“Flaws in the Peer Review System”

The flaws in the scientific journal peer review system undermine the argument that the freedom of individual patients should be subordinated to the judgements of “science.” A substantial, and not only recent, literature exposes a variety of flaws of the system. A recent impactful example is the failure of major medical journals to act in a timely manner to retract many Alzheimer’s studies where fraudulent images have been documented.

This impactful example is documented in painful detail in Charles Piller’s Doctored. The impact is that approaches to Alzheimer’s besides the mainstream’s amyloid hypothesis, have been suppressed, which may have slowed alternative effective therapies against the dread disease.

(p. C4) Suspicion of science journals was supercharged during the Covid pandemic, when most of them broadly supported mandates and lockdowns. Dr. Jay Bhattacharya, now the head of the National Institutes of Health, was among the most prominent critics of such policies. He gained attention as a co-author of the 2020 Great Barrington Declaration, which advocated letting Covid spread, conferring “herd immunity” on the population, only to see his work shunned by the major science journals.

. . .

The peer review system, in which a paper must go through scrutiny from experts, is intended as a form of quality control. But critics suggest that editors tilt the process toward papers that reflect their own favored results. In a May [2025] interview at the Hoover Institution, Bhattacharya said, “Folks think that if it is published in a top peer-reviewed journal, therefore it must be true, and that’s actually inaccurate.” In reality, he argued, “If I’m lucky the journal editor will send it out to two or three peer review editors, chosen by the editor. If they’re friendly with the editor, they’ll send it to friendly peer reviewers.”

Marty Makary, now the head of the Food and Drug Administration, was another prominent critic of science and medical journals during the pandemic. He said that some journals are captured by industry and others by groupthink. At NEJM and JAMA, “it’s clear that it was a group of like-minded friends, many of whom trained together or worked in the same hospital system,” Makary said. “Why should a small group of people be the gatekeepers of which research is read by most doctors in America?”

A 2023 paper in the journal PNAS on “scientific censorship by scientists” found flaws in the peer review system. A journal editor can quietly kill a submitted paper by sending it to hostile reviewers, who amplify minor methodological issues in order to reject a paper they disapprove of. “Many criteria that influence scientific decision-making, including novelty, interest, ‘fit,’ and even quality, are often ambiguous and subjective, which enables scholars to exaggerate flaws or make unreasonable demands to justify rejection of unpalatable findings,” the PNAS study found.

Often, part of what makes a paper “unpalatable” is its perceived politics. Science journals, like academia in general, have drawn increasing criticism for progressive bias. For example, in 2022 the journal Nature Human Behavior published an editorial stating that “considerations of harm can occasionally supersede the goal of seeking or sharing new knowledge,” including research that “may—inadvertently—stigmatize individuals or human groups” or be “discriminatory, racist, sexist, ableist or homophobic.”

“If anything gets published that doesn’t reflect the expected political view, then there is a public campaign to retract the paper,” said Luana Maroja, a professor of biology at Williams College. “Many times, they are successful.”

“I’ve received an anonymous peer review that said, ‘I’m afraid of what these findings will do for the laudable progressive moral agenda,’” said Cory Clark, a behavioral scientist at the University of Pennsylvania and lead author of the PNAS paper. Many researchers, she found, don’t bother asking questions that might lead to “wrong” answers, and if they do, they often don’t try to publish because they’ll only face resistance and blowback. Clark is now doing a study of journal editors, most of whom, she said, fear getting attacked or ostracized themselves.

. . .

Donald Trump’s campaign for president in 2016 spurred some science journals to make political endorsements for the first time. Nature, a U.K.-based journal, endorsed Hillary Clinton for president. Editorials in the Lancet referred to the first Trump administration as “anti-scientific” and called the 2020 election “a fight for the health of the nation.” In a pre-election editorial in 2020, the NEJM called the Trump administration “dangerously incompetent,” writing: “We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.”

For the full story see:

Pamela Paul. “How Scientific Journals Became MAGA’s Latest Target.” The Wall Street Journal (Sat., June 14, 2025): C1 & C4.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date June 13, 2024, and has the same title as the print version.)

