Category: Science

In Defense of Dr. Fauci

On August 3, 2026

Last week, an 85-year-old physician sat before a Senate committee and, for the first time in more than 250 congressional appearances spanning five decades of public service, declined to answer. Dr. Anthony Fauci invoked his Fifth Amendment right against self-incrimination over one hundred times, telling the panel that its chairman’s “evident obsession with calling for my prosecution” left him with no other reasonable choice. He was invoking his Fifth Amendment right against self-incrimination, not because he believed he had committed a crime, but because he no longer trusted that anything he said would be treated as testimony rather than ammunition. It was a stunning scene, and it should trouble anyone who cares about how this country treats its public servants once the politics of a crisis outlast the crisis itself.

Fauci’s career is, by any fair measure, one of the most consequential in the history of American medicine. He joined the National Institutes of Health in 1968 and led the National Institute of Allergy and Infectious Diseases from 1984 until his retirement in 2022, advising seven presidents from Reagan to Biden. He was, for two decades, among the most cited scientists on earth. He helped transform HIV/AIDS from a near-certain death sentence into a manageable chronic condition, and his work undergirded PEPFAR, the President’s Emergency Plan for AIDS Relief, which is credited with saving more than 25 million lives worldwide. For that work, President George W. Bush — a Republican — awarded him the Presidential Medal of Freedom in 2008. Doctor Francis S. Collins, former director of the National Institutes of Health, has called Dr. Fauci “a national treasure” and has stated that “Dr Fauci is the most dedicated public servant I have ever known. His contributions have saved countless lives from HIV/AIDS, Ebola and SARS-CoV-2, and will stand as a profoundly significant gift to humanity.” None of that is in dispute even by his fiercest critics.

What is in dispute is his conduct during COVID-19, when he became the public face of a federal response that asked Americans to accept school closures, business shutdowns, masking, and eventually vaccine mandates. Senator Rand Paul, who now chairs the Senate committee investigating him, has spent years arguing that the National Institutes of Health funded research in Wuhan China contributed to the virus’s emergence, and that Fauci misled Congress about it under oath.

Ahead of last week’s hearing, Paul released more than 1,100 pages of Fauci’s pandemic-era diary entries, obtained after an eight-month search led by Health and Human Services Secretary Robert F. Kennedy Jr. Paul argued that what Fauci wrote privately differs from what he told the public. Paul has now pledged to seek a contempt-of-Congress vote, which he says could open the door to Justice Department prosecution. Neither Paul nor Kennedy seems to understand that a diary entry is a statement fixed in time and may involve personal musing and speculation and that opinion and public statements can evolve as new knowledge becomes available. Or perhaps they don’t care.

Reasonable people can criticize specific decisions made during the pandemic. Some restrictions may have lasted too long. Officials could have communicated uncertainty more clearly. Public health agencies sometimes failed to explain why recommendations changed, allowing confusion and mistrust to spread. The shifting public health guidance that so many Americans remember as evidence of dishonesty is, to most working scientists, simply what science looks like in real time: recommendations changed because the evidence changed, not because anyone was hiding the truth. But that is not to say those criticisms don’t deserve serious discussion.

What deserves equal recognition, however, is the unprecedented uncertainty confronting public health officials. They faced a rapidly evolving virus, incomplete data, overloaded hospitals, political polarization, and an information environment saturated with misinformation. Perfect decisions were impossible.

The main issue in contention is Senator Paul’s accusation that Dr. Fauci falsely testified that NIH never funded gain-of-function research at the Wuhan virology lab. The element of funding is a technical issue. NIH did not directly fund research at the Wuhan lab; they provided a grant to a group known as EchoHealth who in turn funded research at Wuhan. The second element requires a brief explanation of gain-of-function research.

Gain-of-function is laboratory research that deliberately alters a virus or other pathogen to give it new or enhanced biological properties—such as increased transmissibility, infectivity, or the ability to infect a new host—in order to better understand disease mechanisms, improve surveillance, or develop vaccines and treatments. Senator Paul contends that the research did meet the gain-of-function definition while Dr. Fauci contends that it did not meet the federal guidelines in effect at that time and further that the research was not conducted on the SARS-CoV-2 virus and did not result in COVID-19. He continues to maintain that his testimony accurately reflected NIH policy and definitions. Federal reviews, including one commissioned by the National Institutes of Health, have concluded that the specific EcoHealth-funded research did not meet the technical definition of gain-of-function in place at the time, a conclusion Fauci’s critics dispute but have not conclusively rebutted.

As these hearings have pointed out, there is not a single definition of gain-of-function among virologists or microbiologists. Some argue for a tighter definition while others do not. To further add confusion to the question, the American Society for Microbiology has called for a more precise, evidence-based definition of the term gain-of-function.

