater these days is so hard is that so many of them are blended with synthetics, and one major reason for all of that blending is reduced production costs. Earlier this summer, when Gap released a reimagined version of a classic sweater from the early 2000s, fans revolted. What had originally been a chunky, cotton-blend knit turtleneck was now an entirely synthetic printed mesh. The anti-synthetic zeitgeist has transcended clothing; it is an attitude. Gen Z apparently now uses polyester as an insult meaning “cheap” and “inauthentic.”

But the frenzy has gone too far. Are you really sure it’s always better to buy cotton or wool over a nylon blend? The whole point of man-made fibers is that they can have properties that specifically don’t exist in nature. “There are reasons that these things were produced in the first place,” Crutchfield said. When DuPont unveiled nylon—the world’s first synthetic fiber—to the public at the 1939 World’s Fair, it was a revelation. In the dawning era of synthetics, people would no longer be beholden to the limits of nature; instead, we had chemistry, which was going to free women from the drudgery of endless laundering and usher in an age of universal luxury. This did not, perhaps, play out exactly as one might have hoped, but even today, synthetic fabrics have plenty of benefits.

Synthetics can enhance the performance of a garment, or the feel, or the durability, all of which contribute to a garment’s lifespan. The better it serves its intended purpose, the less likely you are to replace it with something new. A beautiful, all-natural raincoat isn’t an especially virtuous purchase if it doesn’t repel rain. On the whole, clothing with some percentage of man-made fiber requires less care than an item made with wool or silk or linen does—no hand-washing, no ironing, no reason to worry that moths might eat your favorite sweater.

Sometimes, they really are the best materials for the job. The designer Issey Miyake’s famous pleated pieces are polyester because, as one textile expert explained to NPR, their thermoplastic qualities are what helps them keep their shape. Polyester actively repels moisture and dries quickly, which is why it’s used in so much athletic gear. Wool is stronger and more durable when it’s blended with a bit of nylon—not important for sweaters, crucial for hiking socks. A little spandex can help a pair of cotton leggings keep their shape. If we want the forgiving comforts of stretch denim and athleisure, “we have to make peace with the fact that synthetic fibers are going to be incorporated into our clothes,” Nancy Deihl, a fashion historian at NYU, told me. Yes, synthetic clothing can release microplastics—bad—but it isn’t clear how much swapping out your stretch pants does to meaningfully reduce your exposure.

There is another problem with the natural-fiber obsession: Plenty of common fibers are neither synthetic nor natural. Semi-synthetics such as Tencel (the brand name for lyocell), modal, and rayon (otherwise known as bamboo) are made from natural plant material that’s been chemically dissolved and then reconstituted, a process that can be staggeringly toxic or ecologically responsible. Conventional cotton, for example, takes significantly more water to produce than lyocell and modal do.

Further complicating matters, although terms such as organic cotton, regenerative cotton, and recycled cotton tell you something about the production of fibers, they do not tell you something about the quality of a garment. Yarn spun from longer cotton fibers is stronger and wears better than yarn spun from shorter ones, but fiber length is a result of the type of cotton plant, or the growing conditions, or how the fibers have been processed. “You can compare the fiber quality of three different cotton fibers, all making the same exact T-shirt,”—same weight of yarn, same knitting machinery, same pattern, same sewing process—“and those three T-shirts can, depending on fiber quality, last wildly different amounts of time,” Crutchfield said. Fiber quality is one reason a 100 percent cashmere sweater can be $50 or upwards of $500. “You must investigate the context and the nuance,” she told me.

And fiber, natural or otherwise, is only one of a matrix of concerns that determine whether your clothing is ethical and well made. “Synthetics and natural fibers can both last a long time, but it depends on how they’re used, how they’re worn, and the quality of the garment they were made into,” Deihl said. The look and performance of any given garment are products of the fibers but also of the fabric weight, the weave, the cut, the construction, and the care instructions—all of which require at least some knowledge to assess, and none of which is easy to evaluate online.

In a dizzying consumer landscape of infinite options, it is understandable, even admirable, to want some kind of universal rubric to guide your purchasing. This can’t be cost, which may or may not correspond with quality, and there is no single label guaranteeing sustainability or ethics. You probably don’t know where a fiber was farmed and how it was harvested and processed—whether it’s been bleached and how it’s dyed, and the conditions under which a garment has been constructed—and the people selling it might not, either. Fiber content, though, is listed on the label: therefore, natural fibers! But natural isn’t a reliable shorthand for good—no matter how much you pay for your all-cashmere pants.

What Happened to Yoga?

2026-08-31T07:30:00-04:00

At a recent Pilates class, where I pumped and pulsed under infrared heat panels until my fingertips were sweating, I ran into a former yoga teacher of mine, our mats inches apart in the neon-lit room. Afterward, I said hi and told her that I hadn’t seen a yoga class that packed in a while. She shrugged. “Yoga,” she told me, “is dead.”

She was being hyperbolic, of course—yoga is still plenty popular. In some ways, it’s more mainstream than ever. People practice it in airports, offices, prisons, schools. But her words illuminated something I’ve noticed: Yoga, it seems, is no longer the defining symbol of holistic health in America that it used to be.

The decline has been building for a while. Yoga studios, which have long been plagued by razor-thin profit margins, took a hit during the pandemic. Independent studios closed; YogaWorks, a California-based chain, filed for bankruptcy. In September 2020, The New York Times asked, “Is This the End of the New York Yoga Studio?” Even after the fitness industry rebounded and people returned to in-person workouts, many yoga studios continued to struggle for all sorts of reasons—rising costs, increased competition from other workout styles, the decision by some students to stick with at-home practices established during the pandemic. On Reddit, teachers commiserated about low class attendance. In May, a beloved studio near my home in the Hudson Valley emailed a desperate plea for students to return, calling its current business “unsustainable.”

[Read: The enduring appeal of being hot]

Plenty of studios are doing just fine: Representatives from apps that track fitness attendance, such as ClassPass and Walla, told me that yoga remains one of the top choices at boutique fitness studios. But the data reveal something else, too. Many yoga studios are succeeding by offering less yoga. Walla’s “veteran” yoga studios, defined as those opened for more than three years, have cut yoga class supply by 25 percent this year. ClassPass said that in April, more than 40 percent of its yoga studios also had reservations for Pilates classes. Mindbody, another booking platform, said that the number of its yoga studios offering Pilates grew more than 20 percent from 2023 to 2025. On the yoga Subreddit, people frequently gripe about Pilates and sculpt classes bumping yoga from the schedule.

Fitness trends come and go. But the workouts people choose also reflect the contemporary understanding of what it means to be well. For years, that meant yoga and its promise of stress reduction and mindfulness. In today’s world of fitness-maxxing and social-media-driven obsession over image, though, the cultural ideal seems to have shifted from inner peace to outward perfection.

When yoga first came into vogue in the United States, physical fitness wasn’t the primary goal. During the countercultural movement of the late 1960s, many Americans were drawn to yoga because it was “exotic,” Andrea R. Jain, a religious-studies professor at Indiana University at Indianapolis and the author of Selling Yoga, told me. At the time, some people disillusioned with mainstream American religion and values were “looking for something radically ‘other’ than the traditions they had been brought up in,” Jain said. Yoga was a compelling answer: It originated in ancient India and is deeply intertwined with Buddhism, Hinduism, and Jainism. Practicing yoga was seen as a rebellious act, an alternative path to spirituality and enlightenment.

