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The Last Day of the Guarantee

A box of prescription drugs sat forgotten in the back closet of a retail pharmacy long enough that some of the pills predated the 1969 moon landing. Sealed bottles, original containers, never opened. Diet pills under brand names nobody has spoken aloud in forty years. Barbiturates. A four-ingredient headache compound. Every one of them was at least twenty-eight years past the date stamped on the label, which meant that under every rule governing American pharmacy, they were garbage. Lee Cantrell, who helps run the California Poison Control System, looked at the box and saw an experiment nobody could afford to run on purpose. He called Roy Gerona at the University of California, San Francisco, a chemist who had grown up in the Philippines watching people take outdated medicine and get better anyway. Gerona ran the contents through liquid chromatography and mass spectrometry. The results were published in the Archives of Internal Medicine on October 8, 2012, under a title that gives away nothing: “Stability of Active Ingredients in Long-Expired Prescription Medications.”

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DO HARM: The Book That Began with a Word I Did Not Know

I am not a physician. I have never cultured a specimen, read a chest film, or signed a death certificate. I trained as a dramatist at Columbia, in the Oscar Hammerstein II Center, which qualifies me to tell you how a scene builds and not much else about a hospital. So let me get the obvious objection out of the way early, because it is the first thing a serious reader should ask. What business does a playwright have writing a book about hospital-acquired infection? The answer is the whole book, and it starts in a shut room in Newark in 2002.

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From the Barn to the Litter-Robot: Seven Things Nobody Tells You About Cats Anymore

When I was a boy in Lincoln, the contract with a cat was short enough to fit on a matchbook. You fed it in the morning and again at dusk, you cracked the back door, and you let the animal go be an animal. If it came back for breakfast, you had a cat. If it did not, you had a story about a cat. Nobody took its temperature. Nobody weighed it. The idea that a cat would sit on a stainless table once a year while a doctor charted its molars would have gotten you laughed out of the feed store. A cat was livestock with opinions, and Nebraska treated it accordingly.

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One Thirty Over Eighty: How America Lowered the Hypertension Line While Europe Held Steady

A single edit to a single table turned tens of millions of healthy Americans into patients overnight. The question is whether the line was drawn for them or for the people who bill them. In November of 2017, the American College of Cardiology and the American Heart Association released a clinical guideline that ran to roughly four hundred and eighty pages, and somewhere in the front matter they moved a single number. The threshold for diagnosing high blood pressure fell from 140/90 to 130/80. Nobody’s artery changed that day. No chest tightened, no vessel narrowed, no symptom appeared. And yet, by the arithmetic of that one revision, about thirty-one million Americans who had been healthy the previous evening were now classified as having a chronic cardiovascular disease. National prevalence of hypertension climbed from near thirty-two percent of adults to near forty-six percent between one edition of a document and the next, and among adults under forty-five the rate more than doubled. Nothing about the population’s arteries had changed; only the boundary of the word had moved.

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Backstage Collapsed: Universal Recording and the Architecture of Courtship

A panelist on a recent broadcast conversation made the following argument. Young people across the wealthy world are not having children. Before they do not have children, they do not date. Before they do not date, they do not interact at the dances, the parties, the mixers their parents and grandparents used as the primary infrastructure for finding mates. Even when they show up at such gatherings, they hold the wall, not approaching, not asking, not risking the awkward overture that has been the entry-cost of human pairing for as long as human pairing has been formalized into ritual occasions. The panelist asked why, and answered himself. They are afraid of being recorded. They are afraid that any silly thing they say or any failed dance step or any drunk confession will be filmed and uploaded and used against them by people they cannot identify in advance. So they withdraw. The species, the panelist concluded, cannot continue under such conditions, and the only available remedy is to restrict the technology that produced those conditions.

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When the Radiologist Becomes the Expense

On March 25, 2026, at a Crain’s New York Business panel discussion of the city’s hospital sector, Mitchell H. Katz, MD, president and CEO of NYC Health + Hospitals, told the assembled executives what cost-cutting now sounds like in the largest public hospital system in the United States. “We could replace a great deal of radiologists with AI at this moment, if we are ready to do the regulatory challenge.” Sandra Scott, MD, who runs One Brooklyn Health, one of the city’s safety-net institutions operating on tight margins, replied that the move would be “a game-changer.” The exchange appeared in Crain’s coverage of the panel and was picked up by the radiology trade press within forty-eight hours.

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Preventative Medicine, or the Manufacture of Patients?

There is a sentence every American patient has heard at the dentist’s chair, the cardiologist’s office, the primary-care visit, and the pharmacy counter. It arrives in a tone of grave responsibility: We caught this early. What follows is a crown, an echocardiogram, a statin, a stress test, a referral, a follow-up appointment, and a copay. The word “preventative” has come to function as a moral shield around a billing code. To question whether the recommended intervention is necessary is treated as ingratitude toward a profession that, the implication goes, only wants to keep you alive.

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