The PNAS article briefly summarized in a passage quoted above is:

Clark, Cory J., Lee Jussim, Komi Frey, Sean T. Stevens, Musa al-Gharbi, Karl Aquino, J. Michael Bailey, Nicole Barbaro, Roy F. Baumeister, April Bleske-Rechek, David Buss, Stephen Ceci, Marco Del Giudice, Peter H. Ditto, Joseph P. Forgas, David C. Geary, Glenn Geher, Sarah Haider, Nathan Honeycutt, Hrishikesh Joshi, Anna I. Krylov, Elizabeth Loftus, Glenn Loury, Louise Lu, Michael Macy, Chris C. Martin, John McWhorter, Geoffrey Miller, Pamela Paresky, Steven Pinker, Wilfred Reilly, Catherine Salmon, Steve Stewart-Williams, Philip E. Tetlock, Wendy M. Williams, Anne E. Wilson, Bo M. Winegard, George Yancey, and William von Hippel. “Prosocial Motives Underlie Scientific Censorship by Scientists: A Perspective and Research Agenda.” Proceedings of the National Academy of Sciences 120, no. 48 (Nov. 20, 2023): e2301642120.

Piller’s Doctored book that I mention in my introductory comments is:

Piller, Charles. Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s. New York: Atria/One Signal Publishers, 2025.

F.D.A. to Reduce Phase 3 Drug Trials from Two to One for Approval of Some Drugs

I have read and learned much from books by Marty Makary and Vinay Prasad, who are now high officials in the F.D.A.  I also have suggested that patient freedom and drug innovation would both be served if the F.D.A. cut back regulations to only regulate for drug safety and leave drug efficacy to the judgement of physicians and patients.

Makary and Prasad have now announced that the F.D.A. will only require one clinical trial to satisfy the Phase 3 stage, instead of the currently common two trials. This is a partial, not a full, step toward my suggestion, but it is a step in the right direction. A modest step is better than no step at all.

I also support their announcement of the increased use of A.I. I believe that will increase efficiency, but doubt that it will soon “radically increase efficiency,” as they claim.

(p. A1) The Food and Drug Administration is planning to use artificial intelligence to “radically increase efficiency” in deciding whether to approve new drugs and devices, one of several top priorities laid out in an article published Tuesday [June 10, 2025] in JAMA.

. . .  And officials want to speed up the final stages of making a drug or medical device approval decision to mere weeks, citing the success of Operation Warp Speed during the Covid pandemic when workers raced to curb a spiraling death count.

“The F.D.A. will be focused on delivering faster cures and meaningful treatments for patients, especially those with neglected and rare diseases, healthier food for children and common-sense approaches to rebuild the public trust,” Dr. Marty Makary, the agency commissioner, and Dr. Vinay Prasad, who leads the division that oversees vaccines and gene therapy, wrote in the JAMA article.

. . .

(p. A16) For some cases, the F.D.A. officials proposed speeding major drug approvals by requiring only one major study in patients rather than two, a practice the agency has used in recent years. The pandemic provided a precedent, they said, for accelerating the process.

“We believe this is clear demonstration that rapid or instant reviews are possible,” Drs. Makary and Prasad wrote.

. . .

Last week, the agency introduced Elsa, an artificial intelligence large-language model similar to ChatGPT. The F.D.A. said it could be used to prioritize which food or drug facilities to inspect, to describe side effects in drug safety summaries and to perform other basic product-review tasks. The F.D.A. officials wrote that A.I. held the promise to “radically increase efficiency” in examining as many as 500,000 pages submitted for approval decisions.

For the full story see:

Christina Jewett. “F.D.A. to Seek Faster Process With A.I. Help.” The New York Times (Weds., June 11, 2025): A1 & A16.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date June 10, 2024, and has the title “F.D.A. to Use A.I. in Drug Approvals to ‘Radically Increase Efficiency’.”)