It is worth being precise about what has and has not been shown. No evidence has emerged that the coronavirus was engineered or leaked from a laboratory; the scientific consensus still points toward a natural spillover event from a wild source.

The elements of perjury require two things: the person knowingly gave false testimony and did so with intention to deceive. Testifying to something that is believed to be true but is later proven to be false does not make the previous testimony perjury. Because the underlying definitions in this charge are under intense debate in the scientific community, the basis for a perjury charge is extremely weak. But we know from recent experience with the reflecting pool that the lack of evidence does not stop the Trump administration from making unfounded criminal charges.

The perjury allegations remain only allegations, litigated in hearing rooms, press conferences, and cable news segments rather than in courts. And Fauci already received a preemptive pardon from President Biden before leaving office specifically to protect him from prosecution over pandemic-era statements — a fact Paul acknowledged, raising the question of exactly what additional legal jeopardy this pursuit is meant to produce.

That question points toward the real story here, which is less about virology than about power. Since President Trump’s return to the White House, several of Fauci’s most vocal critics — Kennedy chief among them — occupy positions from which they can direct the machinery of government at a single retired scientist. A congressional hearing that features senators trying to provoke Fauci by asking about tie colors and the day of the week, his attorney forcibly removed from the room, and a gallery of Trump-aligned activists standing by to testify about vaccine mandates is not a forum for discovering facts.

It is a stage for finishing an old argument by other means. They are attempting to turn a pandemic that killed more than a million Americans, into the fault of one man rather than a shared national failure, much of which occurred on Trump’s watch. And part of it may be personal, given how frequently Fauci found himself publicly correcting a president who does not forget being corrected.

This seems to me to be a case of selective persecution and part of the Trump revenge program.

Fauci may have been an imperfect messenger, and reasonable people can fault his early missteps on masking guidance or his sometimes brusque certainty in front of cameras. But there is a meaningful difference between legitimate oversight of pandemic policy — which Congress should absolutely conduct — and a years-long campaign whose stated goal, in Fauci’s own paraphrase of his chief antagonist, is to see him “behind bars.” When a senator with subpoena power spends a hearing pursuing a scientist’s diary rather than debating the substance of research policy, the effort looks less like accountability and more like retribution dressed up as investigation. It is incredible to me that any reasonable person would believe that a man who spent his entire professional career trying to protect the American public from viral diseases would suddenly and intentionally try to trick them into wearing face masks and closing schools.

The American public deserves a legitimate, evidence-based scrutiny of pandemic-era policies . What the country has gotten instead, at least in the current hearings, looks less like accountability than theater, and neither a scientist’s record nor the public’s understanding of what actually happened is served by a proceeding that produced a great deal of heat and, by most independent accounts, no new facts.

Public servants who make consequential decisions under uncertain conditions deserve scrutiny, not immunity from criticism. But they also deserve a process that seeks truth rather than a scalp. A man who spent fifty years fighting AIDS, Ebola, and a novel coronavirus should not have to plead the Fifth to protect himself from the country he served. That he felt compelled to do so says less about Anthony Fauci than it does about the politics that have consumed the men now pursuing him. This is just one more in a string of embarrassments caused by the Trump administration that have brought shame to the American people in the eyes of the world.

Image generated by author using ChatGPT.

Sources:

1. NBC News, “Anthony Fauci invokes Fifth Amendment right not to answer questions at GOP-led Covid hearing” (July 29, 2026): https://www.nbcnews.com/politics/congress/anthony-fauci-5th-amendment-testify-covid-hearing-rand-paul-rcna589793

2. NewsNation, “Republican COVID-19 allegations against Dr. Anthony Fauci explained”: https://www.newsnationnow.com/health/what-fauci-is-accused-of/

3. The Washington Post, “Fauci’s critics have power. They’re coming after his pandemic record.” (August 2, 2026): https://www.washingtonpost.com/politics/2026/08/02/faucis-critics-have-power-theyre-coming-after-his-pandemic-record/

4. TIME, “Fauci Pleads the Fifth at Senate Hearing on COVID, Escalating Long-Running Clash With Republicans” (July 29, 2026): https://time.com/article/2026/07/29/fauci-fifth-amendment-senate-hearing-covid-rand-paul-republicans/

5. The Washington Post, “Rand Paul threatens to hold Fauci in contempt after he declines to answer questions” (July 29, 2026): https://www.washingtonpost.com/politics/2026/07/29/fauci-set-face-rand-paul-senate-gop-after-release-his-covid-diary/