Over the next few decades, yoga transformed from a fringe activity into a lifestyle empire. During the gym boom of the ’80s and ’90s, people became much more enticed by the practice’s physical aspects; the Los Angeles Times reported in 1987 that yoga was appealing to people burned out from aerobics and craving a gentler workout. In the mid-’90s, “integrative medicine,” a whole-person approach to health, became more widely accepted, and likely gave some of yoga’s messaging more credence. Celebrities also started endorsing the practice’s benefits. Sting appeared shirtless on the cover of Yoga Journal in 1995, one lithe arm wrapped around a leg; three years later, Madonna taught an incredulous Rosie O’Donnell how to do sun salutations and ujjayi breathing on daytime television. They touted deeper connections among their mind, body, and soul, and flaunted the strong bodies yoga had helped them achieve. Madonna told O’Donnell: “I don’t work out anymore. I do yoga.”

[Read: Inside the surprisingly litigious world of luxury fitness]

In 2004, when I took my first class, the commercialization of yoga was well under way. The industry had spawned countless brands of yoga mats and athleisure, then franchised studios, and, eventually, Instagram influencers. (My mom, who practiced yoga in the ’70s and ’80s, recalls students using only towels or blankets, and wearing whatever comfortable clothes they already owned.) Soon, yoga became more than a workout—it was a lifestyle, at times even an identity. If someone said they were into yoga, the assumption was that they were healthy, spiritually minded, and self-aware. Many dedicated students (myself included) signed up for yoga teacher training, some without any intention of making a career of it but rather to further educate themselves in the practice. Etsy vendors sold hoodies that said namaste, a Sanskrit word commonly spoken at the end of a yoga class. And kitschy iterations such as goat yoga—in which playful farm animals tramp all over students’ backs—emerged, geared more toward entertainment than mindful practice.

Yoga’s ubiquity, however, may have triggered its cultural decline in America. The most devout practitioners started arguing that the expansion had trivialized yoga’s spiritual roots. (One former instructor told me he used to teach brewery yoga—which, yes, involved beer; years later, the memory makes him cringe.) The perceived novelty of the practice, Jain said, was less important to young consumers who grew up exposed to more spiritual and religious diversity. In other words, yoga lost its cool.

The practice has also developed a reputation for being a gentle workout that focuses on flexibility, characteristics that don’t align as well with recent fitness trends. In the past few years, more women have adopted strength training involving weights and resistance—especially those of a certain age who are bombarded with messaging about the bone and muscle loss that comes with getting older. Although anyone who’s taken a vinyasa class knows that chaturangas (sometimes called “yoga push-ups”) will fire up the triceps, yoga is not known for quickly building muscle mass. Suzanne Davis, a yoga-studio owner in Oregon, told me that adding lifting classes and wall-mounted resistance machines at her business was a “no-brainer.” Studios still need to pay rent, so they have to meet customers where they are, even if that place is no longer on a yoga mat.

[Read: The perilous spread of the wellness craze]

But wellness culture in general has changed too. Simply exercising and eating well is no longer enough—“biohacking” has become hot. Some of today’s wellness devotees wear continuous glucose monitors to clock blood-sugar spikes in real time as well as $400 titanium rings to track heart-rate variability and REM sleep. The goal: 24/7 self-improvement. Although people surely sign up for yoga to better themselves, the practice typically encourages them to do so slowly, with humility. Yoga tends to be about letting go of ego and striving, and about surrender—principles that don’t quite fit into a culture obsessed with optimization. This priority shift also mirrors what has happened with the body-positivity movement: A push to make peace with our bodies has been minimized amid the rise of GLP-1s, and many people have gone back to sculpting and shrinking. If skinny is unapologetically in again, fitness classes other than yoga might seem like a faster route to toned arms and a flat stomach.

Of course, what people consider a well life could change again. In fact, this year’s report from the Global Wellness Summit, an influential industry conference, suggests that the interest in maximizing every moment has already peaked: “Optimization itself has become a stressor.” Laura Munkholm, the president of the fitness app Walla, told me she knows many people who have given up on tracking entirely. “People are shifting into a conversation of I don’t care what the numbers are. I just want to live well.” Apparently, wellness seekers are craving something restorative. As it turns out, I may have just the activity for them.

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The Measles-Stricken Mother Who Lost Her Newborn Son

2026-08-30T19:20:31-04:00

When the Amish man emerged from his barn to greet me, he had no idea that his newborn son’s death had become national news. The man wore a straw hat, black trousers, and suspenders over a long-sleeved blue shirt; one of his similarly dressed sons was guiding a horse-drawn plow in a nearby field.

The man told me that, like most Amish people, he and his family don’t watch TV or use the internet. They don’t read the newspaper either. So they didn’t know until I told them that last Tuesday, Pennsylvania’s governor, Josh Shapiro, held a press conference to announce the first two “measles-associated” deaths in the state in 35 years. Both of the people who died were from Lancaster County, which is home to the largest Amish community in the country and has been hardest hit by the state’s months-long measles outbreak.

They also didn’t know that Shapiro’s political opponents are accusing him of using the deaths to score political points, or that the county’s coroner later told reporters that his office had performed an autopsy on an infant who tested positive for measles but that the cause of death had been a ruptured spleen. The confusion led Robert F. Kennedy Jr., the secretary of health and human services, to mock Shapiro on X, calling his press conference “unseemly” and an example of “the weaponization of infectious disease fears for political gain.” Without evidence, Kennedy wrote that “the deaths may even have been altogether fabricated by one of the Governor’s hopeful staffers.”

The Amish man asked me not to reveal his and his family’s names or exactly where they live, to protect the family’s privacy. His son has not been publicly identified as the newborn whose death has been the subject of so much controversy. But the circumstances of the death match, and when I told him about the case that had made the news, he said it sounded like his son. When I ran the family’s biographical details past the Lancaster County coroner, Stephen Diamantoni, he said that the office was not currently investigating any additional infant deaths in the area. When further pressed, Diamantoni said he could neither confirm nor deny the identity of the child whose death his office was investigating.

The story the baby’s father told me filled in many details missing from the accounts of both the coroner and the state. And it made clear that, amid the political squabble and competing theories, an actual family is grieving the death of their child.

I spent part of yesterday afternoon speaking with the newborn’s father and mother, whom I’ll call John and Anna. After John and I had been talking for a while, Anna came out of the house, and—although hesitant at first—agreed to join us. We sat at a table on their porch, which overlooks their postcard-beautiful farm, tucked away down a long gravel driveway. They mostly grow corn on their 45 acres, along with some hay and tobacco. They have a well-tended garden next to the house, and a small chicken coop. They’ve lived on the property for 20 years and have 13 children, some of whom stood nearby on the porch to listen or peered out through one of the screen-covered windows.

About a month ago, John and Anna became aware that measles was spreading in their community. At last count, Lancaster County has recorded 210 cases so far this year. Besides John, no one in the family had been vaccinated against the virus. John told me he’d heard from someone that this strain of measles wasn’t dangerous for pregnant women, but he wasn’t sure whether to believe it. (In fact, measles, regardless of the strain, can cause serious pregnancy complications.) Anna, who was pregnant, worried about the effect measles might have on her baby, but she didn’t think she could avoid being exposed. “I saw we can’t even get away from it because so many people have it,” she told me. Even if Anna had wanted to get vaccinated then, it would have been too late: The CDC recommends against giving the vaccine to pregnant women.

