Tag: Mike Magee

Father Christmas Reminds Us We Can Do Better Than This

Dec 23, 2025

By MIKE MAGEE

The Ghost of Christmas Past, in the form of Surgeon General C. Everett Koop, has returned this season to torture one RFK Jr who refuses to fully share life saving vaccines with children. In the encounter, the ghostly Koop reviews a time 37 years ago when citizens came together to celebrate separating scientific fact from fiction with life-saving effects.

Beginning in 1988, the United States, along with the rest of the world, had formally acknowledged and celebrated World AIDS Day on December 1st each year – that is until 2025. At President’s Trump’s direction the State Department, and with HHS support, turned their back on an inconvenient truth – the Republican early record on HIV/AIDS. Let’s channel the truth-telling Surgeon General from Christmas past and remember this telling story.

On June 5, 1981, the CDC reported 6 cases of Pneumocystis carinii associated with a strange immune deficiency disorder in California men. Drs. Michael Gottlieb and Joel Weismann, infectious disease experts who delivered care routinely for members of the gay population in Los Angeles, had alerted the CDC. Inside the organization, there was a debate on how best to report this new illness in gay men.

The vehicle that the CDC chose was a weekly report called the Morbidity and Mortality Weekly Report or MMWR. So as not to offend, the decision was made to post the new finding, not on page 1, but on page 2, with no mention of homosexuality in the title. Almost no one noticed.

On April 13, 1982, nine months after the initial alert, Senator Henry Waxman held the first Congressional hearings on the growing epidemic. The CDC testified that tens of thousands were likely already infected. On September 24, 1982, the condition would for the first time carry the label, AIDS – acquired immune deficiency syndrome.

The new Surgeon General, C. Everett Koop’s focus at the time, along with the vast majority of public health leaders across the nation, was not on a new emerging infectious disease, but rather on the nation’s chronic disease burden, especially cardiovascular disease and cancer being fed by the post-war explosion of tobacco use. He had already surmised that the power of his position lie in communications and advocacy.

One month after his swearing in, he appeared on a panel to release a typically boring Surgeon General update report on tobacco. He was not intended to have a big role. When Koop rose to deliver what all thought would be brief, inconsequential remarks, he wasted no time disintegrating the lobbyist organization, the Tobacco Institute. For print journalists in the audience, he was clear, concise and quotable. For broadcast journalists, he was a dream come true – tall, erect with his Mennonite beard, in a dark suit with bow tie, exuding a combination of extreme confidence and legitimacy mixed with “don’t mess with me” swagger.

As Koop would later say, after that, “I began to be quoted as an authority. And the press from that time on was all on my side… I made snowballs and they threw ‘em.” The other thing that Koop noticed early was that the Reagan Administration didn’t shut him down. That was surprising since Koop’s major supporter in a year long confirmation battle (the AMA opposed his appointment) was NC arch-conservative Senator Jesse Helms.

Add to Jesse’s wrath, R.J. Reynold’s CEO, Edward Horrigan, complained directly to Reagan about Koop’s “increasingly shrill preachments. Cigarette consumption in the US was in free fall. By 1987, 40 states would have laws banning smoking in public places; 33 states had bans in public transportation; and 17 already had eliminated workplace smoking.

Still Reagan didn’t shut him down. Now everyone from public schools to medical groups to women’s associations to civic enterprises wanted him. And beginning in late 1982, he arrived in full regalia, in a magnificent Public Health Service, Vice-Admiral’s uniform with ribbons and epaulettes. And his aide, also in uniform, always carried with him a bag of buttons for distribution which read, “The Surgeon General personally asked me to quit smoking.”

But in the most pressing public health challenge of the day, HIV/AIDS, the department was AWOL. Koop was actively sidelined by top Administration officials. Not surprisingly, the situation deteriorated rapidly. Everyone was feeling the heat, including the CDC, who removed funding for AIDS education after being accused of promoting sodomy by conservatives.

Watching Where and How You’re Walking

Jul 18, 2025

By MIKE MAGEE

In a speech to the American Philosophical Society in January, 1946, J. Robert Oppenheimer said, “We have made a thing …that has altered abruptly and profoundly the nature of the world…We have raised again the question of whether science is good for man, of whether it is good to learn about the world, to try to understand it, to try to control it, to help give to the world of men increased insight, increased power.”

Eight decades later, those words reverberate, and we once again are at a seminal crossroads. This past week, Jensen Huang, the CEO of Nvidia, was everywhere, a remarkably skilled communicator celebrating the fact that his company was now the first publicly traded company to exceed a $4 trillion valuation.