6. AOL News, “Republicans ramp up attacks on Fauci”: https://aol.com/republicans-ramp-attacks-fauci-100000419.html

7. NIH MedlinePlus Magazine, “Meet Anthony S. Fauci, M.D., former Director of NIAID”: https://magazine.medlineplus.gov/article/meet-anthony-s-fauci-m.d-former-director-of-the-national-institute-of-allergy-and-infectious-diseases

8. Academy of Achievement, “Anthony S. Fauci, M.D.” (career timeline): https://achievement.org/achiever/anthony-s-fauci-m-d/

9. PBS American Masters, “Anthony Fauci biography and career timeline”: https://www.pbs.org/wnet/americanmasters/anthony-fauci-biography-and-career-timeline/26116

10. Encyclopaedia Britannica, “Anthony Fauci”: https://www.britannica.com/biography/Anthony-Fauci

Gluten and Your Gut: Celiac Disease, Sensitivity, and the Gluten-Free Craze.

By John Turley

On April 30, 2026

In Medicine, Science

Walk down the aisles at any grocery store today and you’ll find bread, crackers, cereals, and pastas proudly stamped “Gluten-Free” — as if gluten were some kind of dietary villain lurking in your morning toast. For the roughly 1% of Americans with celiac disease, avoiding gluten isn’t a lifestyle choice; it’s a medical necessity. But for the much larger slice of the population without any gluten-related disorder, the science tells a more complicated story.

What Is Celiac Disease, and What Causes It?

Celiac disease is an autoimmune disorder — meaning the immune system turns on the body itself. The trigger is gluten, a protein found in wheat, barley, and rye. Gluten fragments interact with an enzyme called tissue transglutaminase in the gut. The immune system mistakes this complex for a threat and attacks it, but in the process, it damages the body’s own intestinal tissue. This is what makes celiac disease an autoimmune condition, rather than a simple food allergy. The immune system mounts an attack, generating antibodies that damage the villi, the tiny finger-like projections lining the small intestine that are responsible for absorbing nutrients. Over time, that damage leads to malabsorption and a cascade of health problems.

The disease has a strong hereditary component — about 7.5% of close relatives of people with celiac disease also have it. Researchers have identified two specific genetic variants, HLA-DQ2 and HLA-DQ8, that are present in virtually all celiac patients. But here’s the catch: about 40% of the general population carry one of these genes, yet most of them never develop celiac disease. That means genes load the gun, but something else pulls the trigger. Environmental factors — gastrointestinal infections, timing of gluten introduction in infancy, and other autoimmune conditions like type 1 diabetes and thyroid disease, surgery, even pregnancy — all appear to play a role. Researchers continue to study why some genetically susceptible individuals develop the disease while others do not.

Symptoms and Diagnosis: A Tricky Puzzle

If you’re picturing someone doubled over with stomach pain after eating a sandwich, that’s one version of celiac disease — but far from the only one. The disease presents in more than 200 documented ways. Classic gut symptoms include abdominal pain, bloating, diarrhea, and foul-smelling stools. But celiac disease can also show up as iron-deficiency anemia, bone loss, infertility, nerve damage, depression, liver enzyme abnormalities, and even a distinctive itchy skin rash called dermatitis herpetiformis. Children may experience stunted growth and delayed puberty. Some people, especially seniors, may have no obvious symptoms at all.

This symptom diversity is part of why diagnosis is so often delayed. Researchers estimate that somewhere between 60–70% of Americans with celiac disease remain undiagnosed.

The path to diagnosis typically starts with a blood test measuring tissue transglutaminase IgA antibodies — a marker the immune system produces in response to gluten. If that test is positive, a gastroenterologist performs an upper endoscopy and takes small tissue samples from the small intestine to look for the telltale villous damage under a microscope. Both tests need to be done while the patient is still eating gluten; going gluten-free first can produce falsely normal results and delay or prevent an accurate diagnosis.

Treatment: One Answer, Lifelong Commitment

There are no medications, no injections, no surgical fixes for celiac disease. The only effective treatment is a strict, lifelong gluten-free diet. And “strict” really does mean strict — even trace amounts of gluten can damage the intestinal lining, sometimes without producing obvious symptoms. Gluten hides in surprising places: commercial soups, sauces, ice cream, hot dogs, medications, dietary supplements, and even some communion wafers. Working with a registered dietitian is strongly recommended.

The good news is that the intestinal lining is remarkably resilient. Once gluten is eliminated, symptoms typically improve within one to two weeks, and mucosal healing generally follows over one to two years. Nutritional deficiencies — commonly iron, folate, calcium, and B vitamins — are addressed with supplements during recovery. A small subset of patients develop “refractory celiac disease,” where the intestine doesn’t heal despite strict dietary adherence; these cases may require corticosteroids and carry a less favorable prognosis.