The JAMA article mentioned above is:

Makary, Martin A., and Vinay Prasad. “Priorities for a New FDA.” JAMA (2025) doi: 10.1001/jama.2025.10116.

During the Pandemic “Experts” Suppressed the Open Continual Inquiry That Is Science

The governmental violation of the basic rights of citizens, especially the right of free speech, is the most painful and lasting legacy of the Covid-19 pandemic. To flourish in the future, it is worth our time to remember what happened and defend those who protected free speech and the pursuit of true science, which is a method of continual inquiry, not a body of fixed beliefs.

(p. C7) “Science,” the great theoretical physicist Richard Feynman wrote, “is the belief in the ignorance of experts.” The incorrigibly curious Feynman knew that skepticism and a willingness to assimilate new evidence propel the scientific endeavor. Yet by 2020, in response to a global pandemic, the dominant part of America’s political and media class had turned the imperative to “follow the science” into an expression of almost religious reverence for the judgment of experts. Many educated and otherwise intelligent Americans, meanwhile, made a single, bespectacled government scientist their idol: “In Fauci We Trust” read their lawn signs and bumper stickers.

Their faith was misplaced. Credentialed experts, especially those in the fields of epidemiology and public health, had tied themselves to badly flawed theories, closed their minds to new evidence and thrown the mantle of “science” over value judgments for which they had no special competence.

“An Abundance of Caution,” by the journalist David Zweig, documents the poor evidentiary basis for the prolonged school closures and attendant follies such as masking requirements and social distancing. Mr. Zweig distinguished himself throughout the pandemic by his willingness to question the assumptions of self-identified “Covid hawks.” When he dug into the epidemiological modeling papers whose projections seemed decisively to rule out the safety of opening schools, he found “a never-ending matryoshka doll” of citations, resting ultimately on an assumption conceded to be “arbitrary” by its initial author.

Mr. Zweig shows how evidence emerged early on—in March 2020—that the virus did not pose a serious threat to children. American public-health professionals remained largely impervious to this fact.

. . .

“In Covid’s Wake,” by the Princeton political scientists Frances Lee and Stephen Macedo, mostly remains within the idiom of polite academic prose, but they state with disarming plainness that “elite institutions failed us” by giving in to panic. Ms. Lee and Mr. Macedo marvel at how consensus plans—none of which would have required extended lockdowns—were thrown out before Americans ever began dying, in part because public-health experts were entranced by China’s harsh restrictions. American policymakers had sound advice ready at hand, but most of them took the view that safety outweighed individual liberties, economic activity and quality of life.

Where Mr. Zweig emphasizes incuriosity, Ms. Lee and Mr. Macedo stress the willful suppression of reasonable debate, including the unfortunate tendency to paint critics of lockdowns and mask mandates as racists, quacks and conspiracy theorists. Such conduct was especially evident on the question of Covid-19’s origins, as top scientists vilified anyone suggesting the virus may have leaked from a lab in Wuhan, China. Credulous journalists, academics and other cultural arbiters, the authors remind us, embraced the effective censorship of those who questioned the official line.

. . .

Ms. Lee and Mr. Macedo catalog reams of data to show that, before the availability of vaccines, areas imposing the severest restrictions earned no discernible health benefits.

. . .

(p. C8) In 2024 the U.S. House’s Select Subcommittee on the Coronavirus Pandemic issued a genuinely impressive 500-page report, covering Covid-19’s origins, the fraud in pandemic-response programs and the effectiveness or otherwise of various interventions.

For the full review see:

Philip Wallach. “Failing the Pandemic Test.” The Wall Street Journal (Wednesday, April 19, 2025): C7-C8.

(Note: ellipses added.)

(Note: the online version of the review has the date April 18, 2025, and has the title “‘An Abundance of Caution’ and ‘In Covid’s Wake’: Failing the Pandemic Test.”)

The books under review are:

Macedo, Stephen, and Frances Lee. In Covid’s Wake: How Our Politics Failed Us. Princeton, NJ: Princeton University Press, 2025.

