The Grumpy Doc

Grumpy opinions about everything.

Black Soldiers on Both Sides: The Complex Story of African Americans in the Revolutionary War

By

On February 20, 2026

In History

When we picture the American Revolution, we often imagine Continental soldiers in blue coats facing off against British redcoats—but this image leaves out thousands of crucial participants. Between 5,000 and 8,000 Black men fought for the Patriot cause, while an estimated 20,000 joined the British forces. Their stories reveal the war’s profound contradictions and the complex choices Black Americans faced when white colonists fought for “liberty” while holding hundreds of thousands of people in bondage. Their participation reflected the Revolution’s central paradox: a war waged in the name of liberty within a society deeply dependent on slavery.

The irony wasn’t lost on anyone at the time. As Abigail Adams wrote in 1774, “it always appeared a most iniquitous scheme to me to fight ourselves for what we are daily robbing and plundering from those who have as good a right to freedom as we have”.

For most Black participants, the key question was which side offered the clearest path out of bondage rather than abstract allegiance to King or Congress.  The tension between revolutionary rhetoric and the reality of slavery shaped every decision Black Americans made about which side to support.  This dynamic meant that enslaved people frequently escaped to British forces, while free Blacks (especially in New England) were more likely, though not exclusively, to enlist with the Patriots where they already had tenuous civic footholds

The British Offer: “Liberty to Slaves”

In November 1775, Virginia’s royal governor Lord Dunmore made a move that sent shockwaves through the colonies. With his military position deteriorating and losing men under his command, Dunmore issued a proclamation offering freedom to any enslaved person who abandoned their Patriot masters and joined British forces. The proclamation declared “all indented servants, Negroes, or others (appertaining to rebels) free, that are able and willing to bear arms”.

The response was immediate. Within a month, an estimated 300 Black men had enlisted in what Dunmore called the “Royal Ethiopian Regiment,” eventually growing to about 800 men.  Their uniforms were emblazoned with the provocative words “Liberty to Slaves.” The name “Ethiopian” wasn’t random—it referenced ancient associations of Ethiopia with wisdom and nobility. These soldiers saw action at the Battle of Kemp’s Landing, where—in a moment rich with symbolic meaning—one previously enslaved soldier captured his former master, militia colonel Joseph Hutchings.

Dunmore’s promise came with devastating costs. The regiment’s only other major battle was the disastrous British defeat at Great Bridge in December 1775. Far worse was the disease that ravaged the Black soldiers’ ranks. As the Virginia Gazette reported in March 1776, “the jail distemper rages with great violence on board Lord Dunmore’s fleet, particularly among the negro forces”. Disease ultimately killed more of Dunmore’s recruits than combat, as was common among all armies of the time. By 1776, Dunmore was forced to flee Virginia, taking only about 300 survivors with him.

The Patriot Response: Reluctant Acceptance

The Continental Army’s relationship with Black soldiers was complicated from the start. Black men fought at Lexington and Concord.  They also distinguished themselves at Bunker Hill, where Black patriot Salem Poor performed so heroically that fourteen officers petitioned the Massachusetts legislature to recognize his “brave and gallant” service.

But in November 1775, just days after Dunmore’s Proclamation, George Washington—himself a Virginia slaveholder—banned the recruitment of all Black men. The ban didn’t last long. The British continued recruiting Black soldiers, and Washington faced a simple reality: he desperately needed troops. By early 1778, after the brutal winter at Valley Forge had decimated his forces, Washington grudgingly allowed states to enlist Black soldiers. Rhode Island led the way with legislation that promised immediate freedom to any “able-bodied negro, mulatto, or Indian man slave” who enlisted, with the state compensating slaveholders for their “property”.

The result was the 1st Rhode Island Regiment, which became known as the “Black Regiment.” Of its roughly 225 soldiers, about 140 were Black or Native American men. The regiment fought at the Battle of Rhode Island in August 1778, where they held their position against repeated British and Hessian charges—a performance that earned them, according to Major General John Sullivan, “a proper share of the day’s honors”. They went on to fight at Yorktown, where they stood alongside southern militiamen whose peacetime job had been hunting runaway slaves.

Throughout the Continental Army, Black soldiers generally served in integrated units. One French officer estimated that a quarter of Washington’s army was Black—though historians believe 10 to 15 percent is more accurate. As one historian noted, “In the rest of the Army, the few blacks who served with each company were fully integrated: They fought, drilled, marched, ate and slept alongside their white counterparts.”

Naval service—on both sides—was often more racially integrated than the army. Black men served as sailors, gunners, and marines in the Royal Navy and the Continental Navy. Maritime labor traditions had long been more flexible on race, and skill mattered more than status.

Free Blacks in northern towns could enlist much like white common citizens, sometimes motivated by pay, local patriotism, and the hope that visible service would strengthen claims to equal rights after the war.  Enslaved men rarely chose independently; Patriot masters often enlisted them as substitutes to avoid service, while Loyalist masters sometimes allowed or forced them to join British units. In both cases emancipation promises were unevenly honored.

Some enslavers freed men in advance of service, others promised manumission afterward and reneged, while still others simply collected bounties or commutation while trying to retain control over Black veterans. On the British side, imperial policy also vacillated, with some officers fully supporting freedom for Black refugees tied to rebel masters, and others quietly returning runaways to Loyalist owners or exploiting them as unpaid labor.​

The Promise and the Betrayal

As the war ended, the gulf between British and American treatment of their Black allies became stark. In 1783, as British forces prepared to evacuate New York, General George Washington demanded the return of all formerly enslaved people as “property” under the Treaty of Paris. British commander Sir Guy Carleton refused. Instead, he created the “Book of Negroes”—a ledger documenting about 3,000 Black Loyalists who were granted certificates of freedom and evacuated to Nova Scotia, England, Germany, and British territories.

The Book provides glimpses of individual journeys. Boston King, who had escaped slavery in South Carolina to join the British, was evacuated with his wife Violet to Nova Scotia. Their entry simply notes Violet as a “stout wench”—a reminder that even their liberators viewed them through racist lenses. Harry Washington, who had escaped from George Washington’s Mount Vernon plantation, also reached Nova Scotia and later became a leader in the resettlement to Sierra Leone.

Nova Scotia proved no paradise. Black Loyalists received inferior land—rocky and infertile compared to what white Loyalists received. They faced discrimination, exploitation, and broken promises about land grants. By 1792, nearly 1,200 Black Loyalists—about half of those in Nova Scotia—accepted an offer to resettle in Sierra Leone, where they founded Freetown.

For Black Patriots, the outcome was often worse. While some white soldiers received up to 100 acres of land and military pensions from Congress, Black soldiers who had been promised freedom often received nothing beyond freedom—and some didn’t even get that. As one historian put it, they were “dumped back into civilian society”. In June 1784, thirteen veterans of the Rhode Island Regiment had to hire a lawyer just to petition for their back pay. The state responded with an act that classified them as “paupers, who heretofore were slaves” and ordered towns to provide charity.

Lieutenant Colonel Jeremiah Olney, who commanded the Rhode Island Regiment after Christopher Greene’s death, spent years advocating for his former soldiers—fighting attempts to re-enslave them and supporting their pension claims. Some soldiers, like Jack Sisson, finally received pensions decades later in 1818—forty years after they’d enlisted, and often too late. Many died before seeing any recognition.

Even more cruelly, many Black soldiers who had been promised freedom by their masters were returned to slavery after the war. Some remained enslaved for a few years until their owners honored their promises; others remained enslaved permanently, having fought for a freedom they would never experience.

It is plausible that the widespread participation of Black soldiers subtly accelerated Northern emancipation by making slavery harder to justify ideologically, even as Southern resistance hardened.

The Larger Meaning

The American Revolution was the last time the U.S. military would be significantly integrated until President Truman’s Executive Order 9981 in 1948. In 1792, Congress passed legislation limiting military service to “free, able-bodied, white male citizens”—a restriction that would last for generations.

Yet the Revolutionary War period saw more enslaved people gain their freedom than any other time before the Civil War. Historian Gary Nash estimates that between 80,000 and 100,000 enslaved people escaped throughout the thirteen colonies during the war—not all joined the military, but the war created opportunities for flight that many seized.

As historian Edward Countryman notes, the Revolution forced Americans to confront a question that Black Americans had been raising all along: “What does the revolutionary promise of freedom and democracy mean for African Americans?” The white founders failed to answer that question satisfactorily, but the thousands of Black soldiers who fought—on both sides—had already answered it with their lives. They understood that liberty was worth fighting for, even when the people promising it had no intention of extending it to everyone.

Image generated by author using ChatGPT.

Sources

  • “African Americans in the Revolutionary War,” Wikipedia.
  • Museum of the American Revolution, “Black Patriots and Loyalists” and “Black Founders: Black Soldiers and Sailors in the Revolutionary War.”​
  • Gilder Lehrman Institute, “African American Patriots in the Revolution.”​
  • National Archives blog, “African Americans and the American War for Independence.”​
  • Douglas R. Egerton, Death or Liberty: African Americans and Revolutionary America (individual stories on both Patriot and Loyalist sides).
  • Edward Countryman, The American Revolution.
  • Gary B. Nash, The Forgotten Fifth: African Americans in the Age of Revolution.
  • Alan Gilbert, Black Patriots and Loyalists: Fighting for Emancipation in the War for Independence.​
  • DAR, Forgotten Patriots – African American and American Indian Patriots in the Revolutionary War: A Guide to Service, Sources, and Studies).​
  • NYPL LibGuide, “Black Experience of the American Revolution”
  • American Battlefield Trust, “10 Facts: Black Patriots in the American Revolution.”​
  • Massachusetts Historical Society, “Revolutionary Participation: African Americans in the American Revolution.”
  • Fraunces Tavern Museum, “Enlistment of Freed and Enslaved Blacks in the Continental Army.”​
  • American Independence Museum, “African-American Soldiers’ Service During the Revolutionary War.”​
  • Encyclopedia Virginia, “Lord Dunmore’s Ethiopian Regiment.”​
  • Mount Vernon, “Dunmore’s Proclamation and Black Loyalists” and “The Ethiopian Regiment.”​
  • American Battlefield Trust, “Lord Dunmore’s Ethiopian Regiment”
  • Lord Dunmore’s Proclamation (1775), in transcription with context at Gilder Lehrman, Encyclopedia Virginia, and Mount Vernon.​
  • “Book of Negroes” (1783 evacuation ledger of Black Loyalists to Nova Scotia; digital copies and discussions via BlackPast and Dictionary of Canadian Biography).​
  • Boston King, “Memoirs of the Life of Boston King, a Black Preacher,” Methodist Magazine (1798)
  • NYPL “Black Experience of the American Revolution”
  • 1st Rhode Island Regiment, World History Encyclopedia

Strengthening Your Defenses: Understanding and Improving Immune Health in Your Golden Years

By

On February 18, 2026

In Medicine

Getting older comes with plenty of perks—wisdom, perspective, maybe even a better appreciation for a quiet Sunday morning. But one thing that doesn’t improve with age is your immune system. If you’ve noticed that colds seem to hang on longer than they used to, or that recovering from illness takes more time, you’re not imagining things. The aging immune system undergoes real, measurable changes that can affect your health in significant ways.

Understanding Your Immune System

Think of your immune system as an incredibly sophisticated security network spread throughout your entire body. Unlike your heart or lungs, it’s not located in one place—according to the Mayo Clinic, your immune system is essentially a giant collection of cells that travel through your blood and tissues, constantly patrolling for anything that doesn’t belong.