Prognosis: Life After Diagnosis

Most people with celiac disease who strictly follow a gluten-free diet do very well over the long term. Intestinal architecture normalizes, antibody levels drop, and many of the downstream complications — anemia, bone loss, neurological symptoms — improve or resolve. The earlier the diagnosis is made and the gluten-free diet is initiated, the better the outcome.

One significant concern on the long-term horizon is cancer risk. People with longstanding, untreated celiac disease face a roughly 6–8% elevated risk of lymphoma of the small intestine. There is also a modestly increased risk of other gastrointestinal cancers. The reassuring part: patients who achieve normal intestinal histology on a gluten-free diet appear to have the same lymphoma risk as the general population. Adherence to the diet is, quite literally, protective.

Non-Celiac Gluten Sensitivity: The Gray Zone

Between full-blown celiac disease and perfectly healthy gluten tolerance lies a murkier territory: non-celiac gluten sensitivity (NCGS). People with NCGS experience symptoms similar to celiac disease — bloating, abdominal pain, fatigue, headaches, brain fog — after eating gluten, but their blood tests for celiac antibodies are negative and intestinal biopsies show no structural damage. The condition is real and increasingly recognized, but its biology remains incompletely understood.

Non‑celiac gluten sensitivity does not have a single definitive test. Instead, it is a diagnosis of exclusion. Once all other causes have been excluded, NCGS is what’s left.

Milder Forms of Gluten Intolerance

Not everyone with gluten‑related complaints fits neatly into the categories above. Some people never undergo formal testing but notice a pattern: when they eat bread, pasta, or pastries, they just don’t feel good. When they cut back on those foods, they feel lighter and more energetic.

These milder forms of gluten intolerance can be tricky to interpret. The symptoms overlap with irritable bowel syndrome, lactose intolerance, stress‑related gut issues, and reactions to FODMAPs (fermentable carbohydrates) found in wheat and many other foods. In some cases, it may not be gluten itself causing problems but the overall carbohydrate profile of a highly processed, wheat‑heavy diet. Some scientists suggest renaming the condition “non-celiac wheat sensitivity” to better capture this complexity. Still, for the individual, what matters most is whether changing their diet in a structured way leads to sustained relief.

Wheat allergy is a classic IgE‑mediated food allergy to wheat proteins that can cause hives, wheezing, or even anaphylaxis, and needs to be distinguished from celiac disease and NCGS. It is treated like other food allergies and is best managed by an allergist.

The Gluten-Free Craze: Helpful Trend or Expensive Fad?

Here’s where things get interesting — and a little frustrating for nutritional scientists. Surveys suggest that roughly 30% of American adults are actively trying to reduce or eliminate gluten from their diets. A 2013 poll found that 65% of Americans believed gluten-free foods were simply healthier, and 27% thought going gluten-free would help them lose weight. These numbers vastly outpace the actual prevalence of celiac disease and gluten sensitivity combined.

What does the science actually say? For people without celiac disease, NCGS, or a wheat allergy, there’s no compelling evidence that a gluten-free diet improves health, reduces inflammation, boosts athletic performance, or prevents disease. A large 2017 study of over 100,000 participants without celiac disease found no association between long-term gluten consumption and heart disease risk — and in fact suggested that gluten-avoiders who cut back on whole grains might be inadvertently increasing their cardiovascular risk through lower dietary fiber and an increase in refined starches, sugars and fats in gluten substitutes.

There’s also a nutritional downside worth considering. Gluten-free processed foods — the breads, pastas, crackers, and cookies filling grocery shelves — are often lower in fiber, iron, zinc, B vitamins, and folate than their conventional counterparts. They tend to be higher in sugar and fat to compensate for gluten’s structural role. And they’re almost always more expensive.

On the other hand, for some people, adopting a gluten‑free pattern coincides with broader healthy changes—more fruits, vegetables, and home‑cooked meals—so perceived benefits may come from overall diet quality rather than gluten removal itself.

The bottom line from Harvard Medical School is clear: if you feel well and have no digestive symptoms, there’s no evidence that a gluten-free diet will help, and some modest evidence it might hurt.

That said, if you’re experiencing real, persistent gut symptoms and haven’t been evaluated, the right move isn’t to quietly go gluten-free and see if you feel better — it’s to see a doctor and get tested first. Eliminating gluten before testing can produce falsely negative results and close the diagnostic door on a condition that, left untreated, carries genuine long-term risks.