As he explained, “We’ve essentially created a new industry for the first time in three hundred years. the last time there was an industry like this, it was a power generation industry…Now we have a new industry that generates intelligence…you can use it to discover new drugs, to accelerate diagnosis of disease…everybody’s jobs will be different going forward.”

Jensen, as I observed him perform on that morning show, seemed just a bit overwhelmed, awed, and perhaps even slightly frightened by the pace of recent change. “We reinvented computing for the first time since the 60’s, since IBM introduced the modern computer architecture… its able to accelerate applications from computer graphics to physics simulations for science to digital biology to artificial intelligence. . . . in the last year, the technology has advanced incredibly fast. . . AI is now able to reason, it’s able to think… Before it was able to understand, it was able to generate content, but now it can reason, it can do research, it can learn about the latest information before it answers a question.”

Of course, this is hardly the first time technology has triggered flashing ethical warning lights. I recently summarized the case of Facial Recognition Technology (FRT). The US has the largest number of closed circuit cameras at 15.28 per capita, in the world. On average, every American is caught on a closed circuit camera 238 times a week, but experts say that’s nothing compared to where our “surveillance” society will be in a few years.

The field of FRT is on fire.

Towards a Tricoder

Jul 11, 2025

By MIKE MAGEE

On March 9, 1967, the Star Trek classic episode, “The Devil in the Dark” first aired. The Enterprise had received an urgent distress call from miners on the planet Janus VI. They are literally melting after, Horta, a wounded inhabitant has targeted them with liquifying acid rays.

A sympathetic Spock hears the call, and in an effort to disclose cause and motivation, “mind-melts” with the creature. Turns out, all she’s trying to do is protect her babies from a perceived threat. Kirk agrees, and with Spock, calls in Dr. McCoy to access the patient’s condition.

What McCoy encounters is a “rocky-skinned patient.” With the aid of his tricoder, a handheld diagnostic sensor, “Bones” (McCoy’s nickname referencing the historical 19th century American slang “Sawbones” referring to surgeons) uncovers a serious and deep gaping wound that requires immediate attention.

Kirk manages to “beam down” a hundred pounds of thermoconcrete, and McCoy expertly applies it to the wound. All of which is a set-up for his shipmates to wonder if this will work, which generates the iconic most-repeated line in the series storied history. McCoy (clearly irritated) utters – “How do I know? I’m a doctor, not a bricklayer.”

Similarly challenged modern day doctors have been voicing their own frustrations for more than a few decades. But the AMA has been scientifically tracking their discontent only since 2011. The levels of burnout are somewhat down in 2025 compared to peaked pique in 2021. But among the irritants, integration of new technology remain near the top of the list.

Water, Water, Everywhere . . . but Not a Drop to Drink

Jul 9, 2025

By MIKE MAGEE

In the wake of last week’s human tragedy in Texas, it would be easy (and appropriate) to focus on the role played by Trump’s reckless recent dismantling of FEMA and related federal agencies. But to do so would be to accept that the event was an anomaly, or as Trump labeled it on Sunday on his way to a round of golf at Bedminster, “a hundred year catastrophe.”

In reality, tragedies like this are the direct result of global warming, and last week’s suffering and loss are destined to be followed by who knows how many others here and in communities around the world.

In 2009 President Obama joined global leaders in New York City for the Opening Session of the UN. One of the transboundary issues discussed was Global Warming. All agreed that the Kyoto Protocol had failed. It failed because the target to decrease emissions by some 5% was too low. It failed because large transitional nations like India and China were excluded. And it failed because US leadership opted out.

The global community today has a deeper hole out of which it must dig. In doing so we would do well to focus on health and safety as outcome measures, and define strategies to manage the obvious consequences of this ongoing crisis.

Two decades ago, the warnings were clear. Left unattended, we would soon not only need to plan mitigation, but also need to prepare and resource intervention to deal with inevitable human injury and disease fall-out. Of course, back then, we could not have predicted that wise disease interventions in climate ravaged hot spots around the globe, like expansion of USAID funding in the Bush and Obama administrations, would be X’d out under Trump/Musk. Who could have imagined such reckless and ultimately self-destructive moves?

And yet, here we are:

How Did the AI “Claude” Get Its Name?