Your immune defense operates on two levels. The first responders are part of what’s called the innate immune system. It begins with the skin and mucous membranes that act as a barrier.  They are backed up by specialized cells—including macrophages, neutrophils, and natural killer cells that act like scouts, surveying your body for foreign particles like bacteria, viruses, or damaged cells. When they detect something foreign, they sound an alarm and start an immune response triggering inflammation, your body’s response to attack which causes swelling, redness, and heat at infection sites.

This is the signal for your second line of defense—your adaptive immune system—to begin a more specialized and sophisticated attack against the invaders. This system includes T cells that attack and kill infected cells and B cells that make antibodies.  They learn to recognize specific pathogens and once they encounter a particular germ, they remember it. In the future, if you’re exposed to the same germ, your adaptive immune system will mount a more effective and swifter response. This is why you only get chickenpox once, and it’s the principle behind vaccination.

What Happens When the System Ages

Starting around your sixties, your immune system begins what scientists call immunosenescence—a gradual but significant decline in immune function. This isn’t just one simple change, but rather a cascade of alterations affecting both your innate and adaptive immune systems.

One of the most significant changes happens in your thymus, a small organ behind your breastbone that produces T cells. The process of involution involves significant structural thymic changes, including a reduction in size, a decrease in functional thymic tissue, and fatty replacement of the thymic parenchyma.   As a result, you produce fewer fresh T cells to respond to new threats.

At the same time, something paradoxical happens: while your immune system becomes less effective at fighting infections, it also becomes more inflammatory. This chronic inflamed state contributes to biological aging and the development of age-related pathologies. Scientists call this “inflammaging”—chronic low-grade inflammation that persists throughout the body.

The practical consequences are significant. The immune system becomes slower to respond, which increases your risk of getting sick; it also means flu shots or other vaccines may not work as well or protect you for as long as expected. You’re also at higher risk for autoimmune disorders where your immune system mistakenly attacks healthy tissue. Wounds will heal more slowly.

Why Immune Function Declines

Multiple factors contribute to immune aging beyond just the passage of time. Chronic viral infections play a surprising role. Latent and chronic viral infections such as human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) affect the immune system and contribute to immunosenescence . These viruses lie dormant for years and when your immune system begins to age it is no longer able to effectively suppress them. They become active, and your immune system is put on perpetual alert, expressed as chronic inflammation, gradually wearing it down even further.

Your cells also undergo changes at the molecular level. With each cell division, the protective caps on your chromosomes called telomeres get shorter. Eventually, this limits your immune cells’ ability to divide and respond to threats. The shift in immune cell populations is dramatic—you have fewer naive cells ready to respond to new infections and more memory cells dedicated to past threats, which means you’re well-protected against diseases you’ve already had but vulnerable to new ones. Your immune army is continuing to prepare for the last war.

Chronic health conditions that become more common with age—diabetes, heart disease, kidney disease, chronic lung conditions—all accelerate immune aging. Even lifestyle factors like chronic stress, poor sleep, smoking, and excessive alcohol consumption take a heavier toll on your immune system as you age. 

Strengthening Your Immune Defenses

The good news is that lifestyle interventions can meaningfully improve immune function in older adults. The evidence is particularly strong for several key strategies.

Physical Activity Makes a Real Difference

Exercise isn’t just about staying fit—it’s one of the most powerful immune boosters available. Regular exercise mitigates the aging processes of both the innate and adaptive immune system, particularly being associated with improved natural killer cell functioning. Studies comparing physically active older adults to sedentary ones consistently show better immune cell function in the active group.

The type and amount of exercise matters. Mayo Clinic recommends two strength training sessions and 150 minutes of moderate cardiovascular exercise weekly. But you don’t need to become a marathon runner—walking, swimming, cycling, yoga, and tai chi all provide significant benefits. Research shows that influenza vaccine responses are improved in active elderly populations, as demonstrated by higher antibody titers following 10 months of aerobic physical exercise.

The key is consistency and not overdoing it. Moderate, regular exercise strengthens your immune system, while extreme exercise can temporarily suppress it.

Nutrition: Fueling Your Immune Defense

What you eat directly impacts how well your immune system functions. The evidence supports focusing on whole, minimally processed foods rather than any specific “superfood” or restrictive diet. A balanced nutritious diet incorporating a variety of fruits and vegetables, whole grains, proteins, and probiotics positively impacts the immune system.  

Several specific nutrients deserve attention. Protein becomes increasingly important with age because tryptophan, an essential amino acid found in protein-based foods including eggs, fish, dairy products, legumes, and meat, plays important roles in immune function. Omega-3 fatty acids from fish have anti-inflammatory properties that may help counter inflammaging.

The gut-immune connection is particularly important. Your gut contains roughly 70% of your immune system, and the bacteria living there directly influence immune function. Probiotic-rich foods like yogurt, sour cream and cottage cheese, some aged cheeses, and fermented vegetables (sauerkraut, some pickles) help maintain a healthy gut microbiome, which in turn supports immune health.

Certain vitamins and minerals play outsized roles in immune function. Vitamin D is crucial—it mediates immune function and regulation, strengthening of epithelial barriers and antioxidant defense. Unfortunately, it’s estimated that 95% of Americans don’t receive enough vitamin D from their diet alone, and nearly one-third have a vitamin D deficiency.

Zinc is another critical nutrient. Zinc exerts direct anti-viral effects and serves as a cofactor of dozens of proteins important for immune function and antioxidative defense, yet 15% of Americans are not meeting zinc needs from food alone and 30% of the world’s elderly population have a zinc deficiency.

Selenium, while needed in smaller amounts, is equally important. Selenium plays a role in anti-inflammatory, antiviral, and immune-cell activity and is useful in both innate and adaptive immunity through selenoproteins that partly reduce oxidative stress generated by viral pathogens.

Sleep: Your Immune System’s Recovery Time

Sleep isn’t just rest—it’s when your immune system does critical maintenance work. While you sleep, your body produces cytokines, a protein that helps regulate immune responses and fight off infections, and when you lack proper sleep, this decreases the amount of cytokines your body produces. The recommendation is clear: aim for seven to eight hours of quality, uninterrupted sleep per night.

Sleep quality matters as much as quantity. If you’re experiencing insomnia or sleep disruptions, addressing them should be a priority because poor sleep is linked not just to reduced immune function but also to increased risk of chronic diseases.

Stress Management and Social Connection

Chronic stress suppresses immune function in measurable ways. Finding effective stress management techniques—whether meditation, deep breathing, enjoyable hobbies, or time in nature—isn’t just about feeling better emotionally. These practices have real physiological effects on immune function.

Social connection matters more than you might think. Social isolation and loneliness are associated with increased inflammation and reduced immune function. Maintaining meaningful social connections, whether through family, friends, community groups, or religious organizations, appear to have genuine immune benefits.

Vaccination: Working With Your Immune System

Vaccines remain highly effective and are crucial for older adults. Vaccines introduce your immune system to viruses in a controlled manner, helping the adaptive immune system spot and neutralize germs more quickly. Staying current with recommended vaccines—including annual flu shots, pneumonia vaccines, RSV vaccines, shingles vaccines, and COVID-19 boosters—is one of the most effective ways to prevent serious illness.

The Supplement Question

While a balanced diet should be the foundation, supplements can fill genuine gaps, especially for nutrients like vitamin D that are difficult to obtain adequately from food alone. However, researchers still don’t know all the effects of lifestyle on the immune system, and there are no scientifically proven direct links between specific supplements and enhanced immune function in all contexts.

That said, if you’re deficient in specific nutrients, supplementation can help. Supplementation of higher dosages of vitamins D, C, and zinc may have positive effects during viral infections in deficient individuals. The key is working with your doctor to identify any actual deficiencies before starting supplements, because more isn’t always better, and some supplements can interact with medications.

Other Practical Steps

Some immune boosters are refreshingly simple. Hand washing remains one of the most effective ways to prevent infections. Staying hydrated helps your body flush out toxins and keeps immune cells functioning optimally. Not smoking—or quitting if you do—significantly improves immune function because smoking directly damages immune cells and increases inflammation.  Excessive alcohol use also increases inflammation and is a significant source of free radicals.

Getting moderate sun exposure provides natural vitamin D while also offering stress-reduction benefits. Even 15-30 minutes of outdoor time daily can make a difference, though you need to balance sun exposure with skin cancer prevention.

Weight management can help prevent or reverse insulin resistance and metabolic syndrome reducing inflammation and slowing immunosenescence.

The Bottom Line

The aging immune system faces real challenges, but it’s far from helpless. While lifestyle changes don’t guarantee perfect immunity, every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies.

The most effective approach to an improved immune system combines multiple strategies: regular moderate exercise, a varied diet rich in whole foods with adequate protein and micronutrients, quality sleep, stress management, social connection, staying current with vaccinations, and addressing specific nutritional deficiencies through supplementation when needed. None of these interventions will turn back the clock, but together they can meaningfully improve immune resilience and your ability to fight off infections and recover from illness.

Illustration generated by author using Midjourney

Sources

  1. National Center for Biotechnology Information – “Aging of the Immune System: Mechanisms and Therapeutic Targets”
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5291468/
  2. MDPI Vaccines – “Immunosenescence: Aging and Immune System Decline”
    https://www.mdpi.com/2076-393X/12/12/1314
  3. Frontiers in Aging – “The 3 I’s of immunity and aging: immunosenescence, inflammaging, and immune resilience”
    https://www.frontiersin.org/journals/aging/articles/10.3389/fragi.2024.1490302/full
  4. Frontiers in Aging – “Immune Senescence, Immunosenescence and Aging”
    https://www.frontiersin.org/journals/aging/articles/10.3389/fragi.2022.900028/full
  5. National Center for Biotechnology Information – “Physical Activity and Diet Shape the Immune System during Aging”
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7146449/
  6. National Center for Biotechnology Information – “Aging and the Immune System: the Impact of Immunosenescence on Viral Infection”
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6943173/
  7. National Center for Biotechnology Information – “Physical Activity and Nutritional Influence on Immune Function”
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8531728/
  8. National Center for Biotechnology Information – “Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids”
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7415215/
  9. National Center for Biotechnology Information – “Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on COVID-19”
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8571905/
  1. MedlinePlus Medical Encyclopedia – “Aging changes in immunity”
    https://medlineplus.gov/ency/article/004008.htm
  2. Mayo Clinic Press – “Aging and the immune system: Strengthening your body’s defenses”
    https://mcpress.mayoclinic.org/healthy-aging/aging-and-the-immune-system/
  3. Harvard Health Publishing – “How to boost your immune system”
    https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system
  4. Greater Good Health – “Understanding How Seniors Can Boost Their Immune Systems”
    https://greatergoodhealth.com/patients/how-can-seniors-boost-their-immune-systems/
  5. Nature Made – “Super D Immune Complex” (Nutritional information on vitamin D, zinc, and selenium)
    https://www.naturemade.com/products/super-d-immune-complex

Who Will Cover City Hall Now? Democracy in the Age of News Deserts

By

On February 17, 2026

In Commentary, History, Politics

Were it left to me to decide whether we should have a government without newspapers, or newspapers without a government, I should not hesitate a moment to prefer the latter. But I should mean that every man should receive those papers and be capable of reading them. —Thomas Jefferson


