So…Donald Trump got an MRI, but he’s really stupid about it.

Trump added Sunday that he has no idea on what part of his body he got the MRI.

It was just an MRI, he said. What part of the body? It wasn’t the brain because I took a cognitive test and I aced it.

Doctors typically order an MRI to help with diagnosing symptoms or to monitor an ongoing health problem. So-called “preventive” cardiac and abdominal MRIs are not part of routine screening recommendations. What Trump’s doctor called an “executive physical” generally refers to adding extra, non-routine tests including MRIs to pricey and lengthy exams, not covered by insurance, that are marketed to wealthy people.

I can speak authoritatively from a patient’s perspective on MRIs, because I’ve had two of them in the past year. The first was for a knee problem, and the second was that the doctors wanted to rule out that I was having a stroke after a blood vessel in my eye popped.

First thing I can say is that MRIs are expensive and you don’t get them routinely. The doctors have to get approval from the insurance company, which is maybe not an issue for a stupidly rich person. But they don’t just give them to you on a whim — they have a medical reason for checking you out, and they tell you why they’re doing it. Even if you are so rich you can afford to just do it, it’s going to take a substantial chunk of time, maybe an hour or more, so doctors do try to justify it to you.

The second thing is that you know what’s being scanned. For my knee, they braced it with a couple of padded clamps to hold it in place. For my brain scan, they fitted a plastic helmet around my head to limit movement. Only an idiot would fail to recognize what the instrument was for.

Thirdly, afterwards the doctors tell you what they found. In one case, they found I had a torn meniscus; in the other, no evidence that I’d had a stroke (that must be what getting a “perfect” MRI means). They both discussed it with me in person and sent me an after-examination document that spelled it all out. They also noted some deterioration of the cervical vertebrae, but my knees, other than the meniscus, were flawless.

Is Trump so out of it that the doctors treated him as a dumb piece of meat, sending him off for tests without explanation, stuffing him into a noisy tube without explanation and no preparation, and then not bothering to let him know the results? Did he just sleep through the whole procedure?

Fourthly, you don’t “ace” a cognitive test, and it’s mostly separate from MRIs. I had an MRI but I’ve never taken a cognitive test — the doctors have no suspicion that I’m cognitively impaired, so they don’t bother testing. My mother, on the other hand, didn’t get an MRI because she wasn’t exhibiting those kinds of physical symptoms, but she was exhibiting behavioral symptoms, so they gave her a basic cognitive test, like the ones Trump has previously described (she did fail parts of the test, which was heartbreaking to see). Passing a cognitive test only means that you’ve retained basic mental skills, like having short-term memory and being able to draw a clock face.

You get a cognitive test when there are grounds to suspect a patient is having mental problems. I’ve never had one, but Trump has had a couple of them, with good reason, I think.

You get MRIs when there are physical symptoms that warrant a closer look. Trump seems to be getting trundled off to all kinds of exceptional tests, suggesting that doctors are concerned.

Of course, it’s also possible that he has hired a team of unethical, incompetent doctors, similar to his usual hiring practices, and they see Trump as a healthy mark with more money than sense that they can gouge for all kinds of unnecessary testing.

Tragic news from Shelton*, Washington: in an animal sanctuary that specializes in big cats, the Wild Felid Advocacy Center, the tigers and caracals and lynxes have been dropping like flies.

“They’re drowning, basically, in their own lungs,” said Melinda Mathews.

Melinda Mathews lives here full-time with her husband, Mark, who founded the nonprofit in 2006.

“They were immensely suffering,” Melinda said, her face drawn in sadness. “It was the hardest thing, so hard.”

The first to get sick was a cougar, Hannah Wyoming, back in mid-November. The veterinarian thought she had cancer. And when Crackle, an African Caracal got sick, the vet thought the cause was cancer, too.

But the big cats died and others soon followed.

“Basically, we’ve lost a cat every day for about two and a half weeks,” Mark said.

It’s the bird flu, H5N1, that was spreading through all the animals. They think it was transmitted through the cat food, which often contained bird meat. Now there has also been a recall of Northwest Naturals Turkey Recipe cat food after tests showed that it was tainted with H5N1, and after one domestic pet died of bird flu.

This is how those sneaky viruses get you. H5N1 is spread widely in bird populations, but is unlikely to spread to humans, and does so only rarely. Now a variant has a toehold in a common, widespread mammal that thrives in our homes and farms and cities, numbering about 75 million animals. If a pandemic spreads through that population, which would be terrible news in itself, a variant that can thrive in people could arise, and then…lockdowns and mask mandates and a frantic search for a vaccine. Unfortunately, this could come at a time when a big chunk of the population likes to defy basic practices in hygiene and when an incoming administration has expressed a desire to gut the scientific enterprise in the USA, and we’re about to have a demented anti-vaxxer in charge of biomedical research.

I guess the evil cat is going to have to go. I’m not going to harbor a plague vector in my home.

