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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at the University of California, San Francisco, a chemist who had grown up in the Philippines watching people take outdated medicine and get better anyway.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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Take Your Children Offline NOW: Twenty-One Years Later

In July of 2005, I published Take Your Children Offline NOW on this blog, and the comments arrived in two distinct waves. The first wave came from parents who said the article forced them to think, and several of them removed every photograph of their children from their websites within hours of reading it. The second wave came from parents and bloggers who told me, with varying degrees of contempt, that I was hysterical, paranoid, anti-celebration, and ill-positioned to speak on parenting because I was married without children. One commenter wrote that if he lived in fear of someone furtively masturbating to pictures of his kids, he would never get anything done. The post was held up by a few critics as a case study in childless people moralizing at parents.

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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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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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Seeing Around Corners

The phrase “seeing around corners” gets tossed around boardrooms and strategy meetings as though it were a compliment, a kind of secular beatification for the executive or thinker who got there first. But the phrase deserves closer scrutiny, because what it actually describes is a discipline, and one that most people refuse to practice because the conclusions it produces are uncomfortable.

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Mad eBay Dash to Mask Up!

With the novel Coronavirus in full flush, I have never been more self-educated in needing to know more about protective masks. Since the beginning of April, I have wondered at all the face covering options, while knowing, and accepting that the medical grade masks — the now non-ubiquitous N95 masks — are not available to the public. I’ve been searching everywhere for a lead on a KN95 mask or a surgical mask — the lesser protective cousin to the full N95 mask — or some sort of other, non-optimal mask that can protect Janna and me from the vulgarities of Covid-19. We are not having any luck.

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Paris and the Superficial Memes of Selfieness Tragedy

Any tragic world event is an opportunity to convey meaning for profit — personally, politically, fiscally or morally — and the instant rise of the “Peace for Paris” logo designed by Jean Jullien “one minute” after the tragedy, and then immediately posting the image to Facebook and Twitter, begs a larger human question of “selfieness” and cynicism: Is an Artist trying to give hope against trafficking in evil, or is it all a rather cunning ploy to “make the meme” for a tragedy by propagating self-interest-as-a-logo over the perils of human interest?

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