I originally posted this article about a year and a half ago. I was concerned about the future of newspapers then and I’m even more concerned now. I’ve updated my original post to reflect recent losses of newspapers.
When I was growing up in Charleston WV in the 1950s and early 1960s, we had two daily newspapers. The Gazette was delivered in the morning and the Daily Mail was delivered in the afternoon. One of my first jobs as a boy was delivering The Gazette. It worked out to be about 50 cents an hour, but I was glad to have the job. (It was good money at the time.)
Ostensibly, the Gazette was a Democratic newspaper, and the Daily Mail was a Republican one. However, given the politics of the day there was not a significant difference between the two, and most people subscribed to both.
There weren’t a lot of options for news at the time. Of course, there were no 24-hour news channels. National news on the three networks was about 30 minutes an evening with local news at about 15 minutes. By the late 1960s national news had increased to 60 minutes and most local news to about 30 minutes. Although, given the limitations of time on the local stations, most of the broadcast was taken up with weather, sports, and human interest stories with little time left to expand on hard news stories.
We depended on our newspapers for news of our cities, counties, and states. And the newspapers delivered the news we needed. Almost everyone subscribed to and read the local papers. They kept us informed about our local politicians and government and provided local insight on national events. They were also our source for information about births, deaths, marriages, high school graduations and everything we wanted to know about our community.
In the 21st century there are many more supposed news options. There are 24-hour news networks as I’ve talked about in a previous post.  And of course, there are Instagram, Facebook, X and the other online entities that claim to provide news.
There has been one positive development in television news. Local news, at least in Charleston, has expanded to two hours most evenings. There is some repetition between the first and second hour and it is still heavily weighted to sports, weather, and human interest, but there is some increased coverage of local hard news. However, this is somewhat akin to reading the headlines and the first paragraph in a newspaper story. It doesn’t provide in-depth coverage, but it is improved over what otherwise is available to those who don’t watch a dedicated news show. Hopefully, it motivates people to find out more about events that concern them.
The situation has become dire in recent months. The crisis that was building when I first wrote about newspapers has now reached catastrophic proportions. On December 31, 2025, the Atlanta Journal-Constitution published its last print edition after 157 years, making Atlanta the largest U.S. metro area without a printed daily newspaper. Think about that—a major American city, home to over six million people in its metro area, now has no physical newspaper you can hold in your hands.
Just weeks ago in February 2025, the Newark Star-Ledger, New Jersey’s largest newspaper, stopped printing after nearly 200 years. The Jersey Journal, which had served Hudson County for 157 years, closed entirely. These weren’t small-town weeklies—these were major metropolitan dailies that once served millions of readers. The Pittsburgh Post Gazette, founded in 1786, has announced that it will cease publication effective May 3, 2026.
Even more alarming is what just happened at the Washington Post. Just days ago, in early February 2026, owner Jeff Bezos ordered the elimination of roughly one-third of the newspaper’s workforce—approximately 300 journalists. The Post closed its entire sports section, shuttered its books department, gutted its foreign bureaus and metro desk, and canceled its flagship daily podcast. This is the same newspaper that brought down a presidency with its Watergate coverage and has won dozens of Pulitzer Prizes. The Post’s metro desk, which once had 40 reporters covering the nation’s capital, now has just a dozen. All the paper’s photojournalists were laid off. The entire Middle East team was eliminated.
Former Washington Post executive editor Martin Baron, who led the paper from 2013 to 2021, called the cuts devastating and blamed poor management decisions, including Bezos’s decision to spike the newspaper’s presidential endorsement in 2024, which led to the cancellation of hundreds of thousands of subscriptions. The Post lost an estimated $100 million in 2024.
The numbers tell a grim story. Since 2005, more than 3,200 newspapers have closed in the United States—that’s over one-third of all the newspapers that existed just twenty years ago. Newspapers continue to disappear at a rate of more than two per week. In the past year alone, 136 newspapers shut their doors.
Fewer than 5,600 newspapers now remain in America, and less than 1,000 of those are dailies. Even among those “dailies,” more than 80 percent print fewer than seven days a week. We now have 213 counties that are complete “news deserts”—places with no local news source at all. Another 1,524 counties have only one remaining news source, usually a struggling weekly newspaper. Taken together, about 50 million Americans now have limited or no access to local news.
Will TV news be able to provide the details about our community? The format of the newspaper allows for more detailed presentations and for a larger variety of stories. The reader can pick which stories to read, when to read them and how much of each to read. The very nature of broadcast news doesn’t allow these options.
I beg everyone to please subscribe to your local newspapers if you still have one. Though I still prefer the hands-on, physical newspaper, I understand many people want to keep up with the digital age. If you do, please subscribe to the digital editions of your local newspaper and don’t pretend that the other online sources, such as social media, will provide you with local news. More likely, you’ll just get gossip, or worse.
If we lose our local news, we are in danger of losing our freedom of information and if we lose that, we’re in danger of losing our country. For those of you who think I’m fear mongering, countries that have succumbed to dictatorship have first lost their free press.
I believe that broadcast news will never be the free press that print journalism is. The broadcast is an ethereal thing. You hear it and it’s gone. Of course, it is always possible to record it and play it back, but most people don’t. If you have a newspaper, you can read it, think about it, and read it again. There are times when on my second or third reading of an editorial or an op-ed article, I’ve changed my opinion about either the subject or the writer of the piece. I don’t think a news broadcast lends itself to this type of reflection. In fact, when listening to the broadcast news I often find my mind wandering as something that the broadcaster said sends me in a different direction.
In my opinion, broadcast news is controlled by advertising dollars and viewer ratings. News seems to be treated like any entertainment program, catering to what generates ratings rather than facts. I recognize that this can be the case with newspapers as well, but it seems to me that it’s much easier to detect bias in the written word than in the spoken word. Too often we can get caught up in the emotions of the presenter or in the graphics that accompany the story.
With that in mind, I recommend that if you want unbiased journalism, please support your local newspapers before we lose them. Once they are gone, we will never get them back and we will all be much the poorer as a result.
I will leave you with one last quote.
A free press is the unsleeping guardian of every other right that free men prize; it is the most dangerous foe of tyranny. —Winston Churchill
The only way to preserve freedom is to preserve the free press. Do your part! Subscribe!
And you can quote The Grumpy Doc on that!!!!

Sources
Fortune (August 29, 2025): “Atlanta becomes largest U.S. metro without a printed daily newspaper as Journal-Constitution goes digital”
https://fortune.com/2025/08/29/atlanta-largest-metro-without-printed-newpsaper-digital-journal-constitution/
 
Northwestern University Medill School (2025): “News deserts hit new high and 50 million have limited access to local news, study finds”
https://www.medill.northwestern.edu/news/2025/news-deserts-hit-new-high-and-50-million-have-limited-access-to-local-news-study-finds.html
 
NBC News (February 2026): “Washington Post lays off one-third of its newsroom”
https://www.nbcnews.com/business/media/washington-post-layoffs-sports-rcna257354
 
CNN Business (February 4, 2026): “Jeff Bezos-owned Washington Post conducts widespread layoffs, gutting a third of its staff”
https://www.cnn.com/2026/02/04/media/washington-post-layoffs
 
Northwestern University Medill Local News Initiative (2024): “The State of Local News Report 2024”
https://localnewsinitiative.northwestern.edu/projects/state-of-local-news/2024/report/
 
Northwestern University Medill School (2025): “News deserts hit new high and 50 million have limited access to local news, study finds”
https://www.medill.northwestern.edu/news/2025/news-deserts-hit-new-high-and-50-million-have-limited-access-to-local-news-study-finds.htm

Russel Vought and the War on the Environment

By

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.
 
Sources:
Lisa Friedman and Maxine Joselow, “Trump Allies Near ‘Total Victory’ in Wiping Out U.S. Climate Regulation,” New York Times, Feb. 9, 2026.[nytimes +1]
Lisa Friedman, “The Conservative Activists Behind One of Trump’s Biggest Climate Moves,” New York Times, Feb. 10, 2026.[nytimes +1]
Bob Sussman, “The Anti-Climate Fanaticism of the Second Trump Term (Part 1: The Purge of Climate from All Federal Programs),” Environmental Law Institute, May 7, 2025.[eli]
U.S. Environmental Protection Agency, “Trump EPA Kicks Off Formal Reconsideration of Endangerment Finding,” EPA News Release, Mar. 13, 2025.[epa]
Trump’s Climate and Clean Energy Rollback Tracker, Act On Climate/NRDC coalition, updated Jan. 11, 2026.[actonclimate]
“Trump to Repeal Landmark Climate Finding in Huge Regulatory Rollback,” Wall Street Journal, Feb. 9, 2026.[wsj]
Valerie Volcovici, “Trump Set to Repeal Landmark Climate Finding in Huge Regulatory Rollback,” Reuters, Feb. 9, 2026.[reuters]
Alex Guillén, “Trump EPA to Take Its Biggest Swing Yet Against Climate Change Rules,” Politico, Feb. 10, 2026.[politico]
“EPA Urges White House to Strike Down Landmark Climate Finding,” Washington Post, Feb. 26, 2025.[washingtonpost]
“Trump Allies Near ‘Total Victory’ in Wiping Out U.S. Climate Regulation,” Seattle Times reprint, Feb. 10, 2026.[seattletimes]
“Trump Wants to Dismantle Key Climate Research Hub in Colorado,” Earth.org, Dec. 17, 2025.[earth]
“Vought Says National Science Foundation to Break Up Federal Climate Research Center,” The Hill, Dec. 17, 2025.[thehill]
Rachel Cleetus, “One Year of the Trump Administration’s All-Out Assault on Climate and Clean Energy,” Union of Concerned Scientists, Jan. 13, 2026.[ucs]
Environmental Protection Network, “Environmental Protection Network Speaks Out Against Vought Cabinet Consideration,” Nov. 20, 2024.[environmentalprotectionnetwork]
“From Disavowal to Delivery: The Trump Administration’s Rapid Implementation of Project 2025 on Public Lands,” Center for Western Priorities, Jan. 28, 2026.[westernpriorities]
“Russ Vought Nominated for Office of Management and Budget Director,” Environmental Defense Fund statement, Mar. 6, 2025.[edf]
“Project 2025,” Heritage Foundation/Project 2025 backgrounder (as summarized in the Project 2025 Wikipedia entry).[wikipedia]
“EPA to repeal finding that serves as basis for climate change,” The Associated Press, Matthew Daly
https://vitalsigns.edf.org/story/trump-nominee-and-project-2025-architect-russell-vought-has-drastic-plans-reshape-america
https://en.wikipedia.org/wiki/Russell_Vought
https://www.commondreams.org/news/warnings-of-permanent-damage-to-people-and-planet-as-trump-epa-set-to-repeal-key-climate-rule
https://www.eenews.net/articles/trump-team-takes-aim-at-crown-jewel-of-us-climate-research/
https://www.epa.gov/newsreleases/epa-launches-biggest-deregulatory-action-us-history
https://www.pbs.org/newshour/nation/trump-administration-moves-to-repeal-epa-rule-that-allows-climate-regulation
https://www.scientificamerican.com/article/trump-epa-unveils-aggressive-plans-to-dismantle-climate-regulation/
https://www.bloomberg.com/news/articles/2026-02-10/trump-s-epa-to-scrap-landmark-emissions-policy-in-major-rollback​​​​​​​​​​​​​​​​
 
 
 
 

What Is This Thing Called Love?