The Takeaway

Celiac disease is a serious autoimmune condition affecting about 1% of the population, with the majority still undiagnosed. It requires strict, permanent gluten avoidance and careful medical follow-up. Non-celiac gluten sensitivity occupies a legitimate but scientifically murkier space, affecting a real but incompletely defined group of people for whom reducing gluten makes practical sense. For everyone else — the majority of gluten-free shoppers — the science doesn’t support the hype. Gluten itself isn’t the villain; it’s just a protein. The real story is in the individual biology of those who can’t tolerate it.

Illustration generated by author using ChatGPT.

Sources:

· WebMD — Celiac Disease: Symptoms, Causes, and Treatment https://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease

· Merck Manual (Consumer Version) — Celiac Disease https://www.merckmanuals.com/home/digestive-disorders/malabsorption/celiac-disease

· Merck Manual (Professional Edition) — Celiac Disease https://www.merckmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/celiac-disease

· American Academy of Family Physicians (AAFP) — Diagnosis and Management of Celiac Disease: Guidelines From the American College of Gastroenterology (2024) https://www.aafp.org/pubs/afp/issues/2024/0100/practice-guidelines-celiac-disease.html

· Houston Methodist — Celiac Disease: Symptoms, Treatment and What To Know (2024) https://www.houstonmethodist.org/blog/articles/2024/jun/celiac-disease-symptoms-treatment-and-what-to-know/

· PMC / Nutrients Journal — The Gluten-Free Diet for Celiac Disease and Beyond https://pmc.ncbi.nlm.nih.gov/articles/PMC8625243/

· PMC / Diabetes Spectrum — The Gluten-Free Diet: Fad or Necessity? https://pmc.ncbi.nlm.nih.gov/articles/PMC5439366/

· Harvard T.H. Chan School of Public Health — Gluten: A Benefit or Harm to the Body? https://nutritionsource.hsph.harvard.edu/gluten/

·Harvard Health — Ditch the Gluten, Improve Your Health? https://www.health.harvard.edu/staying-healthy/ditch-the-gluten-improve-your-health

Medical Disclaimer

The information provided in this article is intended for general educational and informational purposes only and does not constitute medical advice. It should not be used as a substitute for professional medical advice, diagnosis, or treatment.

Always seek the guidance of a qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.

If you are experiencing a medical emergency, call 911 or your local emergency number immediately.

The author of this article is a licensed physician, but the views expressed here are solely those of the author and do not represent the official position of any hospital, health system, or medical organization with which the author may be affiliated.

Seeing Inside: A Guide to Modern Diagnostic Radiology

By John Turley

On March 16, 2026

In Medicine, Science

Not so long ago, if a doctor needed to know what was happening inside your body, the options were limited — a basic X-ray, an exploratory surgery, or educated guesswork. Today, a radiologist can map your brain’s blood vessels, detect a cancer smaller than a pea, or watch your heart metabolizing sugar in near real time — all without making a single incision.

The first medical X-ray appeared in 1895. For decades, imaging largely meant detecting fractures or large abnormalities. Today, radiology guides emergency care, cancer treatment, stroke therapy, cardiac management, and preventive medicine. Modern diagnostic imaging has transformed medicine in ways that would have seemed like science fiction to physicians just a few generations ago.

Modern imaging falls into three broad categories: structural imaging — what tissues look like, vascular imaging — how blood flows, and functional imaging — how cells behave metabolically. Here’s a plain-language guide to the big three: MRI/MRA, CT/CTA, and PET scans — what they are, how they work, and why they matter.

MRI and MRA: Magnets and Radio Waves

The MRI — magnetic resonance imaging — is one of the most versatile tools in modern medicine, and it works without a single ray of radiation. An MRI passes an electric current through coiled wires to create a temporary magnetic field in your body. A transmitter and receiver then send and receive radio waves, and a computer uses those signals to construct detailed digital images of whatever area is being scanned. Think of it as a very sophisticated tuning fork: it causes hydrogen atoms in your body’s water molecules to briefly align, then releases them — and the energy they emit on the way back creates the image. Because different tissues relax at different rates, MRI can distinguish gray matter from white matter in the brain, normal from inflamed or cancerous tissue, and ligament from muscle with impressive contrast.

The result is exceptional detail, especially for soft tissue. MRI scans take much clearer pictures of your brain, spinal cord, nerves, muscles, ligaments, and tendons than regular X-rays and CT scans. That’s why your orthopedic surgeon orders one when your knee goes sideways, and why neurologists reach for it when they suspect a stroke or multiple sclerosis.