Zweig, David. An Abundance of Caution: American Schools, the Virus, and a Story of Bad Decisions. Cambridge, MA: The MIT Press, 2025.

The over-500-page 2024 report issued by the House’s Select Subcommittee on the Coronavirus Pandemic, and praised above, is:

Pandemic, Select Subcommittee on the Coronavirus. “After Action Review of the Covid-19 Pandemic: The Lessons Learned and a Path Forward.” U.S. House of Representatives. Washington, D.C., Dec. 4, 2024.

Development of IVF Took 10 Years of Trial and Error

If the Joy television movie accurately reflects the history of the development of IVF (in vitro fertilization) then it illustrates a couple of themes that are important. One is the frequent fruitfulness of trial-and-error experimentation. The other is that some medical entrepreneurs are motivated by having some form of ‘skin-in-the-game,’ in this case nurse Jean Purdy. (Support for the second theme is more speculative than for the first, since the evidence that the real Jane Purdy experienced endometriosis and infertility is circumstantial.)

(p. A10) “Joy,” . . . begins in 1968 and charts the 10-year journey of trial, error and more trial and error by an odd trio of pioneers: Bob Edwards (James Norton), a biologist and true-believer in the possibilities of IVF; Patrick Steptoe (Bill Nighy), a surgical obstetrician who is less than convinced but can be; and Jean Purdy (Thomasin McKenzie), a nurse who signs on as Bob’s assistant and, as we learn, has her own agenda regarding infertile women. (Edwards received the 2010 Nobel Prize in Medicine, his partners having passed away.)

Jack Thorne’s screenplay massages the IVF medical story into a personal one, mostly about Jean, who is portrayed as a critical member of the team and the one whose life reflects the social uproar over the mission—giving childless women a choice about becoming mothers.

For the full television review see:

John Anderson. “The Birth of a Medical Miracle.” The Wall Street Journal (Monday, Nov 22, 2024): A10.

(Note: ellipsis added.)

(Note: the online version of the television review has the date November 21, 2024, and has the title “‘Joy’ Review: The Birth of a Medical Miracle on Netflix.”)

A Few More Months of Life Is Front Page News for Pancreatic Cancer Patients

For those with late stage pancreatic cancer, half live less than a year and half live longer than a year, according to the front page WSJ article quoted below. But the article seems to be celebrating a patient who has survived 17 months on a new drug. The patient has a feeling, perhaps because of a lesion that they radiated, that the drug may stop working soon.

So let’s say that without the drug she might have expected roughly a year of life, and now with the drug she has gotten roughly 17 months of life. Sure 17 months is better than 12 months.

But are our expectations so low and our cancer progress so slow, that an extra five months of life is front-page news?

(p. A1) Pranathi Perati was running out of time to treat her stage-four pancreatic cancer when she found out she would get another shot: a clinical trial testing a new experimental drug.

Perati’s odds were slim—3% of late-stage pancreatic-cancer patients are still alive after five years. And half of all pancreatic-cancer patients live for less than a year after their diagnosis. For Perati, the drug, daraxonrasib from Revolution Medicines, has helped keep her alive for 17 months and counting.

. . .

(p. A4) The pill has given her some fatigue and mouth ulcers, but she feels better than she did with chemo. A lesion in her lung started progressing this past winter and was radiated, but her disease has been stable otherwise.

“Seventeen months is a lot of good time to buy,” she said. Still, Perati worries that her time on the drug might soon run out. She has started looking for more options. Her son is set to graduate high school this summer.

For the full story see:

Brianna Abbott. “Treatments Offer Hope On Pancreatic Cancer.” The Wall Street Journal (Saturday, March 1, 2025): A1 & A4.

(Note: ellipsis added.)

(Note: the online version of the story has the date February 28, 2025, and has the title “New Treatments Give Hope to Patients With One of the Deadliest Cancers.”)

Nicholas Wade Highlighted That Early Email to Fauci Supported Lab-Leak Origin of Covid-19

Distinguished science journalist Nicholas Wade was one of the first and the few to early-on risk being canceled by providing evidence in favor of the lab-leak origin of Covid-19.