Sure enough, a few weeks ago, one of John and Anna’s older children got sick. The rest of them soon followed. Two of the children became dehydrated and required IVs. Anna became extremely ill, at one point spiking a fever of 102 degrees. She struggled to hold down food and fluids. For days, she could speak only in a whisper. On August 13, she was taken to a clinic to get an IV for dehydration.

The next day, she went into labor. Anna remembers being very weak. “I didn’t have a single piece of energy,” she told me. The baby was delivered at a birthing center by the same midwife who had attended the births of Anna’s other children and, remarkably, Anna’s own birth. The baby, who weighed seven pounds, was born a little after 5 p.m. on August 14. They knew right away that something was wrong: He had a pulse, but he wasn’t breathing. The midwife contacted paramedics, who arrived within minutes. John recalled them giving the newborn oxygen and gentle chest compressions with two thumbs, to no avail. It was all over in less than half an hour. The paramedics told them that the county coroner would need to be contacted to take the body.

As John and Anna spoke with me, one of their sons, who recently turned 1, played with a toy horse and buggy while one of their daughters bounced an orange ball against the table. Anna and John were somber but matter-of-fact about their son’s death. “There’s nothing we can do about it,” Anna told me. John said he viewed the tragedy as part of God’s plan, and pointed out that other parents lose children too. “I guess he chose us this time,” he told me.

Neither John nor Anna has strong feelings about vaccination. Anna told me she wasn’t sure why her parents didn’t get her any shots. Choosing not to immunize their children wasn’t a political statement, and they didn’t make the decision after extensive research. They just didn’t do it.

Pennsylvania allows children to attend school without being vaccinated if their parents object on religious or moral grounds. Though the Amish Church has no official doctrine against vaccines, the vaccination rate among the Amish tends to be low: Last year, the state’s health department estimated that only 25 percent of the Amish community in Lancaster County had received the measles, mumps, and rubella vaccine. In 2021, Kennedy declared that the United States needs to “think more like the Amish” at an Amish country fair just a short drive from where John and Anna live. Standing under a big white tent, Kennedy also joked about measles, saying that when he and his siblings caught the disease, they had to “stay at home and watch TV the whole week.” That got a big laugh. He also said the best treatment for measles is vitamin A and chicken soup—a statement that Shapiro has been using to attack Kennedy’s vaccine beliefs since he announced the two measles-associated deaths in his state.

Because they don’t follow the news, John and Anna weren’t aware of the controversy between Shapiro and Kennedy. In fact, they didn’t know who either man was. John said that he had recently received a voicemail from someone saying that a man named Kennedy wanted to speak with him, but he didn’t return the call. (An HHS spokesperson declined to answer questions about that call, instead criticizing Shapiro for prematurely speaking about the measles-associated deaths.) John’s father told them that the local newspaper had published a story about a baby who had died, and that it sounded as though the baby could be theirs, but they weren’t sure. They also didn’t think that their baby’s death was much of a mystery. They assumed that Anna’s severe case of measles contributed to their loss. That’s what the midwife told them as well.

Arguments over whether measles caused the infant’s death have largely centered around the lacerated spleen. It’s a confusing detail. When children acquire measles, the infection can lead to an enlarged spleen, which is more likely to burst. To some people, that might seem like clear evidence that the infant died because of measles. But Diamantoni, the coroner, has publicly maintained that his office believes that the spleen was not enlarged and therefore that the cause of death was not related to measles. (Prominent physicians have since pointed out that a ruptured spleen may not look enlarged even if it was affected by measles.) “I’ve had several discussions with our forensic pathologist, and he feels adamantly that this was not a measles death and that it was a traumatic rupture of his spleen,” Diamantoni told me. He also noted that the investigation was still ongoing and he wasn’t sure when it would be completed.

Diamantoni told me he is “very in favor of immunization,” but questioning whether measles really contributed to measles-associated deaths is becoming more typical among anti-vaccine activists. Last year, two young girls died in West Texas’s massive measles outbreak. Not long after their funerals, anti-vaccine activists reframed their deaths as caused by something other than the measles. Yes, they had the measles, the argument went, but really they died from another infection or hospital error. Children’s Health Defense, the anti-vaccine organization Kennedy founded before becoming HHS secretary, aggressively pushed that narrative.

What anti-vaccine activists usually neglect to mention is that measles, which can temporarily hamper the immune system’s memory, sets the stage for other infections. Most young children who die from measles are actually killed by pneumonia after their immune system has been overwhelmed. But they almost certainly wouldn’t have died if not for measles.

What exactly happened to John and Anna’s son remains unclear. A ruptured spleen is extremely rare in newborns in any circumstance, and so far the coroner hasn’t determined what could have caused it. John and Anna told me they had no idea either. In fact, they hadn’t heard anything about a ruptured spleen until I mentioned the coroner’s public comments to them; they simply knew that Anna had been sick, and then they had lost their child. John told me he had called the coroner’s office on Friday but was told that the investigation was still under way. They were surprised that details of their baby’s case were being discussed—if indeed the case that has captured national attention is their son’s—while they were still waiting to hear from the coroner and eager to read his report once the investigation had concluded. When I asked Diamantoni why he hadn’t been in touch with John and Anna, he said, speaking generally, that “there may be lots of factors that go into when a notification is made,” but didn’t elaborate further.

John and Anna’s son’s body was returned to them on August 17. He is buried in a cemetery a few miles away from their home. A small mound of fresh dirt sits in the cemetery’s center, marked on either end with flat wooden stakes. Scrawled on one of the stakes is the word sillborn—the t is missing—along with his father’s name. As in other Amish cemeteries in Lancaster County, a white fence surrounds the neatly kept graves, and the headstones are unadorned. It’s everything the public narrative over the boy’s death hasn’t been: simple, modest, and solemn.

The Golden Girls, but in a Camp Cabin

2026-08-30T07:00:00-04:00

At Camp Social, where grown women return to girlhood, friendship has no preamble. Within 15 minutes of meeting eight of the campers from Cabin 3, I learned this: In their 50s and 60s, they have no use for the menstrual discs in the camp swag bag; one of them found online dating so depressing after her divorce that she’s given up entirely; when they laugh, they pee a little; they feel like they’ve known one another for years, even though most of them met last night.

The campers signed up for this weekend-long adult summer camp for exactly this purpose—to make new friends. On August 21, more than 400 women, some as young as 21, some older than 80, arrived at what usually is a children’s sleepaway camp in the Poconos to spend the weekend bunking in twin beds in log cabins, climbing the ropes course, developing middle-school-level inside jokes, making friendship bracelets, and performing choreographed dances at the flagpole to Cher’s “Believe” and Shania Twain’s “Man! I Feel Like a Woman!” Everyone at Camp Social, regardless of age, is referred to as a “girl.” The camp promises to re-create a childhood experience so that grown-ups can bond with one another as easily as they might have as kids. I signed myself up because I wanted to know what kinds of adults would go back to summer camp and how seriously they would take it.

Nancy Walecki / The Atlantic

My new home for the weekend with more than 400 possible friends-to-be

The girls of Cabin 3 were all in. When they were younger, they told me, making friends did feel more straightforward. But then they got jobs that kept them late at the office, or their kids grew up, or they stopped drinking, and the friendships they’d made with other parents or neighbors faded. They began wondering: How do you meet new people? Where do you go? None of these women ever really thought they’d end up at an adult summer camp, but they saw ads for it and thought, Maybe I’ll give that a try.