Jun 11, 2025

By MIKE MAGEE

Let me be the first to introduce you to Claude Elwood Shannon. If you have never heard of him but consider yourself informed and engaged, including at the interface of AI and Medicine, don’t be embarrassed. I taught a semester of “AI and Medicine” in 2024 and only recently was introduced to “Claude.”

Let’s begin with the fact that the product, Claude, is not the same as the person, Claude. The person died a quarter century ago and except for those deep in the field of AI has largely been forgotten – until now.

Among those in the know, Claude Elwood Shannon is often referred to as the “father of information theory.” He graduated from the University of Michigan in 1936 where he majored in electrical engineering and mathematics. At 21, as a Master’s student at MIT, he wrote a Master’s Thesis titled “A Symbolic Analysis Relay and Switching Circuits” which those in the know claim was “the birth certificate of the digital revolution,” earning him the Alfred Noble Prize in 1939 (No, not that Nobel Prize).

None of this was particularly obvious in those early years. A University of Michigan biopic claims, “If you were looking for world changers in the U-M class of 1936, you probably would not have singled out Claude Shannon. The shy, stick-thin young man from Gaylord, Michigan, had a studious air and, at times, a playful smirk—but none of the obvious aspects of greatness. In the Michiganensian yearbook, Shannon is one more face in the crowd, his tie tightly knotted and his hair neatly parted for his senior photo.”

But that was one of the historic misreads of all time, according to his alma mater. “That unassuming senior would go on to take his place among the most influential Michigan alumni of all time—and among the towering scientific geniuses of the 20th century…It was Shannon who created the “bit,” the first objective measurement of the information content of any message—but that statement minimizes his contributions. It would be more accurate to say that Claude Shannon invented the modern concept of information. Scientific American called his groundbreaking 1948 paper, “A Mathematical Theory of Communication,” the “Magna Carta of the Information Age.”

I was introduced to “Claude” just 5 days ago by Washington Post Technology Columnist, Geoffrey Fowler – Claude the product, not the person. His article, titled “5 AI bots took our tough reading test. One was smartest — and it wasn’t ChatGPT,” caught my eye. As he explained, “We challenged AI helpers to decode legal contracts, simplify medical research, speed-read a novel and make sense of Trump speeches.”

Judging the results of the medical research test was Scripps Research Translational Institute luminary, Eric Topol. The 5 AI products were asked 115 questions on the content of two scientific research papers : Three-year outcomes of post-acute sequelae of COVID-19 and Retinal Optical Coherence Tomography Features Associated With Incident and Prevalent Parkinson Disease.

Not to bury the lead, Claude – the product – won decisively, not only in science but also overall against four name brand competitors I was familiar with – Google’s Gemini, Open AI’s ChatGPT, Microsoft Copilot, and MetaAI. Which left me a bit embarrassed. How had I never heard of Claude the product?

For the answer, let’s retrace a bit of AI history.

How Bright A Light Do We Shine This Memorial Day?

May 26, 2025

By MIKE MAGEE

According to Veterans Administration historians, the origin of Memorial Day dates back to 1864 when three women from Boalsburg, Pennsylvania joined in grief to decorate the graves of family members who had died in the Civil War. A year later, other townspeople joined in and one year later, in 1866, women in Columbus, Mississippi, joined the event, in honor of fallen Confederate soldiers. That was 14 years after the publication of Harriet Beecher Stowe’s Uncle Tom’s Cabin in 1852.

In that first year it was published, Uncle Tom’s Cabin sold over 300,000 copies. Author and critic Alfred Kazin called it “The most powerful and most enduring work ever written about American slavery.” Its prominence in the American lexicon speaks for itself, and its relevance regarding goodness and governance, leadership by legislation, women’s roles in creating civil societies and the underpinnings of Christianity in the unrealized potential of the American dream all speak to the continued value of the publication.

On page 2 of the preface, Harriet Beecher Stowe comments on “memorializing” human hatred and cruelty to the ash bin of history. She writes, “It is a comfort to hope, as so many of the world’s sorrows and wrongs have, from age to age, been lived down, so a time shall come when sketches similar to these shall be valuable only as memorials of what has long ceased to be.”

To this, we must respond today, “Not yet. There is work that remains.”

On the last page of her book, Harriet Beecher Stowe in 1852 reflects (as if on our modern day predicament), “This is an age of the world when nations are trembling and convulsed. A mighty influence is abroad, surging and heaving the world, as with an earthquake. And is America safe? Every nation that carries in its bosom great and unredressed injustice has in it the elements of this last convulsion.”