(p. A13) They told the world that the Covid-19 virus clearly couldn’t have been manipulated in the laboratory. But what they actually thought at first sight was that it had been.

The letter from five virologists published in Nature Medicine on March 17, 2020, was the single most influential statement in capturing the public narrative about the origin of SARS-CoV-2. Here was an authoritative statement from leading experts assuring the public that in terms of the virus’s origin “we do not believe that any type of laboratory-based scenario is plausible.”

But that’s the exact opposite of what these experts thought after taking their first look at the virus. A large batch of emails exchanged with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, was made available this week to BuzzFeed and the Washington Post under the Freedom of Information Act. For the most part the emails concern meeting arrangements or messages from cranks and have been redacted of any meaningful information. But one significant email escaped the censor’s black marker.

On Jan. 31, 2020, shortly after the SARS-CoV-2 genome had been decoded, Kristian Andersen, the five virologists’ leader, emailed Dr. Fauci that there were “unusual features” in the virus. These took up only a small percentage of the genome, so that “one has to look really closely at all the sequences to see that some of the features (potentially) look engineered.”

Mr. Andersen went on to note that he and his team “all find the genome inconsistent with expectations from evolutionary theory.” It isn’t clear exactly what he meant by this striking phrase. But anything inconsistent with an evolutionary origin has to be man-made.

For the full commentary see:

Nicholas Wade. “Fauci Email Bolsters the Lab-Leak Theory.” The Wall Street Journal (Monday, June 5, 2021 [sic]): A13.

(Note: the online version of the commentary has the date June 4, 2021 [sic], and has the same title as the print version.)

Impact of Weight Loss Drugs Underlines the Importance of Serendipity and Medical Entrepreneurship

The story of the creation of the weight loss drugs involves a fair amount of serendipity and medical entrepreneurship. A case has been made that we would have had these drugs 25 years sooner if Pfizer had not abandoned the development of their version due to the dauntingly huge costs of drug development. Recall that the largest component of those huge costs are the mandated Phase 3 randomized double-blind clinical trials.

Almost everyone now views these drugs as a major medical advance. The question is: how big? According to the reviewer quoted below, Dr. Eric Topol speculates: very big indeed. He raises the possibility that to improve lifespan and healthspan eventually most of us will be on one of these drugs.

If so then the weight loss drugs will be even more compelling examples of the importance of regulating so as to allow entrepreneurs to take quick advantage of serendipity. How many lives were lost that could have been saved, how much suffering was experienced that could have been avoided, if over-regulation by the F.D.A. had not delayed the availability of these drugs by 25 years?

(p. A13) More than half of American adults suffer from at least one chronic illness—most commonly diabetes, heart disease, cancer or neurodegeneration. By age 65, 80% are afflicted with two or more conditions. Among those fortunate enough to reach 80, it’s rare to find anyone who has arrived unscathed. In 2008 a group of scientists at the Scripps Research Institute in San Diego set out to recruit 1,400 of these healthy souls—known as the Wellderly—to figure out how they managed it.

Led by the cardiologist Eric Topol, the researchers hoped to identify the genetic factors associated with healthy aging. To their surprise, they found little in the DNA that stood out. They did, however, notice several striking traits. Compared with their peers, the disease-free subjects were generally thinner, exercised more frequently and seemed “remarkably upbeat,” often with rich social lives. These observations encouraged the research team to think about longevity (years of life) and healthspan (years of health) more broadly. In “Super Agers” Dr. Topol shares the results of this intellectual exploration.

. . .

Expensive new weight-loss drugs like Ozempic and Zepbound, Dr. Topol writes, have “extraordinary potential to promote health span.” In addition to stanching appetite, these drugs also seem to rapidly reduce harmful inflammation—an effect that “precedes and is independent of weight loss.” In the future, the author believes it’s “conceivable that most people will be taking” such medications, . . .

For the full review see:

David A. Shaywitz. “Bookshelf; Living the Good Life.” The Wall Street Journal (Wednesday, May 7, 2025): A13.