By

On February 14, 2026

In Commentary

Every February 14th, we’re reminded that we’re supposed to understand love well enough to celebrate it with cards, chocolates, and carefully chosen gifts. Yet if you ask a hundred people to define love, you’ll get a hundred different answers—and most of them will involve a lot of hand-waving and phrases like “you just know.”

So, what is love? After thousands of years of poetry, philosophy, and now neuroscience, we still don’t have a tidy answer. But we do know more than we used to about how it works, why it matters, and what makes it one of the most powerful forces in human experience.

The Chemistry of Connection

Let’s start with the brain, because love—for all its mystery—has a biological basis we can measure. When you’re falling in love, your brain lights up like a Christmas tree in very specific ways. The caudate nucleus and ventral tegmental area, both parts of the brain’s reward system, show intense activity when people look at photos of their romantic partners. These are the same regions that activate when you’re anticipating a reward or experiencing pleasure. Your brain is essentially treating your beloved like the best possible prize.

The neurochemistry is equally dramatic. Dopamine floods your system, creating that giddy, can’t-eat, can’t-sleep sensation of new love. Norepinephrine heightens attention and memory—which is why you remember every detail of your early dates. Meanwhile, serotonin levels actually drop, which creates the obsessive thinking patterns familiar to anyone who’s ever fallen hard for someone. It’s not unlike the neurochemistry of obsessive-compulsive disorder, which explains why new love can feel so all-consuming.

But here’s where it gets interesting: long-term love shows different neural patterns than early infatuation. In established relationships, the brain’s attachment systems become more active, involving oxytocin and vasopressin—hormones that promote bonding and trust. The frenzy calms, but a different kind of connection deepens.

More Than Just Romance

Our cultural obsession with Valentine’s Day focuses almost exclusively on romantic love, but we experience love in multiple forms that are equally powerful. The ancient Greeks understood this—they had several words for different types of love.

There’s eros, the passionate romantic love we celebrate on Valentine’s Day. But there’s also philia, the deep friendship love that bonds us to chosen family and lifelong companions. Storge describes familial love, the affection between parents and children or siblings. Agape is selfless, universal love—the kind that drives people to help strangers or dedicate their lives to causes. And pragma is the mature, enduring love that develops in long partnerships built on compatibility and mutual respect.

Research on attachment theory, pioneered by psychologist John Bowlby, shows that our capacity for all these forms of love develops from our earliest relationships. The bonds we form with caregivers in infancy create templates that influence how we connect with others throughout life. Those early experiences shape whether we tend toward secure, anxious, or avoidant attachment patterns in adult relationships.

The Meaning We Make

So, what does love mean to us? The answer seems to be almost everything.

Love is fundamentally about connection in a species that evolved to be deeply social. We’re not built to survive alone. Anthropological evidence suggests that cooperation and bonding have been essential to human survival for hundreds of thousands of years. Love—in its various forms—is the emotional mechanism that makes us want to stay together, protect each other, and invest in relationships that extend beyond immediate self-interest.

Psychological research backs this up. Studies consistently show that strong social connections are among the most reliable predictors of happiness and wellbeing. A famous Harvard study that followed people for over 75 years found that close relationships—more than money, fame, or achievement—were what kept people happy throughout their lives. The quality of our relationships influences everything from our physical health to our resilience in facing life’s challenges.

Love also gives us a sense of meaning and purpose. Philosopher Martin Buber wrote about “I-Thou” relationships—moments when we genuinely see and are seen by another person, not as objects to be used but as complete beings. These connections, he argued, are where we find authentic existence. Whether or not you buy the full philosophical framework, there’s something to the idea that being truly known and still loved is profoundly meaningful to us

How We Describe the Indescribable

The challenge with love is that it’s simultaneously a biological process, a psychological state, a social bond, and a subjective experience. It’s a feeling, but also a choice. It involves chemistry but transcends chemistry. It’s universal, but manifests differently across cultures and individuals.

When people try to describe love, they often resort to metaphors: it’s a journey, a flame, a force of nature, a home. These metaphors capture something real—that love is dynamic (a journey), consuming (a flame), powerful beyond our control (a force), and provides security (a home). Each metaphor reveals an individual facet of love but is incomplete in itself.

Psychologists sometimes describe love through its components. Robert Sternberg’s triangular theory proposes that love involves intimacy (closeness and connection), passion (physical attraction and arousal), and commitment (the decision to maintain the relationship). Different combinations create different experiences: romance without commitment is infatuation; commitment without passion is companionship; all three together create what he calls “consummate love”.

But even these frameworks feel incomplete because love is also characterized by paradoxes. It makes us feel both euphoric and vulnerable. It’s intensely focused on one person yet can expand our capacity for compassion generally. It’s simultaneously selfish (wanting the beloved) and selfless (wanting their happiness above our own). It’s stable and changing, rational and irrational, simple and impossibly complex.

What We Know, and What We Don’t

Here’s my honest assessment of our understanding: We’re fairly confident about love’s neurological basis and its importance for human wellbeing. The research on attachment, bonding hormones, and the psychological benefit of connection is solid and replicated across many studies.

We’re less certain about the boundaries between types of love or whether our categories reflect universal realities or cultural constructs. The line between deep friendship and romantic love can be fuzzy. What Western culture calls romantic love may be experienced or expressed differently in cultures with arranged marriages or different social structures.

And we really don’t know how to explain why one person falls for this particular person and not that one, why some relationships endure while others fade, or how exactly the alchemy of genuine connection works. We can identify correlates and patterns, but the lived experience of love retains its mystery.

The Point of It All

Maybe the reason love resists simple definition is that it’s less like a thing and more like a capacity—the human ability to extend beyond our individual boundaries and form bonds that transcend pure self-interest. It’s what allows parents to sacrifice for children, friends to show up in crises, partners to build lives together, and strangers to feel compassion for people they’ll never meet.

Valentine’s Day, for all its commercial trappings, is trying to celebrate something genuinely important: our ability to connect, to care, to find meaning in each other. Whether you’re celebrating romantic love, friendship, family bonds, or simply the human capacity for affection, you’re acknowledging one of the most fundamental aspects of what makes us human.

Love might be indefinable, but that doesn’t make it any less real or necessary. It’s the force that pulls us out of isolation and reminds us we’re part of something larger than ourselves. And maybe that’s enough of a definition to work with.

Sources

Cole Porter – What’s This Thing Called Love? Lyrics, 1929

Scientific American – The Neuroscience of Love https://www.scientificamerican.com/article/the-neuroscience-of-love/

Greater Good Science Center, UC Berkeley – The New Science of Love https://greatergood.berkeley.edu/article/item/the_new_science_of_love

Simply Psychology – Bowlby’s Attachment Theory https://www.simplypsychology.org/bowlby.html

Harvard Gazette – Harvard Study on Adult Development https://news.harvard.edu/gazette/story/2017/04/over-nearly-80-years-harvard-study-has-been-showing-how-to-live-a-healthy-and-happy-life/

Verywell Mind – Sternberg’s Triangular Theory of Love https://www.verywellmind.com/triangular-theory-of-love-2795884

Illustration generated by author using ChatGPT.

The Fatal Meeting: When Hamilton and Burr Settled Fifteen Years of Rivalry with Pistols

By

On February 13, 2026

In History, Uncategorized

The story of the Hamilton-Burr duel has all the elements of a Greek tragedy: brilliant men, political ambition, an unforgiving honor culture, and an ending that destroyed both victor and vanquished alike. When Aaron Burr shot Alexander Hamilton on the morning of July 11, 1804, he didn’t just kill one of America’s founding architects—he also ended his own political career and helped doom the entire Federalist Party to irrelevance. Let’s rewind the clock more than a decade to try and understand how these two gifted lawyers and Revolutionary War veterans ended up facing each other with loaded pistols.

The Long Road to Weehawken

Hamilton and Burr moved in the same elite New York political circles from the 1790s onward, but they had remarkably different temperaments and political beliefs. Hamilton was ideological, prolific, and combative—often too much so for his own good. Burr was pragmatic, opaque, self-serving, and famously hard to pin down on principle. They distrusted each other deeply.

Their rivalry stretched back to 1791, when Burr defeated Philip Schuyler for a U.S. Senate seat representing New York. This wasn’t just any political defeat for Hamilton—Schuyler was his father-in-law and a crucial Federalist ally on whom Hamilton had counted to support his ambitious financial programs. Hamilton, who was serving in George Washington’s cabinet as Treasury Secretary, never forgave Burr for this loss. In correspondence from June 1804, Hamilton himself referenced “a course of fifteen years competition” between the two men.  

Their philosophical differences ran deep. Hamilton was an ideological Federalist who dreamed of transforming the United States into a modern economic power rivaling European empires through strong central government, industrial development, and military strength. Burr, by contrast, approached politics more pragmatically—he saw it as a vehicle for advancing his own interests and those of his allies rather than as a way to implement sweeping political visions. As Burr himself allegedly said, politics were nothing more than “fun and honor and profit”. Hamilton viewed Burr as fundamentally dangerous due to his lack of fixed ideological principles. Hamilton wrote in 1792 that he considered it his “religious duty to keep this man from office”

The election of 1800 brought their animosity to a boiling point. Due to a quirk in the original Constitution’s electoral system, Thomas Jefferson and his running mate Aaron Burr tied in the Electoral College with 73 votes each, allowing the Federalists to briefly consider elevating Burr to the presidency.  The decision went to the House of Representatives, and Hamilton—despite despising Jefferson’s Democratic-Republican politics—campaigned hard to ensure Jefferson won the presidency rather than Burr. Hamilton argued that Jefferson, however wrong in policy, had convictions, whereas Burr had none.  In the end, Jefferson gained the presidency and Burr became Vice President, but their relationship was never collegial and Burr was excluded from any meaningful participation in Jefferson’s administration.

By 1804, it was clear Jefferson would not consider Burr for a second term as Vice President. Desperate to salvage his political career, Burr made a surprising move: he sought the Federalist nomination for governor of New York, switching from his Democratic-Republican affiliation. It was a strange gambit—essentially betting that his political enemies might support him if it served their interests. Hamilton, predictably, worked vigorously to block Burr’s ambitions yet again. Although Hamilton’s opposition wasn’t the only factor, Burr lost badly to Morgan Lewis, the Democratic-Republican candidate, in April 1804.

The Cooper Letter and the Challenge

The immediate trigger for the duel came from a relatively minor slight in the context of their long feud. In February 1804, Dr. Charles Cooper attended a dinner party where Hamilton spoke forcefully against Burr’s candidacy. Cooper later wrote to Philip Schuyler describing Hamilton’s comments, noting that Hamilton had called Burr “a dangerous man” and referenced an even “more despicable opinion” of him. This letter was published in the Albany Register in April, after Burr’s electoral defeat.

When the newspaper reached Burr, he was already politically ruined—still Vice President of the United States, but with no prospects for future office. He demanded that Hamilton acknowledge or deny the statements attributed to him. What followed was a formal exchange of letters between the two men and their representatives that lasted through June. Hamilton refused to give Burr the straightforward denial he sought, explaining that he couldn’t reasonably be expected to account for everything he might have said about a political opponent during fifteen years of competition. Burr, seeing his honor impugned and his options exhausted, invoked the code of honor and issued a formal challenge to duel.

Hamilton found himself in an impossible position. If he admitted to the insults, which were substantially true, he would lose his honor. If he refused to duel, the result would be the same—his political career would effectively end. Hamilton had personal and moral objections to dueling. His eldest son Philip had died in a duel just three years earlier, at the same Weehawken location where Hamilton and Burr would meet. Hamilton calculated that his ability to maintain his political influence required him to conform to the codes of honor that governed gentlemen’s behavior in early America.