Which is how they found themselves at breakfast in the mess hall, cross-talking at Gilmore Girls speed, comparing notes on their adult sons, laughing when one revealed her favorite prank—taking a picture of her cleavage on the disposable cameras passed out at weddings. Over the hollering, Jackie Prendergast, a retiree who smiles so wide she shows both rows of teeth, told me that Cabin 3 had decided that its mascot for the weekend would be the flamingo. When a flamingo loses essential nutrients, as it does when reproducing, the pigment begins to drain from its feathers. With time and nourishment, though, the pink returns. “We’ve lost our color, but we’re going to get it back,” Jackie said. Ten minutes later, we headed to archery.

Nancy Walecki / The Atlantic

The vibes were, indeed, good.

The night before, Camp Social’s girls had gathered in the barn for a dance where a band (all male, all handsome) played Prince, Michael Jackson, and Bruno Mars covers. Liv Schreiber, the camp’s 29-year-old founder, took the stage in her Camp Social shirt. “Welcome to camp!” she shouted, then launched into an ecstatic speech about the weekend ahead.

If anyone’s job could be described as “friend maker,” it is Schreiber’s. She is the type of person who skips more than she walks, makes it a point to memorize campers’ names, and, as I witnessed when we met up in New York City before camp, can form a real connection with strangers in a coffee shop in 10 minutes flat. She was working in real estate when she launched a viral matchmaking Instagram account and a matchmaking-party business, which morphed into events for adults to meet new friends. She opened Camp Social in 2023 to relive her own sleepaway-camp experience and to give women a place to meet. The waitlist, she told me, now runs north of 60,000 people.

Adult summer camps have been cropping up over the past couple of decades—one even dates back to the 1970s—but many of them are co-ed and have the feel of either Club Med in the woods or an all-out bacchanalia. Schreiber’s is one of the only all-female options with an explicit friend-making focus. Bubble letters on the camp bulletin board read You Haven’t Met All The People Who Are Going to Love You; the camp’s tagline promises that “99% of campers arrive solo and 100% leave as friends.” To get the crowd riled up at that opening camp dance, Schreiber asked, with genuine enthusiasm, “Who wants to meet a new friend?” Hundreds of hands went up.

Nancy Walecki / The Atlantic

Mornings at the flagpole included choreographed dances to Cher’s “Believe” and Shania Twain’s “Man! I Feel Like a Woman!”

That “99% arrive solo” isn’t technically true. Mother-daughter duos and friends arrive together, and returning campers offer wisdom such as: Get to the Soffe-shorts distribution early to get your size, do not miss the Saturday pool party, and be sure to lean back right before the water slide spits you out into the lake.

Even so, Schreiber has designed the camp for people to make new connections. Before arrival, campers received a guide titled “How to Camp Social,” which encouraged them to reconnect with their childhood self—the person “who made a friend at the playground in four minutes flat, who didn’t ask if she was too much or not enough.” The camp’s “10-Foot Rule” says that if you’re within 10 feet of another camper, you should smile and say hi. Bunks are grouped by age, but other than that, women are encouraged to make friends outside their generation. The counselors (all female) are trained to be welcoming, Schreiber said. They dance with campers at mealtimes, cheer when someone reaches (or tries to reach) the top of the rock wall, and shout out “Camp Social?!”—a cue for campers to circle their hips and respond with a Kool-Aid-Man-style “Ohhhhh yeaaaahhhh.”

Nancy Walecki / The Atlantic

The girls of Cabin 3

Who needs this kind of help making friends as an adult? Before I arrived, I’d wondered how many socially anxious people I might meet. Maybe the shyer campers were making themselves scarce, like Cabin 3’s mysterious tenth bunkmate, who kept to herself, or the girl in my cabin who disappeared when we all got ready for Saturday night’s camp disco. But most of the women there seemed capable enough of making friends; they were just in a moment in their life when opportunities to find those relationships felt scarcer. Compared with men, whose friendship skills are more often lamented, women do typically have more friends and are less likely to be severely socially isolated. But having a lot of friends doesn’t necessarily mean that a person’s social needs are getting met, and overall, rates of loneliness between the genders are roughly the same. The women at Camp Social were new mothers, grandmothers, empty nesters, divorcées, widows, and retirees; pretty much everyone was going through some kind of potentially isolating life transition. The average camper that weekend was 39 years old, an age when many people are taking care of kids and aging parents, which doesn’t leave much time for friendship.

For some attendees, camp simply functioned as a three-day lake vacation they didn’t have to plan—where they could do yoga on a paddleboard, attend an outdoor screening of The Princess Diaries, and drink signature camp cocktails. Last year, Schreiber told me, one woman in her 80s did nothing but archery the entire weekend. But many of the women I met came in order to feel like girls again, maybe with the hope that that would make friendship feel as easy as it did when they were kids.

For Cabin 3, Camp Social seemed to work a spell of quick intimacy. Of the cabin’s 10 girls, eight of them moved as a pack. (The ninth had come with her daughters and was spending time with them; the tenth I could never track down.) On the way to archery—along the lake and past the cabins, the pickleball courts, the pool, and the ropes course—the girls speculated about how someone would even use those menstrual discs, and Sandi Sullivan, who works for a construction company in Chicago, considered transforming her camp-branded bandana into a halter top for the camp disco, like the one her mom made her in the ’70s. When the archery instructor approached the group, he asked Vicki Petroski, a recent retiree, if she’d be a five—as in the fifth person on the range. “No, I’m a 10,” she replied. The girls cackled. The instructor blushed, and they cackled even louder. (Unlike the counselors, the camp’s staff members—who run the archery range, lifeguard the pool, and referee the camp Olympics—all seemed to be handsome 20-something men with British, New Zealand, or Australian accents.)

Nancy Walecki / The Atlantic

Jackie Prendergast, a flamingo regaining her color

“In my 20s and 30s, I never would have talked so openly with other women I’d just met,” Jackie told me. It helped that Cabin 3 had all reached the age where, as Linda Gryn, a business owner from Pennsylvania, said, “We no longer give a shit.” Some of the girls rarely speak about sex with their friends back home, but here, thanks to Vicki, whose daughter is a sex therapist, somehow every conversation seemed to come back to it.

The group was too busy for awkward pauses, anyway. The girls danced: Linda, who had been a majorette in high school and dated a football player, watched the dance instructor like a hawk during morning flagpole routines. They painted (okay, while drinking mimosas) at the paint-and-sip. Vicki went tubing for the first time in about 30 years. “Everything I did was 30 or 40 years ago,” she said. “When I turned 60, I said, Fuck it, I’m having fun again.”

Nancy Walecki / The Atlantic

Vicki Petroski and I survived tubing.

But being 60 is not always as fun as being 10. At the afternoon pool party, as girls from Cabin 3 and I waved at Vicki, in line for the water slide, Christine—the most reserved in the group, a sensible lawyer with a sensible black bob—came over to me. (She is perhaps so sensible that she asked me not to use her last name.) Going to an adult summer camp at all, let alone by herself, was not usually her speed, she said, and she already has a close group of friends. But recently, the man she’d been with for 40 years “decided he didn’t want to be married to me anymore.” One night, he said “I love you” before bed as usual, and then the next day, he told her, “We’ve had a good run, but I’m ready for the next chapter of my life.” A good run? Christine remembered thinking. I thought that I was happily married. Her adult sons were trying to stay neutral; she was trying to be okay with that.