(Note: ellipses added.)

(Note: the online version of the review has the date May 6, 2025, and has the title “Bookshelf; ‘Super Agers’: Living the Good Life.”)

The book under review is:

Topol, Eric. Super Agers: An Evidence-Based Approach to Longevity. New York: Simon & Schuster, 2025.

Correll Managed Georgia-Pacific Well and Then Used Those Skills to Save a Failing Hospital

In my Openness book, I make the case for the many benefits of an economic system of innovative dynamism. One of the lesser, but still important, benefits was first identified by Joseph Schumpeter. He argued for a spillover effect of innovative dynamism. The skills, knowledge, and technologies created by innovative entrepreneurs in the for-profit sector of the economy, are also applied and imitated in the nonprofit and government sectors. So where there is innovative dynamism, not only is the market more creative and efficient, but both the nonprofit and the government sectors are more creative and efficient.

A good example may be Pete Correll who acted entrepreneurially as CEO of Georgia-Pacific to bring more stability to the business by acquiring the James River Corporation, maker of Quilted Northern, and guided the Georgia-Pacific firm through years of lawsuits over asbestos. He eventually sold Georgia-Pacific to Koch Industries, Inc. My impression is that Charles Koch then applied his market-based management system to make the Georgia-Pacific part of his business much more efficient and innovative. [Query: does Koch’s achievement undermine my claim that Pete Correll had acted entrepreneurially in his earlier management of Georgia-Pacific? Or can both Correll and Koch have been good manager/entrepreneurs, but in different ways at different times?]

But according to his obituary in the WSJ, his greatest achievement may have been in taking over a near-bankrupt Atlanta public (aka government) hospital, reorganizing it from government to nonprofit, and modernizing its management and technology.

Carrell’s obituary in the WSJ:

James R. Hagerty. “CEO Helped Save A Public Hospital.” The Wall Street Journal (Sat., June 5, 2021 [sic]): A9.

(Note: the online version of the WSJ obituary has the date June 2, 2021 [sic], and has the title “Retired CEO Saved an Atlanta Public Hospital.”)

For Charles Koch’s entrepreneurial market-based management system see:

Koch, Charles G. The Science of Success: How Market-Based Management Built the World’s Largest Private Company. Hoboken, NJ: Wiley & Sons, Inc., 2007.

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.

It May Take a “Thorny Character” to Be “Willing to Challenge Entire Establishment Belief Systems”

The obituary quoted below misidentifies Richard Bernstein’s main contribution. Yes, it is noteworthy that he was probably the first diabetes sufferer to effectively and continually monitor his own blood glucose level. But his main contribution was that by careful self-monitoring and trial-and-error experimentation he discovered that his health improved when he cutback on both carbs and insulin.

The obituary writer quotes Gary Taubes, but either didn’t read his book or disagrees with it, because Taubes is clear about Bernstein’s main contribution.

I am halfway through Taubes’s book. It is long and sometimes deep in the weeds, but comes highly recommended by Marty Makary and Siddhartha Mukherjee, both of whom I highly respect. The book sadly highlights how mainstream medicine can be very slow to reform clinical practice to new knowledge.

(p. C6) Richard Bernstein was flipping through a medical trade journal in 1969 when he saw an advertisement for a device that could check blood-sugar levels in one minute with one drop of blood. It was marketed to hospitals, not consumers, but Bernstein wanted one for himself. He had been sick his entire life and was worried he was running out of time.

. . .

Since he wasn’t a doctor, the manufacturer wouldn’t even sell him a device. So, he bought one under the name of his wife, Dr. Anne Bernstein, a psychiatrist.

He experimented with different doses of insulin and the frequency of shots. He eased off carbohydrates. He checked his blood sugar constantly to see how it was reacting.

After experimenting for several years, he figured out that if he maintained a low-carb diet, he didn’t need as much insulin and could avoid many of the wild swings in his blood-sugar levels. By checking his blood sugar throughout the day, he learned how to maintain normal levels. It changed his life.

. . .