Dawn at Weehawken

At 5:00 AM on the morning of July 11, 1804, the men departed Manhattan from separate docks. They were each rowed across the Hudson River to the Heights of Weehawken, New Jersey—a popular dueling ground where at least 18 known duels took place between 1700 and 1845. They chose New Jersey because while dueling had been outlawed in both New York and New Jersey, the New Jersey penalties were less severe.

Burr arrived first around 6:30 AM, with Hamilton landing about thirty minutes later. Each man was accompanied by his “second”—an assistant responsible for ensuring the duel followed proper protocols. Hamilton brought Nathaniel Pendleton, a Revolutionary War veteran and Georgia district court judge, while Burr’s second was William Van Ness, a New York federal judge. Hamilton also brought Dr. David Hosack, a Columbia College professor of medicine and botany, in case medical attention proved necessary.

Shortly after 7 a.m., the seconds measured out ten paces, loaded the .56‑caliber pistols, and explained the firing rules before Hamilton and Burr took their positions. What exactly happened next remains one of history’s enduring mysteries. The seconds gave conflicting accounts, and historians still debate the sequence and meaning of events.

In a written statement before the duel, Hamilton expressed religious and moral objections to dueling, worry for his family and creditors, and professed no personal hatred of Burr, yet concluded that honor and future public usefulness compelled him to accept. By some accounts, Hamilton had also written to confidants indicating his intention to “throw away my shot”—essentially to deliberately miss Burr, satisfying the requirements of honor without attempting to kill his opponent. Burr, by contrast, appears to have aimed directly at Hamilton.

Some accounts suggest Hamilton fired first, with his shot hitting a tree branch above and behind Burr’s head. Other versions claim Burr shot first. There’s even a theory that Hamilton’s pistol had a hair trigger that caused an accidental discharge after Burr wounded him.

What’s undisputed is the outcome: Burr’s shot struck Hamilton in the lower abdomen, with the bullet lodging near his spine. Hamilton fell, and Burr reportedly started toward his fallen opponent before Van Ness held him back, worried about the legal consequences of lingering at the scene. The two parties crossed back to Manhattan in their respective boats, with Hamilton taken to the home of William Bayard Jr. in what is now Greenwich Village.

Hamilton survived long enough to say goodbye to his wife Eliza and their children. He died at 2 PM on July 12, 1804, approximately 31 hours after being shot.

Political Aftershocks

The nation was outraged. While duels were relatively common in early America, they rarely resulted in death, and the killing of someone as prominent as Alexander Hamilton sparked widespread condemnation. The political consequences proved catastrophic for everyone involved—and reshaped American politics for the next two decades.

Hamilton’s death turned him into a Federalist martyr. Even many who had disliked his arrogance now praised his intellect, service, and sacrifice. His economic vision, already embedded in American institutions, gained a kind of posthumous authority.

For Aaron Burr, the duel destroyed him politically and socially. Murder charges were filed against him in both New York and New Jersey, though neither reached trial—a grand jury in Bergen County, New Jersey indicted him for murder in November 1804, but the New Jersey Supreme Court quashed the indictment. Nevertheless, Burr fled to St. Simons Island, Georgia, staying at the plantation of Pierce Butler, before returning to Washington to complete his term as Vice President.

Rather than restoring his reputation as he’d hoped, the duel made Burr a pariah. He would never hold elected office again. His subsequent attempt to regain power through what historians call the “Burr Conspiracy”—an alleged plan to create an independent nation along the Mississippi River by separating territories from the United States and Spain—led to a treason trial in 1807. Chief Justice John Marshall presided and Burr was ultimately acquitted, but the trial further cemented Burr’s reputation as a dangerous schemer. He spent his later years quietly practicing law in New York.

For the Federalist Party, Hamilton’s death proved even more devastating than Burr’s personal ruin. Hamilton had been the party’s intellectual architect and most effective leader. At the time of his death, the Federalists were attempting a comeback after their national defeat in the 1800 election. Without Hamilton’s energy, strategic thinking, and ability to articulate a compelling vision for the country, the Federalists lost direction. As one historian put it, “The Federalists would be unable to find another leader as forceful and energetic as Hamilton had been, and their movement would slowly suffocate before finally petering out in the early 1820s”. The party’s decline ended what historians consider the first round of partisan struggles in American history.

An interesting footnote: while many Federalists wanted to portray Hamilton as a political martyr, Federalist clergy broke with the party line to condemn dueling itself as a violation of the sixth commandment. These ministers used Hamilton’s death as an opportunity to wage a moral crusade against the practice of dueling, helping to accelerate its decline in American culture—particularly in the northern states where it was already losing favor.

The duel produced a triple tragedy: Hamilton dead at age 47 (or 49—his birth year remains disputed), Burr politically destroyed despite being acquitted of murder charges, and the Federalist Party fatally weakened at a critical moment in American political development.

The Hamilton–Burr duel sits at the intersection of politics, personality, and culture. It reminds us that the early republic was not a calm, rational experiment run by marble statues—but a volatile environment shaped by ego, fear, and ambition. Institutions were young, norms were fragile, and reputations were all important. What began as fifteen years of professional rivalry and personal enmity ended with two brilliant men eliminating each other from the political stage, neither achieving what they’d hoped for through their fatal meeting on the heights of Weehawken.

Sources

Encyclopedia Britannica “Burr-Hamilton duel | Summary, Background, & Facts” https://www.britannica.com/event/Burr-Hamilton-duel

History.com “Aaron Burr slays Alexander Hamilton in duel” https://www.history.com/this-day-in-history/july-11/burr-slays-hamilton-in-duel

Library of Congress “Today in History – July 11” https://www.loc.gov/item/today-in-history/july-11

National Constitution Center “The Burr vs. Hamilton duel happened on this day” https://constitutioncenter.org/blog/burr-vs-hamilton-behind-the-ultimate-political-feud

National Park Service “Hamilton-Burr Duel” https://www.nps.gov/articles/000/hamilton-burr-duel.htm

PBS American Experience “Alexander Hamilton and Aaron Burr’s Duel” https://www.pbs.org/wgbh/americanexperience/features/duel-alexander-hamilton-and-aaron-burrs-duel/

The Gospel Coalition “American Prophets: Federalist Clergy’s Response to the Hamilton–Burr Duel of 1804” https://www.thegospelcoalition.org/themelios/article/american-prophets-federalist-clergys-response-to-the-hamilton-burr-duel-of-1804/

Wikipedia “Burr–Hamilton duel” https://en.wikipedia.org/wiki/Burr–Hamilton_duel

World History Encyclopedia “Hamilton-Burr Duel” https://www.worldhistory.org/article/2548/hamilton-burr-duel/​​​​​​​​​​​​​​​​

For more information about the history of dueling in early America see my earlier post: Pistols at Dawn, The Rise and Fall of the Code Duello.

Images generated by author using ChatGPT.

VO₂ Max Explained: The Fitness Metric That Predicts Health and Longevity

By

On February 11, 2026

In Medicine

If you’ve ever wondered what separates elite endurance athletes from weekend warriors—or why your friend can cruise up hills while you’re gasping for air—the answer often comes down to a vital sign you’ve probably never heard of — VO2 max. Think of it as your cardiovascular system’s horsepower rating, a number that tells you how efficiently your body can use oxygen during intense exercise.

What VO2 Max Actually Means

VO2 max stands for maximal oxygen consumption; it measures the maximum amount of oxygen your body can take in, transport, and use during exercise. Scientists express it in milliliters of oxygen per kilogram of body weight per minute (ml/kg/min). When you’re working out at your absolute limit—say, sprinting up a hill until you simply can’t go any faster—your muscles are burning through oxygen to produce energy. VO2 max represents the ceiling of that process, the point where your body has maxed out its oxygen delivery system and can’t use any more oxygen even if you try to push harder.

An average sedentary man might have a VO2 max around 30-40 ml/kg/min, while an average woman might measure 25-30 ml/kg/min. Elite endurance athletes, however, occupy an entirely different universe. Cross-country skiers and distance runners can reach values of 70-85 ml/kg/min or even higher. The legendary Norwegian cyclist Oskar Svendsen reportedly recorded a VO2 max of 97.5 ml/kg/min, which is probably the upper reaches of human cardiovascular capacity.

 The rest of us are also affected by VO2 Max.  In later life, it is closely tied to our everyday activities. There’s a minimum aerobic capacity required for independent living—walking briskly, climbing stairs, carrying groceries. As VO2 max declines to that functional threshold, small losses can translate into disproportionate declines in independence. Conversely, modest improvements can produce meaningful gains in stamina, balance, and confidence.

The Gold Standard of Measurement

The most accurate way to measure VO2 max involves what’s called a graded exercise test, typically performed in a lab or clinical setting. You’ll hop on a treadmill or stationary bike while wearing a mask connected to a metabolic cart—essentially a sophisticated machine that analyzes every breath you take. The test starts easy but gets progressively harder every few minutes. The technician increases either the speed, incline, or resistance while the equipment measures exactly how much oxygen you’re consuming and how much carbon dioxide you’re producing.

You keep going until you reach exhaustion—the point where you literally cannot continue despite maximum effort. The highest oxygen consumption rate recorded during this test is your VO2 max. It’s not a particularly pleasant experience, but it’s incredibly accurate. The test also provides valuable data about your anaerobic threshold, the point where your body starts relying more heavily on systems that don’t require oxygen and where lactic acid begins accumulating in your muscles.

For those of us without access to exercise labs, there are several field tests we can use to estimate VO2 max reasonably well. The Cooper test, developed by Dr. Kenneth Cooper in the 1960s, involves running as far as you can in 12 minutes on a track (that wouldn’t be too far for me). The distance you cover correlates with your VO2 max through established formulas [VO2max: (distance covered in meters – 504.9) / 44.73 =  VO2 max in ml/kg/min].  Age and gender normed values can be found on a number of fitness websites. Many fitness watches and apps now offer VO2 max estimates based on heart rate data during runs, though these are less precise than laboratory testing.

Why This Number Matters

VO2 max serves as one of our strongest predictors of cardiovascular health and longevity. Research published in major medical journals has consistently shown that higher VO2 max values correlate with lower risks of heart disease, diabetes, and all-cause mortality. A 2018 study in the Journal of the American Medical Association (JAMA) that followed over 122,000 patients found that cardiorespiratory fitness (measured by VO2 max) was a better predictor of mortality than traditional risk factors like hypertension, diabetes, or even smoking.

The relationship is striking, for every 3.5 ml/kg/min increase in VO2 max, mortality risk drops by about 13 percent. People in the lowest fitness category (those with the poorest VO2 max scores) have death rates two to three times higher than those in the highest fitness category, even when controlling for other health factors.

Beyond mortality statistics, VO2 max influences your daily quality of life. A higher VO2 max means your heart doesn’t have to work as hard during routine activities. Climbing stairs, carrying groceries, playing with kids or grandkids—all these activities demand less relative effort when your cardiovascular system operates efficiently. Your body becomes better at delivering oxygen-rich blood to working muscles and clearing away metabolic waste products, which means you fatigue less easily and recover more quickly.

The Path to Improvement

The encouraging news is that VO2 max responds remarkably well to training, especially if you’re starting from a sedentary baseline. You can’t completely escape genetics—some people are simply born with larger hearts, more efficient lungs, or a higher percentage of slow-twitch muscle fibers—but training can typically improve VO2 max by 15-30 percent in previously untrained people.