Just then, Vicki went down the slide. The red-and-yellow half tube shot her multiple feet in the air, and we cheered when she emerged from the lake, grinning. Her curls were matted; the purple face paint she put on for camp Olympics was running down her cheeks.

Nancy Walecki / The Atlantic

The water slide was a hit among campers.

Somehow, as the evening set in, everyone still had the energy for karaoke and the disco. The girls in my own cabin, all in their 20s, were getting along well, but if Cabin 3 had reached the peak of camp friendship, my cabin was still in the “friendly roommates who ask about one another’s day” stage. As we got ready to go back out, one bunkmate did my makeup; another, who had been to Camp Social three times, told me the “vibes were off” at the pool party this year because it was overcast. At karaoke, while other bunks performed as a group, we bobbed our heads and drank our alcoholic “Bug Juice,” garnished with gummy worms. Meanwhile, Cabin 3 was on fire. Sandi, whose camp-branded bandana she wore tied up as a headband after all, raged to Smash Mouth’s “All Star.” At the disco, they danced in sequins and jumpsuits to the songs that had been on the charts when Linda was in high school.

Then it was Sunday morning and time to go back to real life.

Nancy Walecki / The Atlantic

“Y.M.C.A.” at the disco

Before the last morning flagpole, campers swapped Instagram handles and phone numbers. People seemed to have made friends, although a couple of younger girls I spoke with told me they definitely had not. They were ashamed that, even in an environment set up for friendship, they hadn’t connected with anybody. Those who had made friends wondered whether they would see them again soon or if they’d be only “camp friends.” When I asked my bunkmates whether they thought they’d stay in touch with anyone, one of them said rather ominously, “Only time will tell.”

Nancy Walecki / The Atlantic

Goodbye, Camp Social!

But over breakfast, the girls of Cabin 3 helped one another download WhatsApp and started a group chat. Since then, they’ve been trading photos of the shirts they had tie-dyed and group pictures from the disco. One of the girls, Jacqui Moore, had painted a flamingo at the paint-and-sip, which has stuck as the group’s symbol. “Keep your pink coming!” Linda wrote in one message. Three girls who live close to one another in Pennsylvania are planning to get lunch. Others might join one bunkmate walking a marathon. (In accordance with their flamingo theme, they say their team name would be “The Flockstars.”)

They probably won’t come back to Camp Social, though: The camp served its purpose. Maybe these women will get together annually to share the secrets they can’t with the people they see everyday. Maybe they’ll have a ball at Jacqui’s 60th birthday party. Maybe, like their other friendships, these will fade too. For now, they’re planning a reunion for next year. Greece—or maybe Moab?—could be nice.

Pennsylvania’s Public-Health Officials May Be Wrong About a Measles Death

2026-08-27T19:47:44-04:00

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Measles outbreaks around the country are already a disaster, but more bad news arrived on Tuesday. Pennsylvania Governor Josh Shapiro announced that two measles-associated deaths had occurred in Lancaster County. “These mark the first deaths related to measles within the Commonwealth in 35 years,” an accompanying statement declared. Both individuals were said to have been unvaccinated, but the state Health Department declined to release any other information about the cases, citing privacy concerns.

By yesterday morning, though, this story was in doubt. Lancaster County Commissioner Josh Parsons posted on X that he had spoken with the county’s coroner, who said that he had not identified any deaths due to measles. One individual, Parsons wrote, “died WITH measles, but not from measles.” That evening, Health and Human Services Secretary Robert F. Kennedy Jr. offered a more conspiratorial angle: Perhaps the entire episode had been “fabricated by one of the Governor’s hopeful staffers.”

Pennsylvania’s Health Department quickly doubled down: “As a pediatrician with more than 30 years of caring for children,” the state’s health secretary wrote, “I have thoroughly reviewed the case investigation information and sadly can confirm that there were two recent measles-associated deaths in Lancaster County.” But the facts that have emerged over the past 48 hours suggest that health officials may indeed have committed a catastrophic communication blunder—by either overstating the evidence or politicizing the deaths of citizens without conveying complete information about what had happened.

Here’s what we know so far: In the one case for which additional information has been released, an infant whose lab tests showed evidence of a measles infection died shortly after birth because of a lacerated spleen. According to an interview with the county coroner conducted by The Philadelphia Inquirer, a forensic pathologist decided that this fatal injury was not related to the infection.

That pathologist’s judgment might be wrong. Viruses (including measles) can cause the spleen to grow abnormally large, making it prone to rupture. A 2024 Polish study, for instance, documented an enlarged spleen in four out of 26 infants who had been hospitalized for measles. But there are certainly other potential explanations. Only a doctor familiar with all of the details of this particular patient’s situation would be equipped to reach a reasonable conclusion. Yet when Shapiro announced the two fatalities, he implied that the link was unambiguous. “Death from measles is completely preventable,” he said.

The baby in Lancaster could not have been vaccinated; newborns are not typically given their first dose of the MMR vaccine until they are 1 year old. According to the coroner, the infected newborn acquired the disease in utero from their mother. (Her vaccination status has not been publicly confirmed.) If some genuine uncertainty remains as to whether a measles infection led directly to the baby’s death, state officials’ announcement was premature. Think of the consequences: A grieving parent would hear her governor announce that the tragedy was in some way her fault. And anti-vaccine activists would have the opportunity to pounce on the mistake to continue downplaying the lethality of infections.

As a pathologist, I am used to fielding questions about how and why people die. Such calls were particularly frequent during the early days of the coronavirus pandemic, when many people doubted COVID-19’s official death toll. Some alleged that anyone who merely happened to die while infected—in a car crash, let’s say, or from cancer—was being counted in official numbers. (In fact, government statistics were underestimating the number of Americans who were dying from COVID.) Admittedly, determining why someone died is in many cases difficult for experts such as myself. The body is a frustratingly complex machine. A mild illness can lead to a cascade of severe bodily dysfunction; disparate diseases may all crop up simultaneously. Seemingly ill people can live for years, while apparently healthy individuals rapidly deteriorate. And measles, in particular, may pose a special challenge for cause-of-death discernment, because the virus tends to interfere with the body’s normal immune responses, making death from any pathogen more likely.

[Read: Yes, some children may have died from COVID shots]

Doctors have developed a specialized language to convey these nuances. Many people end up having two listed causes of death: an immediate cause and an underlying cause. The immediate cause is the disease process that was most closely related to a fatal malfunction of a patient’s heart, lungs, or brain; the underlying cause is the event that initiated a patient’s decline. The Pennsylvania Health Department has said that it uses the term measles-associated death when measles infection is present but may not be the “immediate cause of death.” To see how this works, consider the deaths of two children from measles in Texas last year. Anti-vaccine activists seized on the fact that these kids had both died after contracting non-measles infections to cast doubt on the conclusion that measles was the cause. In fact, this is the typical way that measles kills: The virus weakens a patient’s body, allowing harmful bacteria or viruses to take hold more easily. Bacterial pneumonia or sepsis may have been the children’s immediate cause of death—but measles was the underlying cause.