With his diabetes under control, he tried to spread the word and change the way the disease is treated. In the early years, he was dismissed by much of the medical establishment. His ideas went against accepted wisdom and he was, after all, not a doctor. In 1979, at the age of 45, he enrolled at the Albert Einstein College of Medicine, where he received his M.D.

“I never wanted to be a doctor,” he told the New York Times in 1988. “But I had to become one to gain credibility.”

Bernstein went into private practice in Mamaroneck, N.Y., where he treated diabetics and continued to advocate for his ideas—to his patients, in articles, YouTube videos, letters to the editor, and writing books, including “Dr. Bernstein’s Diabetes Solution.”

. . .

Gary Taubes, the author of “Rethinking Diabetes,” said that it was Bernstein’s work that eventually led to the Diabetes Control and Complications Trial, a landmark study that demonstrated that diabetics could blunt the destructive effects of the disease by keeping their blood-sugar levels nearer normal. Released in 1993, the results led to the kind of self-monitoring and frequent shots of insulin that remains part of the standard treatment plan for Type 1 diabetes today—part of what Bernstein had been pushing for years.

This was only partial vindication for Bernstein. The medical establishment never fully embraced Bernstein or the strict low-carb diet that he prescribed, which some considered unrealistic.

Taubes said that Bernstein was a bit of a “thorny character” who was easy for the establishment to dislike. He also noted that’s something that comes with the territory when you spend your career telling people they’re wrong and you’re right.

“But often it’s the people who are not easy to like,” Taubes said, “who are the ones who are willing to challenge entire establishment belief systems.”

For the full obituary see:

Chris Kornelis. “A Diabetic Who Pioneered Self-Monitoring for Blood Sugar.” The Wall Street Journal (Sat., May 10, 2025): C6.

(Note: the online version of the WSJ obituary has the date May 9, 2025, and has the title “Richard Bernstein, Who Pioneered Diabetics’ Self-Monitoring of Blood Sugar, Dies at 90.”)

Bernstein’s book mentioned above is:

Bernstein, Richard K., MD. Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars. New York: Little, Brown Spark, 2011.

Taubes’s book mentioned above is:

Taubes, Gary. Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments. New York: Knopf, 2024.

Trump Is a Change Agent Because He Can Take the Ill Will of the Stagnationists

In an earlier blog entry I pondered Charlie Munger’s sage analysis that agents of change must often be willing to take the “ill will” aimed at them from the stagnationists who benefit from stasis. The stagnationists may be corrupt, or incompetent, or simply lack the imagination or the energy to do something in a better way.

Agents of change are scarce because most of us care a lot about what other people think of us. We experience psychic stress if we are systematically stigmatized, or even just ignored. Donald Trump may be capable of making major changes because, through temperament or resolve, he has found a way to shut out the psychic stress; a way to take the ill will.

Kessler’s commentary, quoted below, was published early in the pandemic, on Feb. 10, 2020. At that point Kessler believed that Trump’s success with the economy would get Trump re-elected. But as the months of 2020 rolled on, the pandemic increasingly hurt Trump’s prospects; hence the source of the pandemic still matters a lot, and whether the vaccine was intentionally delayed a few weeks, to release it just after the election, also still matters a lot.

A key question is whether Trump still has the core “agenda of tax cuts, deregulation and originalist judges” that Kessler believed was the Trump core agenda in 2016.

I hope yes, but fear no. In 2025 are tariffs and industrial policy part of the “distraction” (aka “MacGuffin”) Kessler posits, or are they part of Trump’s core agenda?

(p. A15) Is he a disease or a cure? Like him or hate him, there’s tons of spilled ink trying to assess President Trump’s governing style. To me, the key to understanding Trumpism is remembering why he was elected.

What do I mean? Voters chose Donald Trump as an antidote to the growing inflammation caused by the (OK, deep breath . . .) prosperity-crushing, speech-inhibiting, nanny state-building, carbon-obsessing, patriarchy-bashing, implicit bias-accusing, tokey-wokey, globalist, swamp-creature governing class—all perfectly embodied by the Democrats’ 2016 nominee. On taking office, Mr. Trump proceeded to hire smart people and create a massive diversion (tweets, border walls, tariffs) as a smokescreen to let them implement an agenda of tax cuts, deregulation and originalist judges.