The most effective approach combines several training methods. High-intensity interval training (HIIT) has emerged as particularly powerful tool for boosting VO2 max. These workouts involve short bursts of near-maximal effort followed by recovery periods. A classic protocol might involve running hard for four minutes at about 90-95 percent of your maximum heart rate, then recovering with light jogging for three minutes, repeated four or five times. Studies show that just two or three HIIT sessions per week can produce significant improvements in VO2 max within eight to twelve weeks.

Longer, steady-state aerobic exercise also plays a crucial role. These sessions—think longer runs at a conversational pace—improve your cardiovascular system’s efficiency and build the capillary networks that deliver oxygen to muscles. The optimal training program typically includes both high-intensity intervals and longer moderate-intensity sessions, along with adequate recovery time.

Interestingly, resistance training can indirectly support VO2 max improvements as well. While lifting weights won’t directly boost your oxygen consumption capacity the way running does, it helps maintain lean muscle mass, improves movement efficiency, and can enhance your ability to perform high-intensity cardiovascular work.

This high intensity training is all well and good for young, relatively healthy people. But what about older folks, particularly those with underlying medical problems?

The encouraging news: VO2 max responds to training well into our 70s, 80s, and beyond.  Key approaches involve the same elements but tailored to age and medical history.

Moderate-intensity aerobic exercise (brisk walking, cycling, swimming) performed most days of the week is the primary element. Individually adjusted interval training, including carefully supervised higher intensity intervals, have shown impressive VO2 max gains even in older populations.  Strength training is beneficial for older folks as well, and as an added benefit, it helps maintain and even improve bone density. A personal trainer can help design your fitness program to maximize improvement while minimizing the likelihood of injury.  

Stop any exercise immediately if you experience chest pain, dizziness, or extreme shortness of breath. Remember consistency matters more than intensity alone and, most importantly, never start any exercise program without checking with your doctor first. 

The Inevitable Decline

Here’s the less cheerful part: VO2 max naturally declines with age, typically dropping about 10 percent per decade after age 30 in sedentary people. This decline accelerates after age 70. However—and this is crucial—regular exercise dramatically slows this process. Senior athletes who maintain consistent training can preserve VO2 max values that rival or exceed those of sedentary people decades younger. A fit 60-year-old can easily have a higher VO2 max than an inactive 40-year-old.

The decline happens for several reasons: maximum heart rate decreases, cardiac output drops, muscle mass decreases, and the body becomes less efficient at extracting oxygen from blood. But none of these changes are inevitable consequences of aging alone—they’re heavily influenced by activity levels.

Putting It in Perspective

While VO2 max provides valuable information about cardiovascular fitness, it’s worth remembering that it’s just one metric among many. You don’t need the VO2 max of an Olympic athlete to be healthy and enjoy an active life (thankfully). A moderate VO2 max maintained consistently into your later years will serve you far better than a high value in your twenties followed by decades of inactivity.

The real value of understanding VO2 max lies in what it represents: your body’s fundamental capacity to generate energy and support movement. When you work to improve this capacity through regular cardiovascular exercise, you’re investing in both your current quality of life and your long-term health prospects.  Every little bit helps—so put down the remote, get up off the couch and start walking.  You’ll be glad you did.

​​​​

Sources:

  • American College of Sports Medicine on VO2 max testing: https://www.acsm.org/
  • Mayo Clinic on cardiorespiratory fitness: https://www.mayoclinic.org/
  • National Institutes of Health research on fitness and mortality: https://www.nih.gov/
  • JAMA Network 2018 study on cardiorespiratory fitness and mortality: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707428

Image generated by author using ChatGPT

When They Knew: How the Fossil Fuel Industry Buried Its Own Climate Science

By

On February 9, 2026

In Commentary, Politics

The story begins not with climate deniers casting doubt on new science, but with something far more troubling: companies conducting rigorous research, understanding exactly what their products would do to the planet, and then spending decades lying to the public. They treated science as an internal planning tool and then deployed public relations, front groups, and “manufactured doubt” to delay regulation and protect profits.

The Oil Industry’s Own Scientists Saw It Coming

In 1977, a scientist named James Black stood before Exxon’s management committee with an uncomfortable message. According to internal documents later uncovered by investigative journalists, Black told executives that burning fossil fuels was increasing atmospheric carbon dioxide, and that continually rising CO2 levels would increase global temperatures by two to three degrees—a projection that is still consistent with today’s scientific consensus. He warned that we had a window of just five to ten years before “hard decisions regarding changes in energy strategies might become critical”.

What happened next is remarkable for its precision. Throughout the late 1970s and 1980s, Exxon assembled what one scientist called “a credible scientific team” to investigate the climate question. They launched ambitious projects, including outfitting a supertanker with custom instruments to measure how oceans absorbed CO2—one of the most pressing scientific questions of the era. A 2023 Harvard study analyzing Exxon’s internal climate projections from 1977 to 2003 found they predicted global warming with what researchers called “shocking skill and accuracy.” Specifically, the company projected 0.20 degrees Centigrade of warming per decade, with a margin of error of just 0.04 degrees—a forecast that has proven largely correct.

Exxon wasn’t alone. Shell produced a confidential 1988 report titled “The Greenhouse Effect” that warned of climate changes “larger than any that have occurred over the last 12,000 years,” including destructive floods and mass migrations. The report revealed Shell had been running an internal climate science program since 1981. In one striking document from 1986, Shell predicted that fossil fuel emissions would cause changes “the greatest in recorded history”.

Even industry groups understood what was coming. In 1980, the American Petroleum Institute (API) invited Stanford scientist John Laurmann to brief oil company representatives at its secret “CO2 and Climate Task Force”. His presentation, now public, warned that continued fossil fuel use would be “barely noticeable” by 2005 but by the 2060s would have “globally catastrophic effects.” That same year, the API called on governments to triple coal production worldwide, publicly insisting there would be no negative consequences.

The Coal Industry Knew Even Earlier

If anything, the coal industry understood the problem first. A 1966 article in the trade publication Mining Congress Journal by James Garvey, president of Bituminous Coal Research Inc., explicitly discussed how continued coal consumption would increase atmospheric temperatures and cause “vast changes in the climates of the earth.” A combustion engineer from Peabody Coal, now the world’s largest coal company, acknowledged in the same publication that the industry was “buying time” before air pollution regulations would force action.

This 1966 evidence is particularly damning because it predates widespread public awareness by decades. The coal industry didn’t stumble into climate denial—they entered it with full knowledge of what they were obscuring.

Major coal interests also had early awareness that carbon emissions posed regulatory and market risks, particularly for coal‑fired electricity, and they participated in joint industry research and strategy discussions about climate change in the 1980s and 1990s. At the same time, coal associations helped create public campaigns such as the Information Council for the Environment (ICE—even then a disturbing acronym), whose internal planning documents explicitly set an objective to “reposition global warming as theory (not fact)” and to target specific demographic groups with tailored doubt‑based messages.

According to a report from the Union of Concerned Scientists, these efforts often relied on “grassroots” fronts, advertising, and even forged constituent letters to legislators to undermine support for climate policy and to counter the conclusions of mainstream climate science, which even the companies’ own experts did not refute.

What They Said Publicly

The contrast between private knowledge and public statements is stark. While Exxon scientists were building sophisticated climate models internally, the company’s public messaging emphasized uncertainty. In a 1997 speech, Exxon CEO Lee Raymond told an audience at the World Petroleum Conference: “Let’s agree there’s a lot we really don’t know about how climate change will change in the 21st century and beyond”.  They spread messaging that emphasized uncertainty, framed global warming as just a “theory,” and highlighted supposed flaws in climate models, even as their own scientists were using those models to make precise projections. The company and allied trade associations supported think tanks and advocacy groups such as Citizens For Sound Science, that questioned if human activity was responsible for warming and opposed binding limits on emissions, producing a stark discrepancy between internal scientific knowledge and external communication.

In 1989, Exxon helped create the Global Climate Coalition—despite its environmental sounding name, the organization worked to cast doubt on climate science and block clean energy legislation throughout the 1990s. Electric utilities and coal‑linked organizations joined this coalition to systematically attack climate scientists and lobby to weaken or stall international agreements like the Kyoto Protocol, despite internal recognition that greenhouse gases were driving warming.

Internal API documents from a 1998 meeting reveal an explicit strategy to “ensure that a majority of the American public… recognizes that significant uncertainties exist in climate science”.

In 1991, Shell produced a film, “Climate of Concern,” which stated that human driven—as opposed to greenhouse gas driven—climate change was happening “at a rate faster than at any time since the end of the ice age” and warned of extreme weather, flooding, famine, and climate refugees.  They understood the science but tried to shift the blame.

According to a 2013 Drexel University study, between 2003 and 2010 alone, approximately $558 million was distributed to about 100 climate change denial organizations. Greenpeace reports that Exxon alone spent more than $30 million on think tanks promoting climate denial.

The Tobacco Playbook

The parallels to Big Tobacco’s strategy are not coincidental—they’re intentional. Research by the Center for International Environmental Law uncovered more than 100 documents from the Tobacco Industry Archives showing that oil and tobacco companies not only used the same PR firms and research institutes, but often the same individual researchers. The connection goes back to at least the 1950s.  A report published in Scientific American suggests the oil and tobacco industries both hired the PR firm Hill & Knowlton Inc. as early as 1956.

A 1969 internal memo from R.J. Reynolds Tobacco Company stated plainly: “Doubt is our product since it is the best means of competing with the ‘body of fact’ that exists in the mind of the general public”. This became the template. Create uncertainty. Emphasize what isn’t known rather than what is. Fund research that casts doubt. Attack the credibility of independent scientists. They formed organizations with scientific-sounding names that existed primarily to muddy the waters.

In one particularly brazen example, a 2015 presentation by Cloud Peak Energy executive Richard Reavey titled “Survival Is Victory: Lessons From the Tobacco Wars,” explicitly coached coal executives on how to apply tobacco industry tactics.

What makes the fossil fuel case particularly egregious is the temporal dimension. These weren’t companies caught off-guard by emerging science. They funded the research. They understood the findings. Their own scientists urged action. A 1978 Exxon memo noted this could be “the kind of opportunity we are looking for to have Exxon technology, management and leadership resources put into the context of a project aimed at benefitting mankind”.

Instead, when oil prices collapsed in the mid-1980s, Exxon pivoted from conducting climate research to funding climate denial. By the late 1980s, according to reporting by InsideClimate News, Exxon “curtailed its carbon dioxide research” and “worked instead at the forefront of climate denial”.

Where We Stand Now

Across the oil, gas, and coal industries, there is not a genuine scientific dispute inside companies but a divergence between what in‑house experts knew and what corporate leaders chose to communicate to the public and policymakers. This divergence mirrors the tobacco industry’s long‑running use of organized doubt. In both arenas, industry actors treated early recognition of harm as a legal and political threat and responded by investing in campaigns to confuse, delay, and reframe the science rather than addressing the risks their own research had identified.

The evidence trail has led to legal action. More than 20 cities, counties, and states have filed lawsuits against fossil fuel companies for damages caused by climate change, arguing the industry knowingly deceived the public. The European Parliament held hearings in 2019 on climate denial by ExxonMobil and other actors. The hashtags #ExxonKnew, #ShellKnew, and #TotalKnew have become rallying cries for accountability.