Wait, what’s that? The cat has informed me that she’s an indoor cat and we never let her go outside anyway, despite all the tail-twitching staring she does at the window. Also, all of her cat food is fish-based, because she doesn’t like the taste of bird — she wants to murder them, not eat them.

Also, we haven’t trimmed her razor sharp claws in a while, and she knows where we sleep.

*I know where Shelton is! My grandson lives in Lacey, and I have other relatives in McCleary.

I have not been masking up all summer long. This town is very sparsely populated in the summer, and instead of masking I have just been avoiding humanity as much as possible.

That’s about to change. The students are flooding back this weekend, I have advising meetings starting Monday, and I’m expected to mingle with everyone starting next week. I may have to carry a black widow on my shoulder to discourage that sort of thing.

COVID cases are rising again, so it’s a good idea to minimize exposure, so I’ll be wearing my mask all the time starting Monday. I’m also reading about the current backlash — would you believe nurses in the UK are discouraged from wearing masks?

Meanwhile, a hospital nurse in Scotland said they faced abuse for still wearing a mask.

“It horrifies me that if l choose to wear a mask I’m questioned by my colleagues and patients,” they said.

“It’s like the last couple of years and long Covid doesn’t exist or doesn’t matter when it does. I don’t want to wear a mask but l don’t want to spread or catch it either.”

They said they were at their “wit’s end” after almost three decades in nursing.

As well as seeing a rise in cases among their local populations, 40% of nurses reported that they have had Covid-19 themselves this summer.

Of those, 21% said they had attended work while infected with the virus.

In the comments section, many nurses said that the policies in their workplaces and the attitudes of managers meant they felt pressured to come to work even if they had Covid-19.

They also reported that they were discouraged from testing themselves and patients.

A care home nurse in England said that “management is actively discouraging staff from testing due to concerns about a reduced workforce”.

A nursing associate based in NHS hospitals in England added: “It’s like Covid never existed… we get told off for testing.”

Similarly, an advanced nurse practitioner in England said: “I feel that there is huge pressure on staff to work with Covid even if symptomatic which increases [the] risk of spread to patients.”

Wait, what? Nurses are told to continue working maskless with patients while symptomatic with COVID? I’ve been to the local hospital a few times this summer, and I noticed that while they still grill you on COVID symptoms and travel when you check in, no one there is wearing a mask. It would be slightly annoying to come down with a potentially deadly respiratory disease because you went in for your colonoscopy.

That settles it. The mask is back, baby. And I will look good wearing it.

I’ve been at home, rarely stepping out, other than to visit an empty university and a lab populated entirely and exclusively by spiders. And I like it that way! Alas, it all changes on Tuesday, when the students return and I have to mingle with them 5 days a week. I have my masks, and I’ve been thoroughly vaccinated, but I’m also aware that there are plague demons among us. People like Joseph Ladapo, surgeon general of Florida, and accomplice to the fast-fading fascist, Ron DeSantis.

It used to be fairly easy to dismiss Florida’s surgeon general, Dr. Joseph A. Ladapo, as a clownish anti-vaccine quack posing a danger mostly to residents of his home state.

That has become harder to do as time goes on, as Ladapo has moved from promoting useless treatments for COVID-19, such as the drugs hydroxychloroquine and ivermectin, to waging an ever-expanding fact-free campaign against the leading COVID vaccines.

This month, Ladapo established a new low for himself. In a public advisory issued Wednesday by the Florida Department of Health, he declared the vaccines “not appropriate for use in human beings” and counseled doctors to steer patients to other treatments. He explicitly called for a “halt in the use of COVID-19 mRNA vaccines.”

He’s basing this sweeping dismissal on ONE (1) swiftly debunked paper by an anti-vax crank.

It’s not just COVID, though. I’m concerned about that as I prepare to share an atmosphere with students again, but also because we’ve got idiots like Ladapo everywhere who are disrupting basic public health with their absurd ideas.

Then there’s the public health context: As COVID infections have been surging coast to coast, advisories from public health authorities to resume masking and take other protective measures, such as making sure you’re up to date on vaccinations, are almost invisible.

Even more worrisome, the incidence of other vaccine-preventable diseases may be rising. As many as nine cases of measles have been reported in Philadelphia, some associated with an infection started at a daycare center with a family that violated quarantine rules.

Among the victims, according to the Philadelphia Inquirer, are “an infant who was too young to get vaccinated, an unvaccinated older child and the older child’s unvaccinated parent.”

Nine cases may not sound like a lot — 41 were reported nationwide in 2023 — but they could be a harbinger of worse to come, in clusters in which anti-vaccine propaganda has taken hold.

The “invisible” aspect of public health advisories is notable — my university used to have a big bold link on the main web page that pointed to the status of the pandemic on campus, with recommendations for protecting oneself. It’s gone. You have to dig to find any updates on COVID. I guess someone thinks COVID-19 is over.

And then, undermining public confidence in such basic principles of good preventive medicine, such as vaccines and hygiene, as Ladapo is doing, is going to do long-lasting harm. I don’t want to die of COVID, but I also don’t want to die of polio, or measles, or the bubonic plague, or some exotic new disease that springs up in the rotting flesh of some Republican ignoramus. Ladapo and all of these conservative know-nothings are making that more probable.