The situation does not seem to be as clear-cut in Pennsylvania. A fatal splenic injury caused by a congenital measles infection may be plausible, but it would not be a typical cause of death from the disease. And regardless of whether measles unequivocally led to either of the two deaths in Pennsylvania, officials have already emboldened vaccine skeptics and lent credibility to their doubts. The state Health Department seems to have withheld relevant information from its constituents—that is, that local investigators were not themselves attributing the infant’s death to measles—and then it politicized its announcement of the deaths by having Shapiro, who is currently running for reelection, play a prominent role in the press conference. (In response to questions, Stephanie Nojiri, the deputy press secretary for the health department, directed me to the health secretary’s prior statement. She declined to provide any further details about the cases, again citing patient confidentiality.)

[Read: Do childhood vaccines cause tornadoes?]

Public-health experts should have known that the anti-vaccine movement would use any modicum of ambiguity in the evidence to press its case. Kennedy himself has been doing this for years. In 2021, he called the idea that “measles is a deadly disease” propaganda, and visited an Amish fair in Lancaster County to congratulate locals on their wariness toward vaccines (“The Amish are doing it right,” he said), make light of measles’ risks, and tout chicken soup and vitamin A as its cure.

Kennedy has repeatedly denied having any responsibility for measles outbreaks. Indeed, he is neither the underlying nor the immediate cause of the country’s current crisis. Vaccine doubts have been around as long as the shots themselves, and immunization rates had begun to decline, at least a bit, before Kennedy became HHS secretary. But another part of a death certificate is relevant here: a listing of any significant conditions that contributed to a patient’s death. There is no doubt that Kennedy’s years as a prominent anti-vaccine activist and his actions since taking office have misinformed the public about immunizations. Health leaders who reach premature conclusions and unjustly turn a family’s private tragedy into a public morality tale will only make this preexisting condition worse.

The Lights Are Back On in Gary, Indiana

2026-08-26T15:41:37-04:00

Last night, NIPSCO, an Indiana utility company that provides electricity to half a million people in the northern part of the state, finally made the deadline for restoring power to the city of Gary. On August 11, a derecho swept across northwest Indiana, and winds nearing 100 miles an hour knocked out power for more than 370,000 people, NIPSCO has said. In Gary, home to nearly 70,000 people, 75 percent of them Black, more than half of the utility’s customers lost power in the initial aftermath of the storm. For the next two weeks, NIPSCO kept pushing back its timeline for restoring power; even on Monday, thousands in Gary were still in the dark. As of yesterday evening, the utility said, it had restored power to 99 percent of its customers—which also meant that hundreds of people in Gary still didn’t have electricity this morning.

Blackouts follow plenty of storms, and at a press conference eight days after the storm hit, Gary Mayor Eddie Melton described the ongoing blackout as a situation for “not just Gary” but also all of northwest Indiana. However, as the days of darkness stretched on, and the power started going back in other parts of the region—first Dyer and East Chicago, then Hobart and Merrillville—the initial inconvenience of a Tuesday, a Wednesday, then a Thursday, then a Friday without power started to become a crisis in Gary. This past weekend, Melton was no longer talking about the blackout as a regional problem. Gary, he told me, had not initially been on NIPSCO’s schedule for restoring power and had seemingly been overlooked until the city pushed back.

NIPSCO declined to comment on the specifics of its restoration schedule, but a spokesperson wrote in a statement that it had hired extra contractors and drawn on support from neighboring utilities and that “no outage is being overlooked.”

The people I spoke with in Gary felt differently—that whatever efforts had been made to restore power had not been fast enough. They described throwing out maggot-filled food from their refrigerators, and temporarily moving in with friends and family members who had generators. They were charging their phones in their cars while running the air-conditioning just to stay cool in the summer heat. Gary’s median household income is about $40,000 a year; nearly 20 percent of its people are 65 or older, according to the latest U.S. census data—it’s a community with limited money to spare. People were spending their last dollars on gas to drive through the city on roads without functional streetlights—past uprooted trees, fallen street signs, and loose power lines—just to find supplies.

As the power outage dragged on, relief efforts started reaching the city, but some were first come, first served; others limited relief packages to one per household, which kept people from picking up extra care packages for neighbors stuck at home. “Our seniors are stuck in their apartments, completely dark,” Willett Wright, a 77-year-old resident who was still without power, told me. “There’s no generators in the world that can get up to their apartments. They’re stuck in their rooms with all this heat, and no food.”

Power slowly began to come back this weekend, but not across all of Gary’s neighborhoods. Some residents were still waiting in the dark. And even in the places where power had come back on, the lights were still flickering. If you ask Gary residents what time their power was turned back on, they can share it almost down to the minute: 11:32 p.m. on Saturday; just after midnight on Sunday; 2:45 p.m. on Monday.

Indiana is used to dealing with some types of severe storms, which were responsible for nearly 50 percent of the major disaster costs in the state over the past 44 years, a 2025 report from the National Oceanic and Atmospheric Administration found. But this derecho—a strong windstorm that moves in straight lines and can be as fast as a hurricane or a tornado—felt different, residents told me. Climate change is contributing to a steady increase in storm frequency and severity across the United States, which is in turn increasing damage to power grids across the country, Kyri Baker, a University of Colorado at Boulder associate professor who focuses on power systems and power-grid resilience, told me. “A lot of the extreme weather events are happening in areas that we didn’t initially expect,” she said. “Utilities need to change their game plans in preparing for those low-probability events.”

Gary’s problems with infrastructure were clear long before the storm rolled in. Over the past decades, as deindustrialization has shrunk the city’s population and tax base, its infrastructure has crumbled too. NIPSCO has a monopoly on Gary’s electricity, and a 2025 analysis by the Citizens Action Coalition, a consumer-advocacy organization, found that NIPSCO customers were already paying the highest bills of any of Indiana’s five investor-owned electric utilities; last year, NIPSCO was approved for another rate increase to upgrade power lines and technology updates. Even though low-income Black households tend to spend more of their incomes on utilities, they are disproportionately affected by electric-grid failures and face slower restoration times after extreme weather events. (NIPSCO did not respond to questions about its infrastructure investments or its rates.)

Each day that the lights stayed off added to the disruption in people’s lives. David Rucker and his wife, Tiffany, told me that they’d had to drive about an hour every day to Chicago to charge his BiPAP ventilator, which he needs to breathe when he sleeps. The device runs only four hours when it’s battery-powered. Although Gary is only about 30 minutes away from the South Side of Chicago, the journey takes twice as long, because their car’s transmission needs to be fixed. “The money we would’ve spent to fix it, we don’t have,” Tiffany said. “Now everything is depleted. The storm has taken a lot—mentally, physically, and monetarily.” Their power was restored on Monday night at 10 p.m.

As the power comes back on, people are ready to restock and return to a sense of normalcy. They are refilling insulin prescriptions that went bad in warm refrigerators, recharging glucometers, and getting wellness check-ups for high blood pressure and A1C levels, practitioners at Gary’s NorthShore Health Center said. Several people I spoke with said that they are cautiously refilling their refrigerators with groceries, and stocking up on batteries in case of another emergency. Earlier this week, Indiana Governor Mike Braun requested an investigation into NIPSCO’s tree maintenance, as well as a review of approved state funds for the city’s infrastructure. Yesterday, President Trump approved a major-disaster declaration for Indiana, allowing FEMA aid to help the state recover from the damage. The city is finally getting some of the attention and help it has long needed.

More American Families Are Refusing Vaccines

2026-08-25T12:59:39-04:00

As millions of children around the country start another school year, they’ll be confronting new classes, new teachers, and, inevitably, a new slate of germs. And this fall, they’ll be more vulnerable to infectious disease than children have been in decades.