Senator Sheldon Whitehouse has explicitly compared the fossil fuel industry’s actions to the tobacco racketeering case that ultimately held cigarette makers accountable. As he noted in a Senate speech, the elements of a civil racketeering case are straightforward: defendants conducted an enterprise with a pattern of racketeering activity.

The difference between the tobacco and fossil fuel cases may be one of scale. As researchers Naomi Oreskes and Erik Conway documented in their book Merchants of Doubt, both industries worked to obscure truth for profit. But while tobacco kills individuals, climate change threatens entire ecosystems and future generations.  The time to act is now.

Sources:

Scientific American – “Exxon Knew about Climate Change Almost 40 Years Ago”
https://www.scientificamerican.com/article/exxon-knew-about-climate-change-almost-40-years-ago/
 
Harvard Gazette – Harvard-led analysis finds ExxonMobil internal research accurately predicted climate change
https://news.harvard.edu/gazette/story/2023/01/harvard-led-analysis-finds-exxonmobil-internal-research-accurately-predicted-climate-change/
 
InsideClimate News – Exxon’s Own Research Confirmed Fossil Fuels’ Role in Global Warming Decades Ago
https://insideclimatenews.org/news/02052024/from-the-archive-exxon-research-global-warming/
 
PBS Frontline – Investigation Finds Exxon Ignored Its Own Early Climate Change Warnings
https://www.pbs.org/wgbh/frontline/article/investigation-finds-exxon-ignored-its-own-early-climate-change-warnings/
 
NPR – Exxon climate predictions were accurate decades ago. Still it sowed doubt
https://www.npr.org/2023/01/12/1148376084/exxon-climate-predictions-were-accurate-decades-ago-still-it-sowed-doubt
 
Science (journal) – Assessing ExxonMobil’s global warming projections
https://www.science.org/doi/10.1126/science.abk0063
 
Climate Investigations Center – Shell Climate Documents
https://climateinvestigations.org/shell-oil-climate-documents/
 
The Conversation – What Big Oil knew about climate change, in its own words
https://theconversation.com/what-big-oil-knew-about-climate-change-in-its-own-words-170642
 
ScienceAlert – The Coal Industry Was Well Aware of Climate Change Predictions Over 50 Years Ago
https://www.sciencealert.com/coal-industry-knew-about-climate-change-in-the-60s-damning-revelations-show
 
The Intercept – A Major Coal Company Went Bust. Its Bankruptcy Filing Shows That It Was Funding Climate Change Denialism
https://theintercept.com/2019/05/16/coal-industry-climate-change-denial-cloud-peak-energy/
 
Center for International Environmental Law – Big Oil Denial Playbook Revealed by New Documents
https://www.ciel.org/news/oil-tobacco-denial-playbook/
 
Wikipedia – Tobacco industry playbook
https://en.wikipedia.org/wiki/Tobacco_industry_playbook
 
Scientific American – Tobacco and Oil Industries Used Same Researchers to Sway Public
https://www.scientificamerican.com/article/tobacco-and-oil-industries-used-same-researchers-to-sway-public1/
 
Environmental Health (journal) – The science of spin: targeted strategies to manufacture doubt with detrimental effects on environmental and public health
https://link.springer.com/article/10.1186/s12940-021-00723-0
 
Senator Sheldon Whitehouse – Time to Wake Up: Climate Denial Recalls Tobacco Racketeering
https://www.whitehouse.senate.gov/news/speeches/time-to-wake-up-climate-denial-recalls-tobacco-racketeering/
 
VICE News – Meet the ‘Merchants of Doubt’ Who Sow Confusion about Tobacco Smoke and Climate Change
https://www.vice.com/en/article/meet-the-merchants-of-doubt-who-sow-confusion-about-tobacco-smoke-and-climate-change/
 
Union of Concerned Scientists – The Climate Deception Dossiers
https://www.ucs.org/sites/default/files/attach/2015/07/The-Climate-Deception-Dossiers.pdf
 
 
Illustration generated by author using ChatGPT.
 
 
 
 
 
 

The Founding Feuds: When America’s Heroes Couldn’t Stand Each Other

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On February 6, 2026

In Commentary, History, Politics

The mythology of the founding fathers often portrays them as a harmonious band of brothers united in noble purpose. The reality was far messier—these brilliant, ambitious men engaged in bitter personal feuds that sometimes threatened the very republic they were creating.  In some ways, the American revolution was as much of a battle of egos as it was a war between King and colonists.

The Revolutionary War Years: Hancock, Adams, and Washington’s Critics

The tensions began even before independence was declared. John Hancock and Samuel Adams, both Massachusetts firebrands, developed a rivalry that simmered throughout the Revolution. Adams, the older political strategist, had been the dominant figure in Boston’s resistance movement. When Hancock—wealthy, vain, and eager for glory—was elected president of the Continental Congress in 1775, the austere Adams felt his protégé had grown too big for his britches. Hancock’s request for a leave of absence from the presidency of Congress in 1777 coupled with his desire for an honorific military escort home, struck Adams as a relapse into vanity. Adams even opposed a resolution of thanks for Hancock’s service, signaling open estrangement. Their relationship continued to deteriorate to the point where they barely spoke, with Adams privately mocking Hancock’s pretensions and Hancock using his position to undercut Adams politically.

The choice of Washington as commander sparked its own controversies. John Adams had nominated Washington, partly to unite the colonies by giving Virginia the top military role. Washington’s command was anything but universally admired and as the war dragged on with mixed results many critics emerged.

After the victory at Saratoga in 1777, General Horatio Gates became the focal point of what’s known as the Conway Cabal—a loose conspiracy aimed at having Gates replace Washington as commander-in-chief. General Thomas Conway wrote disparaging letters about Washington’s military abilities. Some members of Congress, including Samuel Adams, Thomas Mifflin, and Richard Henry Lee, questioned whether Washington’s defensive strategy was too cautious and if his battlefield performance was lacking. Gates himself played a duplicitous game, publicly supporting Washington while privately positioning himself as an alternative.

When Washington discovered the intrigue, his response was characteristically measured but firm.  Rather than lobbying Congress or forming a counter-faction, Washington leaned heavily on reputation and restraint. He continued to communicate respectfully with Congress, emphasizing the army’s needs rather than defending his own position.  Washington did not respond with denunciations or public accusations. Instead, he handled the situation largely behind the scenes. When he learned that Conway had written a critical letter praising Gates, Washington calmly informed him that he was aware of the letter—quoting it verbatim.

The conspiracy collapsed, in part because Washington’s personal reputation with the rank and file and with key political figures proved more resilient than his critics had anticipated. But the episode exposed deep fractures over strategy, leadership, and regional loyalties within the revolutionary coalition.

The Ideological Split: Hamilton vs. Jefferson and Madison

Perhaps the most consequential feud emerged in the 1790s between Alexander Hamilton and Thomas Jefferson, with James Madison eventually siding with Jefferson. This wasn’t just personal animosity—it represented a fundamental disagreement about America’s future.

Hamilton, Washington’s Treasury Secretary, envisioned an industrialized commercial nation with a strong central government, a national bank, and close ties to Britain. Jefferson, the Secretary of State, championed an agrarian republic of small farmers with minimal federal power and friendship with Revolutionary France. Their cabinet meetings became so contentious that Washington had to mediate. Hamilton accused Jefferson of being a dangerous radical who would destroy public credit. Jefferson called Hamilton a monarchist who wanted to recreate British aristocracy in America.

The conflict got personal. Hamilton leaked damaging information about Jefferson to friendly newspapers. Jefferson secretly funded a journalist, James Callender, to attack Hamilton in print. When Hamilton’s extramarital affair with Maria Reynolds became public in 1797, Jefferson’s allies savored every detail. The feud split the nation into the first political parties: Hamilton’s Federalists and Jefferson’s Democratic-Republicans. Madison, once Hamilton’s ally in promoting the Constitution, switched sides completely, becoming Jefferson’s closest political partner and Hamilton’s implacable foe.

The Adams-Jefferson Friendship, Rivalry, and Reconciliation

John Adams and Thomas Jefferson experienced one of history’s most remarkable personal relationships. They were close friends during the Revolution, working together in Congress and on the committee to draft the Declaration of Independence (though Jefferson did the actual writing). Both served diplomatic posts in Europe and developed deep mutual respect.

But the election of 1796 turned them into rivals. Adams won the presidency with Jefferson finishing second, making Jefferson vice president under the original constitutional system—imagine your closest competitor becoming your deputy. By the 1800 election, they were bitter enemies. The campaign was vicious, with Jefferson’s supporters calling Adams a “hideous hermaphroditical character” and Adams’s allies claiming Jefferson was an atheist who would destroy Christianity.

Jefferson won in 1800, and the two men didn’t speak for over a decade. Their relationship was so bitter that Adams left Washington early in the morning, before Jefferson’s inauguration. What makes their story extraordinary is the reconciliation. In 1812, mutual friends convinced them to resume correspondence. Their letters over the next fourteen years—158 of them—became one of the great intellectual exchanges in American history, discussing philosophy, politics, and their memories of the Revolution. Both men died on July 4, 1826, the fiftieth anniversary of the Declaration of Independence, with Adams’s last words reportedly being “Thomas Jefferson survives” (though Jefferson had actually died hours earlier).

Franklin vs. Adams: A Clash of Styles

In Paris, the relationship between Benjamin Franklin and John Adams was a tense blend of grudging professional reliance and deep personal irritation, rooted in radically different diplomatic styles and temperaments. Franklin, already a celebrated figure at Versailles, cultivated French support through charm, sociability, and patient maneuvering in salons and at court, a method that infuriated Adams. He equated such “nuances” with evasiveness and preferred direct argument, formal memorandums, and hard‑edged ultimatums. Sharing lodgings outside Paris only intensified Adams’s resentment as he watched Franklin rise late, receive endless visitors, and seemingly mix pleasure with business, leading Adams to complain that nothing would ever get done unless he did it himself, while Franklin privately judged Adams “always an honest man, often a wise one, but sometimes and in some things, absolutely out of his senses.” Their French ally, Foreign Minister Vergennes, reinforced the imbalance by insisting on dealing primarily with Franklin and effectively sidelining Adams in formal diplomacy. This deepened Adams’s sense that Franklin was both overindulged by the French and insufficiently assertive on America’s behalf. Yet despite their mutual loss of respect, the two ultimately cooperated—often uneasily—in the peace negotiations with Britain, and both signatures appear on the 1783 Treaty of Paris, a testament to the way personal feud and shared national purpose coexisted within the American diplomatic mission.

Hamilton and Burr: From Political Rivalry to Fatal Duel

The Hamilton-Burr feud ended in the most dramatic way possible: a duel at Weehawken, New Jersey, on July 11, 1804, where Hamilton was mortally wounded and Burr destroyed his own political career.

Their rivalry had been building for years. Both were New York lawyers and politicians, but Hamilton consistently blocked Burr’s ambitions. When Burr ran for governor of New York in 1804, Hamilton campaigned against him with particular venom, calling Burr dangerous and untrustworthy at a dinner party. When Burr read accounts of Hamilton’s remarks in a newspaper, he demanded an apology. Hamilton refused to apologize or deny the comments, leading to the duel challenge.

What made this especially tragic was that Hamilton’s oldest son, Philip, had been killed in a duel three years earlier defending his father’s honor. Hamilton reportedly planned to withhold his fire, but he either intentionally shot into the air or missed. Burr’s shot struck Hamilton in the abdomen, and he died the next day. Burr was charged with murder in both New York and New Jersey and fled to the South.  Though he later returned to complete his term as vice president, his political career was finished.