How do these morons get any power at all in government, I’d like to know.

And he’s giving us even more reason to punch him!

Infamous “Pharma Bro” Martin Shkreli announced his newest venture yesterday, and it’s about as awful as you’d expect. In a Substack post and on Twitter, he unveiled DrGupta.ai, a “virtual healthcare assistant” that (predictably) Shkreli believes will disrupt medicine—in spite of some very real and worrying legal and ethical gray areas.

“My central thesis is: Healthcare is more expensive than we’d like mostly because of the artificially constrained supply of healthcare professionals,” he wrote on Substack. “I envision a future where our children ask what physicians were like and why society ever needed them.”

“Dr. Gupta” is just Shkreli’s latest health venture since being released from prison last May. Last year, he founded Druglike, a drug discovery software platform being investigated by the Federal Trade Commission. The FTC is looking into whether Shkreli is violating a court-ordered lifetime ban on working in the pharmaceutical industry by running Druglike.

Madness. If you replace all the healthcare professionals who generate the data that is leeched off by a glorified chatbot with said chatbot, where is the information that they parrot going to come from? All you’re going to have left is a feedback loop that is disconnected from any reality checks, it’s going to get progressively worse, and we’re not going to get any new medical knowledge.

It’s quite rich that he’s blaming the high expenses of medical care on scarce skilled medical labor and knowledge, when he’s the guy who artificially elevated the cost of life-saving drugs. Blame the greedy pharmaceutical executives instead.

Hey, people like Shkreli are the ones who could be replaced by a mindless software program!

A few weeks ago, I had what is called a transient ischemic attack — don’t worry, it was brief, hasn’t returned, and the doctors examined me inside & out with embarrassing thoroughness, and have given me a clean bill of health — but it was terrifying. For a whole ten minutes, I couldn’t focus on a simple and familiar task on the computer. I knew what I had to do, if I was thinking normally, and I couldn’t figure out how to find basic, abstract functions on the screen in front of me. When it passed, then click-click-click it was a second’s work, and I couldn’t understand what had happened.

Today I read Ed Yong’s latest, and dear god, it is chilling.

On March 25, 2020, Hannah Davis was texting with two friends when she realized that she couldn’t understand one of their messages. In hindsight, that was the first sign that she had COVID-19. It was also her first experience with the phenomenon known as “brain fog,” and the moment when her old life contracted into her current one. She once worked in artificial intelligence and analyzed complex systems without hesitation, but now “runs into a mental wall” when faced with tasks as simple as filling out forms. Her memory, once vivid, feels frayed and fleeting. Former mundanities—buying food, making meals, cleaning up—can be agonizingly difficult. Her inner world—what she calls “the extras of thinking, like daydreaming, making plans, imagining”—is gone. The fog “is so encompassing,” she told me, “it affects every area of my life.” For more than 900 days, while other long-COVID symptoms have waxed and waned, her brain fog has never really lifted.

Of long COVID’s many possible symptoms, brain fog “is by far one of the most disabling and destructive,” Emma Ladds, a primary-care specialist from the University of Oxford, told me. It’s also among the most misunderstood. It wasn’t even included in the list of possible COVID symptoms when the coronavirus pandemic first began. But 20 to 30 percent of patients report brain fog three months after their initial infection, as do 65 to 85 percent of the long-haulers who stay sick for much longer. It can afflict people who were never ill enough to need a ventilator—or any hospital care. And it can affect young people in the prime of their mental lives.

AAAAAAAAAAAAIIEEE! That’s what I experienced…for ten minutes. But that’s one of the possible symptoms of long-COVID, and people go through it for months? I can’t imagine it. I wouldn’t want to go through that.

For example, Robertson’s brain often loses focus mid-sentence, leading to what she jokingly calls “so-yeah syndrome”: “I forget what I’m saying, tail off, and go, ‘So, yeah …’” she said. Brain fog stopped Kristen Tjaden from driving, because she’d forget her destination en route. For more than a year, she couldn’t read, either, because making sense of a series of words had become too difficult. Angela Meriquez Vázquez told me it once took her two hours to schedule a meeting over email: She’d check her calendar, but the information would slip in the second it took to bring up her inbox. At her worst, she couldn’t unload a dishwasher, because identifying an object, remembering where it should go, and putting it there was too complicated.

That’s exactly what I was trying to do! I was trying to put a presentation I had to give on my calendar/email, and somehow I couldn’t figure out where anything was or what steps I had to take. Even my brief experience with that was intolerably frustrating. It was so awful that immediately after I recovered my ability to act again, I checked into a hospital, despite feeling totally fine once it passed.

Thanks, Ed Yong. Now in addition to worrying about respiratory failure and death, I can dread losing my brain. I’ve managed to avoid getting COVID at all so far, and now I’m motivated to be even more scrupulous in my preventive efforts. It’s too bad my employers, a fucking university, has so little concern about the minds of their faculty and students.