MRA — magnetic resonance angiography — is MRI’s cousin, using the same magnetic technology but focused specifically on blood vessels. It lets physicians map arteries and veins in remarkable detail, identifying narrowing (stenosis), bulges (aneurysms), or blockages (occlusions) without the need for invasive catheterization. If your doctor suspects a blockage in the blood vessels feeding your brain or kidneys, an MRA can reveal it clearly. A contrast dye is sometimes injected to make vessels stand out even more sharply.

The main trade-offs with MRI are time and noise — scans generally take between 30 to 50 minutes, and the machine produces the kind of clanging racket that makes earplugs standard issue. People with certain metal implants or severe claustrophobia can’t always use it, which is where CT steps in.

CT and CTA: X-Rays, Upgraded

The CT scan — computed tomography — takes the familiar chest X-ray and turns it into something far more powerful. A CT scan takes multiple X-ray images from different angles rotating around the body, separates them by depth then processes them by computer to create cross-sectional views — essentially a detailed 3D picture rather than a flat 2D image. Think of slicing a loaf of bread: instead of seeing only the crust, you can examine every slice.

A CT shows more detail than a standard X-ray and is used to diagnose cancer, heart disease, injuries from trauma, and musculoskeletal disorders — it’s one of the most common imaging tests used today. Emergency departments rely on CT heavily because it’s fast, often completed in 10 to 15 minutes, and can quickly identify life-threatening conditions like internal bleeding or pulmonary embolism.

CTA — CT angiography — adds an injected contrast dye to the mix, allowing physicians to see blood vessels with high clarity. Contrasting agents help show various structures of the body more clearly, making CTA the go-to test for evaluating coronary arteries, aortic aneurysms, and vascular disease throughout the body. Unlike MRA, it’s faster and more widely available, though it does involve a dose of radiation — something physicians weigh carefully against the diagnostic benefit.

PET Scan: When Function Matters More Than Form

If MRI and CT show you the structure of the body, the PET scan — positron emission tomography — shows you what’s happening inside it. This is a fundamentally different question, and the technology reflects that.

A PET scan is used to see metabolism and chemical activity within your body. It can detect abnormal changes before structural changes occur — meaning it can detect cancer before a tumor is large enough to be seen on a CT or MRI. That’s a remarkable capability. The scan works by injecting a small amount of a radioactive tracer — most commonly a form of glucose — into your bloodstream. Diseased cells, particularly cancer cells, absorb more of the radiotracer than healthy ones do. Active cells consume glucose. Cancer cells, inflamed tissue, and active brain regions often use more glucose than surrounding tissue. These are called “hot spots,” and the PET scanner detects this radiation to produce images of affected tissue.

Beyond cancer, PET scans are invaluable in cardiology — showing whether heart muscle is still alive after a heart attack — and in neurology, helping diagnose Alzheimer’s disease, epilepsy, and brain tumors by revealing abnormal patterns of brain activity.

The trade-off is resolution. The image resolution of nuclear medicine images may not be as high as that of CT or MRI, which is why PET is rarely used alone today. Combined PET/CT scanners perform almost all PET scans today , marrying metabolic information with anatomical precision. Hybrid PET/MRI scanners are also emerging though not yet in widespread use. They are particularly valuable for soft-tissue cancers of the brain, liver, and pelvis.

How They Compare — and Why It Matters

The simplest way to think about these three technologies is this: CT shows shape and structure quickly, with emphasis on bone and dense tissue; MRI shows soft tissue in extraordinary detail without radiation; and PET shows function and cellular activity that neither of the others can see directly.

A patient with suspected cancer might undergo a CT scan to identify the location of a mass, followed by a PET to determine its metabolic activity, and then an MRI to map its relationship to critical soft tissues. Used together, these tools give physicians a picture of disease that is more complete than any single test could provide.

The value to modern medicine is difficult to overstate. These technologies allow doctors to diagnose conditions earlier, stage cancers more accurately, guide surgical planning, and monitor how well treatments are working — all without exploratory surgery. Survival rates for many cancers have improved substantially in part because imaging lets us find disease when it’s still manageable.

The era when medicine was largely guesswork about what lay beneath the skin is over. Today, radiologists are, in a very real sense, reading the body like an open book.

Illustration generated by author using ChatGPT.