To this, we believers in human goodness and democracy must respond, “We will never be free, safe and healthy if our elected leaders promote policies – whether here or abroad – that belie our finer instincts, promote fear, and trigger predation.”

The White House, until recently, has largely been a sacred and treasured shrine. Back in 2013, our President at the time, Barack Obama, hosted our former President, George H.W. Bush and his family there to commemorate the 5000th award of a “Daily-Point-of-Light”, that the former President had launched to “honor individuals who demonstrate the transformative power of service, and who are driving significant and sustained impact through their everyday actions and words that light the path for other points of light.”

Here in part, is what President Obama said that day: “…given the humility that’s defined your life, I suspect it’s harder for you to see something that’s clear to everybody else around you, and that’s how bright a light you shine — how your vision and example have illuminated the path for so many others, how your love of service has kindled a similar love in the hearts of millions here at home and around the world. And, frankly, just the fact that you’re such a gentleman and such a good and kind person I think helps to reinforce that spirit of service. So on behalf of us all, let me just say that we are surely a kinder and gentler nation because of you and we can’t thank you enough.”

Just a dozen years ago, just to be publicly “thanked” seemed enough. And “active citizenship” as a member of this great nation was viewed by many – by most – as a duty and an honor – even to the point of sacrificing one’s life in defense of this nation.

That, after all, is what Memorial Day commemorates. Action is required, as is goodness and virtue by example and daily behavior.

We continue to struggle in the shadow of Uncle Tom’s Cabin. We lack perfection, but we certainly could, and should, do better. Because, to be healthy in America, to realize our full potential, to be civilized, as Ralph Waldo Emerson said, “to make good the cause of freedom against slavery you must be… Declaration of Independence walking.”

Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)

A Proud Republican Who Faced Off A Party Leader. . .and Won!

May 9, 2025

By MIKE MAGEE

This past week, Trump’s posting of himself as The Pope surfaced once again David French’s classic Christmas, 2024, New York Times column titled “Why Are So Many Christians So Cruel?”

As I wrote at the time, “French and his wife and three children have experienced the cruelty first hand since he openly expressed his opposition to Donald Trump during the 2016 Presidential campaign. That resulted in threats to his entire family by white supremacists who especially targeted his adopted Ethiopian daughter. Ultimately, he was “cancelled” by his own denomination, the small (approximately 400,000 members), Calvinist “Presbyterian Church of America”.

Over the past week, American politicians of every stripe have debated what exactly was Trump’s motive in debasing the Papacy as Pope Francis was being laid to rest. Three main theories have emerged.

1. As a malignant narcissist, Trump could not bear the fact that Pope Francis was stealing his limelight.

2. Trump was appealing to conservative Christian Evangelicals who are strongly opposed to the Papacy on theological grounds.

3. Trump was appealing to conservative Catholics like New York Post columnist Charles Gasparino who says, “… we respect Trump more than the socialist Pope.”

Of course, there likely are elements of truth in each of these. But I prefer to fall back on my New York City high school training and believe that this is the product of a dull witted school yard bully who thought this was funny.

This is not to say he has the courage to claim ownership. (Obviously this doesn’t get posted without his approval.) No. He lies to your face, saying:

“I had nothing to do with it, Somebody made up a picture of me dressed like the pope, and they put it out on the internet. That’s not me that did it, I have no idea where it came from — maybe it was A.I. But I have no idea where it came from.”

With his blessing, the image was posted at 10:29 PM on May 02, 2025 on his Truth Social account.

Pope Francis Links to Scalia on Due Process: The Case Made by a Skadden Litigator

Apr 25, 2025

By MIKE MAGEE

The Pope’s passing interrupted an epic battle between Trump and the rest of the civilized world over whether America remains a society “under the law.” Critical to the rule of law is the principle of “Due Process,” as described in not one, but two Amendments to our Constitution.

The Fifth Amendment states that no inhabitant shall be “deprived of life, liberty or property without due process of law.”

The Fourteenth Amendment, ratified after the Civil War and Emancipation, uses the same eleven words, called the “Due Process Clause,” to describe a legal obligation of all states.

In arrogantly ignoring any pretense of “Due Process” last week by deporting accused (but not proven) alleged gang member Kilmar Abrego Garcia to an El Salvador top security prison along with 220 others, and ignoring a court order to return the planes while still in flight, Trump basically thumbed his nose at America’s legal system. This was a bridge too far, even for some of his political supporters in Congress.

With that case still in litigation, the Administration tried to repeat the publicity stunt with another group of accused aliens this past weekend and was slapped down by the Supreme Court in an unanimous decision.