Adams vs. Hamilton: The Federalist Crack-Up

One of the most destructive feuds happened within the same party. John Adams and Alexander Hamilton were both Federalists, but their relationship became poisonous during Adams’s presidency (1797-1801).

Hamilton, though not in government, tried to control Adams’s cabinet from behind the scenes. When Adams pursued peace negotiations with France (the “Quasi-War” with France was raging), Hamilton wanted war. Adams discovered that several of his cabinet members were more loyal to Hamilton than to him and fired them. In the 1800 election, Hamilton wrote a fifty-four-page pamphlet attacking Adams’s character and fitness for office—extraordinary since they were in the same party. The pamphlet was meant for limited circulation among Federalist leaders, but Jefferson’s allies got hold of it and published it widely, devastating both Adams’s re-election chances and Hamilton’s reputation. The feud helped Jefferson win and essentially destroyed the Federalist Party.

Washington and Jefferson: The Unacknowledged Tension

While Washington and Jefferson never had an open feud, their relationship cooled significantly during Washington’s presidency. Jefferson, as Secretary of State, increasingly opposed the administration’s policies, particularly Hamilton’s financial program. When Washington supported the Jay Treaty with Britain in 1795—which Jefferson saw as a betrayal of France and Republican principles—Jefferson became convinced Washington had fallen under Hamilton’s spell.

Jefferson resigned from the cabinet in 1793, partly from policy disagreements but also from discomfort with what he saw as Washington’s monarchical tendencies (the formal receptions and the ceremonial aspects of the presidency). Washington, in turn, came to view Jefferson as disloyal, especially when he learned Jefferson had been secretly funding attacks on the administration in opposition newspapers and had even put a leading critic on the federal payroll. By the time Washington delivered his Farewell Address in 1796, warning against political parties and foreign entanglements, many saw it as a rebuke of Jefferson’s philosophy. They maintained outward courtesy, but their warm relationship never recovered.

Why These Feuds Mattered

These weren’t just personal squabbles—they shaped American democracy in profound ways. The Hamilton-Jefferson rivalry created our two-party system (despite Washington’s warnings). The Adams-Hamilton split showed that parties could fracture from within. The Adams-Jefferson reconciliation demonstrated that political enemies could find common ground after leaving power.

The founding fathers were human, with all the ambition, pride, jealousy, and pettiness that entails. They fought over power, principles, and personal slights. What’s remarkable isn’t that they agreed on everything—they clearly didn’t—but that despite their bitter divisions, they created a system robust enough to survive their feuds. The Constitution itself, with its checks and balances, almost seems designed to accommodate such disagreements, ensuring that no single person or faction could dominate.

SOURCES

  1. National Archives – Founders Online

https://founders.archives.gov

2.   Massachusetts Historical Society – Adams-Jefferson Letters

https://www.masshist.org/publications/adams-jefferson

       3.    Founders Online – Hamilton’s Letter Concerning John Adams

https://founders.archives.gov/documents/Hamilton/01-25-02-0110

       4.    Gilder Lehrman Institute – Hamilton and Jefferson

https://www.gilderlehrman.org/history-resources/spotlight-primary-source/alexander-hamilton-and-thomas-jefferson

       5.    National Park Service – The Conway Cabal

https://www.nps.gov/articles/000/the-conway-cabal.htm

       6.    American Battlefield Trust – Hamilton-Burr Duel

https://www.battlefields.org/learn/articles/hamilton-burr-duel

        7.   Mount Vernon – Thomas Jefferson

https://www.mountvernon.org/library/digitalhistory/digital-encyclopedia/article/thomas-jefferson

        8.   Monticello – Thomas Jefferson Encyclopedia

https://www.monticello.org/research-education/thomas-jefferson-encyclopedia

        9.   Library of Congress – John Adams Papers

https://www.loc.gov/collections/john-adams-papers

10. Joseph Ellis – “Founding Brothers: The Revolutionary Generation”

https://www.pulitzer.org/winners/joseph-j-ellis

Illustration generated by author using ChatGPT.

Fecal Microbiota Transplantation: When Waste Becomes Therapy

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On February 4, 2026

In Medicine

Today I’m going to talk about something that may sound unbelievable and maybe even a little gross—fecal transplant. Yes, it’s exactly what it sounds like. Getting a transplant of someone else’s poop.

The human gut contains trillions of microorganisms—bacteria, viruses, fungi—living in a complex ecosystem that influences everything from digestion to immune function. This is called the microbiome.  When this ecosystem gets disrupted, the consequences can range from uncomfortable to life-threatening. Enter one of medicine’s most counterintuitive treatments: fecal microbiota transplantation, or FMT, where stool from a healthy donor is transferred to a patient to restore a healthy community of gut microbes.

What Is FMT

The basic idea is simple: if someone’s microbiome has been badly disrupted (most commonly by repeated antibiotic exposure), replacing it with a balanced microbial ecosystem can help the gut recover.  At its core, FMT is taking fecal matter from a healthy donor and introducing it into a patient’s gastrointestinal tract. But it’s not the solid waste itself that matters; it’s the billions of beneficial bacteria and other microorganisms living in that material. Think of it as a probiotic treatment on steroids, delivering an entire functioning ecosystem rather than just a few select bacterial strains.

The gut microbiome plays crucial roles in digestion, vitamin production, immune system regulation, and even protection against harmful pathogens. When antibiotics, illness, or other factors devastate this ecosystem, dangerous bacteria like Clostridioides difficile (C. diff) can take over, causing severe diarrhea, inflammation, and potentially fatal infections.

The Clinical Track Record

While it may sound like “weird science”, FMT has been around for centuries. It was used in ancient Chinese medicine in a formulation called “yellow soup“ to treat food poisoning and intractable diarrhea. It was used as early as the 16th century in Europe to treat sick farm animals, particularly sheep and cattle.

FMT’s most dramatic success story involves C. diff infections, particularly the recurrent cases that don’t respond to antibiotics. Multiple randomized controlled trials have shown FMT to be remarkably effective—with cure rates often exceeding 80-90% for recurrent C. diff infections, compared to roughly 25-30% for continued antibiotic therapy. A landmark 2013 study reported in the New England Journal of Medicine was stopped early because FMT was so dramatically superior to standard treatment that continuing to withhold it from the control group seemed unethical.

Beyond C. diff, researchers are investigating FMT for inflammatory bowel diseases like ulcerative colitis and Crohn’s disease, with mixed but occasionally promising results. Some studies have shown potential for ulcerative colitis, with remission rates around 24-27%. The research into Crohn’s disease, irritable bowel syndrome, metabolic disorders, and even neurological conditions is ongoing but less conclusive. The FDA currently considers FMT an investigational treatment for most conditions except recurrent C. diff, where it’s become a recognized therapeutic option.

How It Works

The actual process of FMT can use several routes. The most common approaches involve colonoscopy, where the donated material is delivered directly to the colon, or through nasogastric or nasoduodenal tubes that thread through the nose down to the small intestine. More recently, oral capsules containing frozen, encapsulated donor stool have become available, offering a less invasive alternative that patients often prefer.

Before the transplant, the donated stool is carefully processed. It’s typically mixed with a saline solution and filtered to remove large particles while preserving the microbial communities. The resulting liquid suspension is what gets delivered to the patient. For frozen preparations, this material is mixed with a cryoprotectant, frozen at extremely cold temperatures, and can be stored for months before use.

The preparation isn’t just about the donor material—patients often undergo their own preparation. Many protocols include antibiotics to reduce the overgrowth of harmful bacteria before the transplant, followed by bowel cleansing similar to what you’d do before a colonoscopy. The idea is to create a relatively clean slate where the new microbial ecosystem can establish itself.

Sources of Donor Material

This brings us to one of the most critical aspects: donor selection and screening. Not just anyone can donate stool for medical use. The screening process is extensive and rigorous, rivaling or exceeding the scrutiny applied to blood donation.

Donors undergo detailed health questionnaires covering everything from recent travel and antibiotic use to gastrointestinal symptoms and risk factors for infectious diseases. They provide blood and stool samples that are tested for a long list of potential pathogens: C. diff, Helicobacter pylori, parasites, hepatitis A, B, and C, HIV, syphilis, and various other bacteria and viruses. The FDA issued guidance requiring additional testing for multi-drug resistant organisms after several patients contracted serious infections from FMT.

Donors generally fall into two categories: directed donors and universal donors. Directed donors are typically family members or friends who undergo screening and provide stool specifically for one patient. Universal donors go through the same rigorous screening but provide samples that can be used for multiple patients. These universal donors often work with stool banks—specialized facilities that collect, process, screen, and distribute donor material to healthcare providers.

The largest stool bank in the United States, OpenBiome, was founded in 2012 and has processed material from thousands of donors for tens of thousands of treatments. They report that only about 2-3% of volunteer donors successfully make it through the screening process, highlighting just how selective the criteria are. These banks have made FMT more widely available, eliminating the need for individual healthcare facilities to find and screen their own donors.

The Balance of Promise and Caution

While FMT represents a genuine breakthrough for recurrent C. diff infections, the medical community remains appropriately cautious about expanding its use. The FDA regulates FMT and has expressed concerns about potential risks, particularly after cases where patients developed serious infections from inadequately screened donors. There questions about the long-term effects of introducing another person’s microbiome, and there are theoretical concerns about transmitting conditions or predispositions we don’t fully understand.

The research into FMT for conditions beyond C. diff continues, but many trials have shown modest or inconsistent results. The microbiome’s role in health and disease is incredibly complex, and what works dramatically for one condition may not translate to others. Still, the fundamental insight—that our gut microbiome profoundly influences our health and that we can therapeutically manipulate it—has opened potential new avenues in medicine.

Sources

                1. van Nood, E., et al. (2013). “Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile.” New England Journal of Medicine, 368(5), 407-415. https://www.nejm.org/doi/full/10.1056/NEJMoa1205037

                2. U.S. Food and Drug Administration. “Fecal Microbiota for Transplantation: Safety Information.” https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/fecal-microbiota-transplantation-safety-information

                3. Cammarota, G., et al. (2017). “European consensus conference on faecal microbiota transplantation in clinical practice.” Gut, 66(4), 569-580. https://gut.bmj.com/content/66/4/569

                4. Moayyedi, P., et al. (2015). “Fecal Microbiota Transplantation Induces Remission in Patients With Active Ulcerative Colitis in a Randomized Controlled Trial.” Gastroenterology, 149(1), 102-109. https://www.gastrojournal.org/article/S0016-5085(15)00381-5/fulltext

                5. Kelly, C.R., et al. (2016). “Update on Fecal Microbiota Transplantation 2015: Indications, Methodologies, Mechanisms, and Outlook.” Gastroenterology, 150(1), 276-290. https://www.gastrojournal.org/article/S0016-5085(15)01626-7/fulltext

                6. OpenBiome. “Our Process: Screening.” https://www.openbiome.org/safety

                7. Quraishi, M.N., et al. (2017). “Systematic review with meta-analysis: the efficacy of faecal microbiota transplantation for the treatment of recurrent and refractory Clostridium difficile infection.” Alimentary Pharmacology & Therapeutics, 46(5), 479-493. https://onlinelibrary.wiley.com/doi/full/10.1111/apt.14201​​​​​​​​​​​​​​​​

Illustration generated by author using Midjourney

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