Sources:

UNC Health Appalachian — MRI, CT, and PET Scan Comparison: https://www.unchealthappalachian.org/blog/2024/comparing-mri-ct-and-pet-scans-how-they-work-and-when-theyre-use/

WashU Mallinckrodt Institute of Radiology — Differences Between CT, MRI, and PET: https://www.mir.wustl.edu/do-you-know-the-differences-between-a-ct-mri-and-pet-scan/

Cleveland Clinic — PET Scan Overview: https://my.clevelandclinic.org/health/diagnostics/10123-pet-scan

RadiologyInfo.org — PET/CT: https://www.radiologyinfo.org/en/info/pet

Open MedScience — CT, MRI, and PET Differences: https://openmedscience.com/ct-mri-and-pet-scanners-unravelling-the-differences-in-modern-medical-imaging/

Healthline — MRI vs. PET Scan: https://www.healthline.com/health/mri-vs-pet-scan

Revere Health — MRI, CT, and PET Explained: https://reverehealth.com/live-better/mri-ct-pet/

Russel Vought and the War on the Environment

By John Turley

On February 16, 2026

In Commentary, History, Politics, Science

Recently, there’s been a a lot of attention given to RFK Jr. and his war on vaccines. More potentially devastating than that is Russel Vought and his war on environmental science.
Russell Vought hasn’t exactly been working in the shadows. As the director of the Office of Management and Budget since February 2025, he’s been methodically implementing what he outlined years earlier in Project 2025—a blueprint that treats climate science not as settled fact, but as what he calls “climate fanaticism.” The result is undeniably the most aggressive dismantling of environmental protections in American history.
The Man Behind the Plan
Vought’s resume tells you everything you need to know about his approach. He served as OMB director during Trump’s first term, wrote a key chapter of Project 2025 focusing on consolidating presidential power, and has openly stated his goal is to make federal bureaucrats feel “traumatized” when they come to work. His philosophy on climate policy specifically? He’s called climate change a side effect of building the modern world—something to manage through deregulation rather than prevention.
Attacking the Foundation: The Endangerment Finding
The centerpiece of Vought’s climate strategy targets what EPA Administrator Lee Zeldin has called “the holy grail of the climate change religion”—the 2009 Endangerment Finding. This Obama-era scientific determination concluded that six greenhouse gases (carbon dioxide, methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons, and sulfur hexafluoride) endanger public health and welfare. It sounds technical, but it’s the legal foundation for virtually every federal climate regulation enacted over the past fifteen years.
Just last week EPA Administrator Zeldin announced that the Trump administration has repealed this finding. This action strips EPA’s authority to regulate greenhouse gas emissions under the Clean Air Act—meaning no more federal limits on power plant emissions, no vehicle fuel economy standards tied to climate concerns, and no requirement for industries to measure or report their emissions. White House press secretary Karoline Leavitt said this action “will be the largest deregulatory action in American history.”
More than 1,000 scientists warned Zeldin not to take this step, and the Environmental Protection Network cautioned last year that repealing the finding would cause “tens of thousands of additional premature deaths due to pollution exposure” and would spark “accelerated climate destabilization.” Abigail Dillen president of the nonprofit law firm Earthjustice said “there is no way to reconcile EPA’s decision with the law, the science and the reality of the disasters that are hitting us harder every year.” She further said they expect to see the Trump administration in court. Obviously, the science is less important to Trump, Zeldin and Vought than the politics.
The Thirty-One Targets
In March 2025, Zeldin announced what he proudly called “the greatest day of deregulation in American history”—a plan to roll back or reconsider 31 key environmental rules covering everything from clean air to water quality. The list reads like a regulatory hit parade, including vehicle emission standards (designed to encourage electric vehicles), power plant pollution limits, methane regulations for oil and gas operations, and even particulate matter standards that protect against respiratory disease.
The vehicle standards are particularly revealing. The transportation sector is America’s largest source of greenhouse gas emissions, and the Biden-era rules were crafted to nudge automakers toward producing more electric vehicles. At Vought’s direction, the EPA is now reconsidering these, with Zeldin arguing they “regulate out of existence” segments of the economy and cost Americans “a lot of money.”
Gutting the Science Infrastructure
Vought’s agenda extends beyond specific regulations to the institutions that produce climate science itself. In Project 2025, he proposed abolishing the Office of Domestic Climate Policy and suggested the president should refuse to accept federal scientific research like the U.S. National Climate Assessment (NCA). The NCA, published every few years, involves hundreds of scientists examining how climate change is transforming the United States—research that informs everything from building codes to insurance policies.
According to reporting from E&E News in January, Vought wants the White House to exert tighter control over the next NCA, potentially elevating perspectives from climate deniers and industry representatives while excluding contributions made during the Biden administration. This is a plan that has been in the works for years. Vought reportedly participated in a White House meeting during Trump’s first term where officials discussed firing the scientists working on the assessment.
The National Oceanic and Atmospheric Administration (NOAA) has also been targeted. In February 2025, about 800 NOAA employees—responsible for weather forecasting, climate monitoring, fisheries management, and marine research were fired. Project 2025 had proposed breaking up NOAA entirely, and concerned staff members have already begun a scramble to preserve massive amounts of climate data in case the agency is dismantled.