Those reforms have left the market free to do its magic and got the economy grooving like it’s 1999. The daily Trump hurricane—like the commotion over the Chiefs from Kansas—makes the media focus on the all-powerful wizard while ignoring the policy makers behind the curtain.

Alfred Hitchcock called this kind of distraction a “MacGuffin”—something that moves the plot along and provides motivation for the characters, but is itself unimportant, insignificant or irrelevant. It can be a kind of sleight of hand, a distraction, and Mr. Trump uses his own public persona as a MacGuffin in precisely that way. The mobs decked in “Resist” jewelry fall for it every time.

For example, Sen. Bernie Sanders used his remarks during the Senate impeachment trial to point out that the media had documented some 16,200 alleged lies by President Trump. The MacGuffin worked! Mr. Sanders and his peers are focused on the president’s words, while most voters see the real plot unfolding in America—millions of jobs and rising wages.

The president’s success comes from his ability to shrug off critics.  . . .  Rather than cower at the criticism he faces from the mobs, he probably smirks and thinks to himself, “Yeah, I don’t believe in that” and tweets away.

That’s the only reaction that can withstand today’s far left, which has become increasingly self-righteous.

For the full commentary see:

Andy Kessler. “President Donald J. MacGuffin.” The Wall Street Journal (Monday, February 10, 2020 [sic]): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date February 9, 2020 [sic], and has the same title as the print version.)

Gans Showed That Urban Working-Class Enclaves, and Modern Suburban Housing Developments, Can Contain Vibrant Communities

In my Openness book I argue that, especially in America and Europe, life has generally gotten better in the last couple of hundred years.

Some critics argue, to the contrary, that modern suburban housing developments are boring, conformist locations lacking a sense of community and cultural vibrancy. They then use this argument to advocate that government urban planners adopt regulatory and subsidy policies to “infill the urban core,” i.e., force suburbanites to live downtown.

Herbert J. Gans, quoted below, refuted the critics.

(p. B11) Herbert J. Gans, an eminent sociologist who studied the communities and cultural bastions of America up close and shattered popular myths about urban and suburban life, poverty, ethnic groups and the news media, died on Monday [April 21, 2025] at his home in Manhattan. He was 97.

. . .

His findings were often surprising. For his first book, “The Urban Villagers: Groups and Class in the Life of Italian-Americans” (1962), he immersed himself in the life of Boston’s working-class West End. The area was later bulldozed for “slum clearance,” and he lamented the destruction of a vibrant community. A half-century later, the book still stood as a classic statement against indiscriminate urban renewal.

Similarly, Dr. Gans challenged conventional wisdom about postwar suburbia in “The Levittowners” (1967). For more than two years, he lived in Levittown, N.J., later renamed Willingboro, and concluded that the residents had strong social, economic and political commitments, and that notions of suburbanites as conformist, anxious, bored, cultureless, insecure social climbers were wrong.

For the full obituary, see:

Robert D. McFadden. “Herbert J. Gans, 97, Who Explored American Society Up Close, Dies.” The New York Times (Thursday, April 24, 2025): B11.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the obituary was updated April 23, 2025, and has the title “Herbert J. Gans, 97, Dies; Upended Myths of Urban and Suburban Life.”)

Gans’s books mentioned in the passages quoted above, are:

Gans, ‎Herbert J. The Levittowners: Ways of Life and Politics in a New Suburban Community. New York: Columbia University Press, 1967.

Gans, ‎Herbert J. The Urban Villagers: Groups and Class in the Life of Italian-Americans. Glencoe, IL: The Free Press of Glencoe, 1962.

My book mentioned in my initial comments is:

Diamond, Arthur M., Jr. Openness to Creative Destruction: Sustaining Innovative Dynamism. New York: Oxford University Press, 2019.