Earlier this month, President Trump signed yet another executive order insisting that the United States shrink its schedule of recommended vaccines—federal guidance that currently guards Americans against 17 diseases with safe, effective shots. He also demanded that the U.S. split the MMR vaccine into three separate courses for measles, mumps, and rubella, without citing solid scientific evidence or acknowledging the infeasibility of such a system. (Scholars have already questioned whether the order has legal power.) Days later, the CDC released new data showing that, under Trump, the nationwide vaccine-exemption rate among kindergartners has reached a record high.

The new exemption rate of 4.2 percent is a relatively modest bump, up from the previous school year’s 3.6. The national numbers, though, paper over widening gaps among states. Roughly 98 to 99 percent of West Virginia kindergartners, for instance, are still getting routine shots. Meanwhile, in Idaho, the percentage of kindergartners who are up-to-date on vaccines that guard against diseases such as polio, chickenpox, and measles has tumbled to about 75 percent—well below the estimated thresholds for reliably staving off such outbreaks. These numbers reflect what Thomas Patterson, the president of the American Academy of Pediatrics’ Idaho chapter, has been seeing and hearing in the hospitals and clinics where he works: more families expressing skepticism, more families refusing or delaying shots, and more families opting out of his care after he reveals that he supports all of the vaccines that the AAP recommends. (The professional society has sued Trump’s Department of Health and Human Services over its attempts to pare down vaccine recommendations.) Idaho also bans employers, schools, and day cares from requiring medical interventions, including vaccines. Its vaccine-exemption rate is now 17.5 percent, the highest in the nation.

National polls show that the majority of Americans still think vaccines work well to prevent disease, and that at least two-thirds support requiring vaccines in schools. Those sentiments remain especially common in Democratic strongholds. Jennifer Shu, a pediatrician in Atlanta, told me that in the past year and a half, she and her colleagues have been flooded with calls from families who are worried that the vaccines they want for their children could soon be taken away. In response to a request for comment, Kush Desai, a White House spokesperson, told me in an email, “None of the Trump administration’s actions undermine access to or insurance coverage of any vaccine—they instead create an environment that fosters parents making informed decisions together with physicians and public health officials who are supposed to guide and support, not force, crucial vaccinations to ultimately ensure that American children do not suffer from serious vaccine preventable infections.” (HHS did not respond to a request for comment.)

At the same time, surveys show that national confidence in vaccine safety has eroded, especially among Republicans, who are also far less likely to support school requirements for shots. Since the start of the coronavirus pandemic, the partisan split around vaccine attitudes has been widening. The second Trump administration has exacerbated those tensions, pediatricians around the country told me—and top health officials’ inaccurate portrayals of vaccine side effects seem to have emboldened more people to push back against standard medical advice. Elizabeth Hawse, a pediatrician in Lexington, Kentucky, told me that many of her patients have begun asking whether she’s aware of any new research to indicate that vaccines need to be newly restricted. Those questions tend to follow federal vaccine news: administration officials’ suggestions that the U.S. should mirror Denmark’s trimmer vaccine schedule, or Health Secretary Robert F. Kennedy Jr.’s handpicked vaccine advisory committee’s elimination of the long-standing recommendation for universal hepatitis B vaccination at birth. Hawse’s answer is blunt: Nothing has changed.

Faced with doubts that tend to be informed more by politics than by scientific evidence, pediatricians have only so many tools. Sometimes, they can convince families with facts—reassuring them, for instance, that decades of studies have debunked the notion that vaccines cause autism, or correcting Trump’s recent statement that vaccines are the “size of a bottle of soda poured into a little child’s body” (most vaccines are about a tenth of a teaspoon). Other parents respond more to common emotional ground: Hawse tells them that she gave these vaccines to her own children, the oldest of whom is 26. Caitlyn Neltner, another doctor at the same practice as Hawse, told me that she shows patients her own vaccination record from the 1990s. Families seem comforted by the shared experience, Hawse said—and by the fact that the pediatrician-recommended vaccine schedule has remained mostly unchanged for decades.

Some doctors told me that they’ve started spending far longer discussing vaccines with families, and that some conversations stretch across hours or multiple visits—heavy workloads that can sap the time and resources that small practices could otherwise offer to other patients. Benjamin Dowse, a pediatrician in southern Utah, where vaccination rates remain low, told me that, in a few cases, turning a “no” on vaccines into a “yes” has been possible only over the course of several years. Sometimes, the work seems unlikely to ever pay off. Patterson, in Idaho, has learned to pick his battles: Families who buy heavily into conspiracy theories or are adamant that vaccines have harmed their loved ones aren’t likely to be easily persuadable.

Several of the pediatricians I spoke with, especially those in larger cities, told me that they insist their patients follow the AAP-recommended vaccine schedule. But in rural areas, telling families to seek care elsewhere is not really an option, Dowse said. If he pressures people too much about vaccines and they leave his care entirely, they may end up without any pediatrician, which would put their kids at risk of all sorts of preventable health problems.

In places where vaccination rates are not high enough to prevent outbreaks, disease itself can make a powerful argument. Lately, the U.S. has been battling its worst measles resurgence in the past 35 years; just this morning, Pennsylvania announced two measles-associated deaths in unvaccinated residents. A few pediatricians told me that the arrival of the virus in their community has spurred an interest in vaccines, even from previously skeptical families. Lisa Costello, a pediatrician in West Virginia, told me that the grandparents in her community are some of the biggest advocates for vaccines: Many of them can still remember a time before routine polio immunization, when the disabling disease ran rampant, and never want to return to it. Even so, fear of disease isn’t always enough. Vaccination rates have ticked up only slightly in South Carolina, the epicenter of the largest recent measles outbreak—and exemption rates have risen too.

As federal guidance on vaccines softens, states’ ability to require shots is one of the most effective strategies to keep protections against diseases in place. West Virginia—where some counties lack any pediatricians at all and many families must drive long distances to seek care, including vaccines—has maintained some of the highest childhood-vaccination rates in the country for many years because it does not allow nonmedical exemptions. States that have followed West Virginia’s lead, including California, have seen vaccination rates increase as well. Meanwhile, some of the most obvious drops in protection have played out in states where vaccination laws have slackened. Prior to 2023, Mississippi forbade nonmedical exemptions, too, and its kindergarten-vaccination rate was the nation’s highest; more than 99 percent of children met school requirements. But since a federal judge eliminated that restriction, eight counties in the state have dropped below 95 percent, potentially putting them at risk for measles outbreaks.

Last July, citing concerns about falling vaccination rates, the AAP recommended the elimination of all nonmedical exemptions to school-immunization requirements. But in the current political environment, vaccine policies seem more likely to further degrade. In his recent executive order, Trump explicitly embraced liberal exemption policies, citing a need for “maximizing parental choice over childhood vaccines.” Politicians—most of them Republican—and anti-vaccine activist groups have continued to push for the elimination of vaccine requirements in several states as well. In March, before South Carolina’s recent measles outbreak had officially been declared over, state lawmakers killed a Democrat-sponsored bill that would have eliminated religious exemptions for the MMR vaccine for kids in public schools.

Kennedy has told Americans to consult their doctors about vaccination; he’s also urged them to distrust experts and do their own research. Many Americans are, in effect, now being asked to choose between the advice of their preferred politicians and their longtime health-care providers. Anita Henderson, a pediatrician in southern Mississippi, told me that she recently encountered a family who had vaccinated all of their older children but, on the mother’s insistence, were declining shots for their new baby. As they were leaving the appointment, Henderson said, the mother turned back “and made the comment, I’m so glad President Trump made that law changing the vaccine schedule. I’m glad he is bringing to light all the problems that we’re seeing with vaccines.”