Budget Cuts as Policy
Vought’s Center for Renewing America has proposed eliminating the Department of Energy’s Office of Energy Efficiency and Renewable Energy, the EPA’s environmental justice fund, and the Low Income Home Energy Assistance Program. During the first Trump administration, Vought oversaw budgets proposing EPA cuts as steep as 31%—reducing the agency to funding levels not seen in decades. In a 2023 speech, he explained the logic bluntly: “We want their funding to be shut down so that the EPA can’t do all of the rules against our energy industry because they have no bandwidth financially to do so.”
This isn’t just about climate, it is also about fairness and the recognition that environmental policies have had a predominately negative effect on low income areas. EPA has cancelled 400 environmental justice grants, closed environmental justice offices at all 10 regional offices, and put the director of the $27 billion Greenhouse Gas Reduction Fund on administrative leave. The fund had been financing local economic development projects aimed at lowering energy prices and reducing emissions.
Eliminating Climate Considerations from Government
Perhaps more insidious than the high-profile rollbacks are the procedural changes that make climate considerations disappear from federal decision-making. In February, Jeffrey Clark—acting administrator of the Office of Information and Regulatory Affairs (OIRA) under Vought’s OMB—directed federal agencies to stop using the “social cost of carbon” in their analyses. This metric calculates the dollar value of damage caused by one ton of carbon pollution, allowing agencies to accurately assess whether regulations produce net benefits or defects for society.
Vought has also directed agencies to establish sunset dates for environmental regulations—essentially automatic expiration dates after which rules stop being enforced unless renewed. For existing regulations, the sunset comes after one year; for new ones, within five years. The stated goal is forcing agencies to continuously justify their rules, but the practical effect is creating a perpetual cycle of regulatory uncertainty.
The Real-World Stakes
The timing of these rollbacks offers a grim irony. As Vought was pushing to weaken the National Climate Assessment in January 2025, the Eaton and Palisades fires were devastating Los Angeles—exactly the type of climate-intensified disaster the assessment is designed to help communities prepare for. The administration’s response? Energy Secretary Chris Wright described climate change as “a side effect of building the modern world” at an industry conference.
An analysis by Energy Innovation, a nonpartisan think tank, found that Project 2025’s proposals to gut federal policies encouraging renewable electricity and electric vehicles would increase U.S. household spending on fuel and utilities by about $240 per year over the next five years. That’s before accounting for the health costs of increased air pollution or the economic damage from unmitigated climate change.
Environmental groups have vowed to challenge these changes in court, and the legal battles will likely stretch on for years. The D.C. Circuit Court of Appeals will hear many cases initially, though the Supreme Court will probably issue final decisions. Legal experts note that while Trump’s EPA moved with unprecedented speed on proposals in 2025, finalizing these rules through the required regulatory process will take much longer. As of December, none of the major climate rule repeals had been submitted to OMB for final review, partly due to what EPA called a 43-day government shutdown (which EPA blamed on Democrats, though the characterization is widely disputed).
What Makes This Different
Previous administrations have certainly rolled back environmental regulations, but Vought’s approach differs in both scope and philosophy. Rather than tweaking specific rules or relaxing enforcement, he’s systematically attacking the scientific and legal foundations that make climate regulation possible. It’s the difference between turning down the thermostat and ripping out the entire heating system.
The Environmental Defense Fund, which rarely comments on political appointees, strongly opposed Vought’s confirmation, with Executive Director Amanda Leland stating: “Russ Vought has made clear his contempt for the people working every day to ensure their fellow Americans have clean air, clean water and a safer climate.”
Looking Forward
Whether Vought’s vision becomes permanent depends largely on how courts rule on these changes. The 2007 Supreme Court decision in Massachusetts v. EPA established that the agency has authority to regulate greenhouse gases as air pollutants under the Clean Air Act—the very authority Vought is now trying to eliminate. Overturning established precedent is difficult, though the current Supreme Court’s composition makes the outcome possible, if not likely.
What we’re witnessing is essentially a test of whether one administration can permanently disable the federal government’s capacity to address climate change, or if these changes represent a temporary setback that future administrations can reverse. The stakes couldn’t be higher: atmospheric CO2 concentrations continue rising, global temperatures are breaking records, and climate-related disasters are becoming more frequent and severe. Nothing less than the future of our way of life is at stake. We must take action now.

Full disclosure: my undergraduate degree is in meteorology, but I would never call myself a meteorologist since I have never worked in the field. But I still maintain an interest, from both a meteorological and a medical perspective. The Grump Doc is never lacking in opinions.

Illustration generated by author using Midjourney.

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