What Trump is learning the hard way is that without “Due Process” the law profession might as well hang up its shingle. Trump thought he had Chief Justice Roberts in his pocket when he purposefully allowed himself to be caught on a hot mic as he passed the Chief Justice on his way to deliver the 2025 State of the Union Address. His words for the camera, “Thank you again. Thank you again. Won’t forget it.” were intended to signal to the world, He owes me big time, and I own him.

A common “Due Process” thread connecting these two current events (the Pope’s death and the illegal deportation of Kilmar Albrego Garcia) includes another Supreme Court Justice – Antonio Scalia. Catholic and trained by Jesuits, he shared a common lineage with Pope Francis, the first Jesuit ever to lead the Catholic Church. Other Justices also share this Jesuit educational parentage including Clarence Thomas, Brett Kavanaugh, and Neil Gorsuch.

But Francis and Antonin have a second historical connection. Pope Francis, the day before the 2025 State of the Union address, publicly labeled the immigration policies of the incoming President and Vice President, “a disgrace.” More recently, the Vatican spoke out in opposition to last weeks El Salvador imprisonments. Part of criticism tracks back to the lack of “Due Process.”

Glaringly obvious today, this was just one arm of an aggressive Project 2025 campaign against America’s Legal Profession. By late March, multiple DC based law firms pledged allegiance to the Trump Administration to avoid being barred from entering Federal buildings to represent their clients. Some members of the targeted firms resisted. For example, Skadden associate, Rachel Cohen, resigned from her firm in protest, stating, “It does just all come around to, is this industry going to be silent when the president operates outside the balance of the law, or is it not?”

Feeling the Pressure

Apr 7, 2025

By MIKE MAGEE

After Trump crashed the markets, citizens worldwide are “feeling the pressure.” But in the spirit of calming us down, let’s consider a story of human cooperation and success from our past.

It has been estimated that a medical student learns approximately 15,000 new words during the four years of training. One of those words is sphygmomanometer. the fancy term for a blood pressure monitor. The word is derived from the Greek σφυγμός sphygmos “pulse”, plus the scientific term manometer (from French manomètre).

While medical students are quick to memorize and learn to use the words and tools that are part of their trade, few fully appreciate the centuries-long efforts to advance incremental insights, discoveries, and engineering feats that go into these discoveries.

Most students are familiar with the name William Harvey. Without modern tools, he deduced from inference rather than direct observation that blood was pumped by a four chamber heart through a “double circulation system” directed first to the lungs and back via a “closed system” and then out again to the brain and bodily organs. In 1628, he published all of the above in an epic volume, De Motu Cordis.

Far fewer know much about Stephen Hales, who in 1733, at the age of 56, is credited with discovering the concept of “blood pressure.” A century later, the German physiologist, Johannes Müller, boldly proclaimed that Hales “discovery of the blood pressure was more important than the (Harvey) discovery of blood.”

Modern day cardiologists seem to agree.

The World’s Psychoactive Drug of Choice

Apr 4, 2025

By MIKE MAGEE

Question: What is the world’s most widely used psychoactive drug?

Answer: Caffeine

In the U.S., caffeine is consumed mainly in the form of coffee, tea, and cola. But coffee dominates. Worldwide, humans consume over 10 million tons of coffee beans a year. Roughly 16% (1.62 million tons) is devoured by Americans. The daily intake of caffeine varies depending on type of beverage and brand as the chart below indicates.

On average, each American consumes approximately 164 mg of caffeine each day. That’s roughly 1 small cup of Dunkin or (3.5) 12-ounce Diet Cokes (Trump consumes at least 12 cans of Diet Coke a day).

Across the globe, daily consumption of caffeine is close to universal. Eight in 10 humans consume a caffeinated beverage daily. That makes this chemical substance the “most commonly consumed psychoactive substance globally.” Its popularity is related to its ability to deliver three useful physiological enhancements – wakefulness, motor performance, and cognition.

Chemically, caffeine is a close cousin of adenosine which is present in brain neurons. Adenosine builds up in synaptic connections between brain neurons. When it binds to special receptors, it activates neurons that promote sleepfulness. Ingested caffeine is water and lipid soluble, and therefore is able to traverse the blood-brain barrier. Once inside, its chemical structure mimics that of adenosine, and it occupies adenosine receptors because it shares the same approximate shape and size. When these receptors are occupied by caffeine, adenosine molecules are unable to activate the receptors. The net effect is wakefulness.