By the time that baby is old enough to attend public school, Henderson expects that many more schoolchildren in her state will lack the vaccine safeguards they need. In Mississippi, she said, health department officials have logged more than 7,000 religious exemptions among kids 4 or younger. The more young children who join that poorly protected cohort, the more vulnerable everyone in the community will be the next time a dangerous virus arrives.

It’s Low-Calorie and Packed With Protein. Is It Healthy?

2026-08-21T13:49:45-04:00

Ice cream is one of life’s simplest and most enduring culinary pleasures. The first published recipe, which dates back to the 17th century, combined milk, water, sugar, and candied citron or pumpkin. By the early 20th century, companies were regularly adding stabilizers to their ice creams to prevent them from getting freezer burn and artificial dyes to give them appealing hues. But the core essence of ice cream—sweetened, frozen dairy—remained largely unchanged into the 21st century. Even Halo Top, the diet ice cream that surpassed Ben & Jerry’s as the nation’s best-selling in 2017, simply subbed in skim milk and artificial sweeteners to keep the calories down.

Then came David. The protein-bar company has turned its attention to “frozen dessert,” which is, of course, more commonly known as ice cream, though the company can’t legally call their product that. Instead of being made with cream and milk, it comprises a “protein system,” a “structure system,” a “fat system,” and a “flavor system,” each of which is composed of ultra-processed ingredients such as whey protein isolate and “modified plant fat.” The only whole natural ingredients on the vanilla flavor’s label are water, salt, and vanilla bean. And yet, the treat’s basic nutritional stats are impressive: A pint has just 210 calories, less than 1 gram of sugar, and 30 grams of protein. Unlike diet ice creams of the past, it is rich and creamy. When the product launched on David’s website in June, it sold out in 28 minutes. (The company declined to tell me how many units it sold.)

David’s ice cream is perhaps the most outwardly refined of a whole category of frozen desserts that are being deliberately packed with protein. These protein-ice-cream companies and others processing their way to a palatable nutrition label are making a bet on what Americans truly want from food. We (and our government) might have grown more skeptical than ever of industrially produced foods, but we also expect quite a lot from every morsel we consume. When I recently spoke with Brendan Niemira, the chief science and technology officer of the Institute of Food Technologists, he spent nearly two minutes listing qualities that Americans now desire: that food be tasty and safe, sure, but also low-calorie, high-protein, probiotic, full of omega-3 fatty acids, and so on.

Last month, PepsiCo launched a powdered oatmeal drink, with 15 grams of protein, that dissolves in cold milk or water. It also makes a prebiotic version of Pepsi that contains 3 grams of fiber and does not taste like Metamucil. Kraft Heinz recently introduced a mac and cheese with 17 grams of protein and 6 grams of fiber, thanks largely to a “proprietary protein-and fiber-enriched pasta.” Nestlé offers a 45-calorie “pre-meal hunger support nutritional drink” that is composed almost entirely of industrially processed ingredients and that the company says helps people feel full sooner. At the Institute of Food Technologists’ annual conference earlier this summer, I feasted on “better-for-you BBQ pizza,” the crust of which was fortified with wheat-protein isolate, and watermelon-lime “satiety soda” that was spiked with corn fiber. I even ate frozen yogurt that starred a “network of cell-signaling peptides from the fava bean” and was supposed to help me recover from workouts.

On paper, Americans are generally wary of such products: In a June 2025 survey, more than 60 percent of respondents said they believe that ultra-processed foods are addictive. And some experts worry that the ingredients such products depend on—emulsifiers, preservatives, and sugar substitutes—are somehow messing with our metabolism, such that the impressive macros of these products don’t provide the full picture of their healthfulness. (The FDA approves the safety of such additives, but that review process historically has focused on toxicity and, say, cancer risk, not metabolic effects.) Many believe that the manipulation of ingredients causes our bodies to react in unforeseen ways to the food we eat—that a manufactured “protein system” might not be beneficial in the way that, say, lentils’ protein system is. Or they note the simple fact that many UPFs—even those that may be high-protein, probiotic, or high-omega-3—still contain a lot of fat, sugar, and salt, which are clearly bad for us.

Take PepsiCo’s SunChips Fiber, which launched in March. A 7-ounce bag of the chips—seven servings, according to the company, but honestly not that enormous of a snack—has 21 grams of fiber, most of what the FDA recommends an adult eat in a day. But it also has 910 calories. Even if these fiber-filled SunChips had fewer calories, UPF critics would point to the way they’re made—using an industrial process called extrusion, which essentially pulverizes grains into easily digestible morsels—as a potential danger. (Some researchers suspect that extruded grains spike insulin more than their unprocessed counterparts.)

The problem is that the science around which processing steps and industrial ingredients might actually be harmful is still in its infancy. And it will struggle to catch up with the food industry’s innovation. Major food companies are regularly creating new processes for spiking foods with nutrients without making them taste like health foods. Nestlé’s “hunger support” drink, for example, uses something the company calls “whey protein microgels,” which help prevent the drink from getting too thick in the manufacturing process. David’s frozen dessert is so low-calorie and yet so indulgent because of that “modified plant fat,” a chemical called esterified propoxylated glycerol that is not absorbed by the digestive tract and was cleared for use in food by the FDA in 2015. (An earlier nondigestible fat, olestra, infamously flopped after people began reporting that it was causing them “anal leakage” in the ’90s; safety studies of EPG indicate that such leakage could occur with very high doses.) Scientists might be convinced that extrusion can make an otherwise healthy product like whole grains metabolically harmful. But what about “supercritical fluid extrusion” that—according to Frito-Lay, which patented the technology—uses less heat and thus can “deliver high levels of fruits or vegetables” in a still-crispy snack?

Until experts can articulate precisely why ultra-processed health foods are a problem, we’ll all be stuck in limbo. Companies will continue offering ever more processed and refined health foods, made with shiny new ingredients and methods; meanwhile, some experts will continue warning Americans that we should not eat them, without being able to back those warnings up with data on the latest foods. Every time a new processed health food hits the shelves, anyone who visits a grocery store will have to guess whether this one will be truly healthy. In the face of some uncertainty, at least some Americans are, so far, turning to products such as David’s: The company sold $131 million worth of its protein bars in their first year on the market.

Most Americans don’t actually need more protein in their diet, and certainly they could get it without spending about $9 on a pint of David. “This so-called ice cream looks to me a boondoggle for all concerned, save those selling it at, no doubt, extremely high profit margins,” David Katz, the founding director of the Yale-Griffin Prevention Research Center, told me via email. But David’s CEO, Peter Rahal, told me his detractors are Luddites. He argued that people need more protein than the daily recommended amount to “thrive,” and that having the option of a new diet ice cream on the shelf shouldn’t be controversial. “You want the full-fat, full-cream, full-sugar thing that has this amazing heritage, go for it. But if you want something that’s really close to taste and texture, that’s more advanced and more sophisticated, it should be there for you,” he said. (David’s product is so expensive, Rahal said, because of the cost of whey protein.)

Clearly, some Americans see the world like Rahal does. When the craving for ice cream hits, a pint under 300 calories has its own appeal—even if it’s not ice cream at all.