Part the First: Pharmacopeia.<\/strong>\u00a0 Who doesn\u2019t love a garden?\u00a0 It sometimes seems that all drugs come from plants, initially. \u00a0My first biology teachers claimed they were taught that bacteria were plants back when life was either animal or plant.\u00a0 Garden of Healing<\/a> is a bit long but very interesting.\u00a0 It is also a break from the unending task of Science-Based Medicine to keep up with the Three Amigos plus Dr. Oz<\/a> in charge of the Department of Health and Human Services.<\/p>\n Other plants not included in the Garden of Healing are willow and wormwood.\u00a0 Willow bark extracts contain salicylates.\u00a0 Aspirin is acetylsalicylic acid.\u00a0 My generation was taught in Biology 101 that Aristotle prescribed willow bark tea for the pain of childbirth.\u00a0 This is probably not true but it makes a good story.\u00a0 The use of willow extracts in the treatment of pain and fever has a long history: From plant extract to molecular panacea: a commentary on Stone (1763) \u2018An account of the success of the bark of the willow in the cure of the agues\u2019<\/a>.\u00a0 This is the rare article that explains the mechanism of aspirin<\/a> in historical context.\u00a0 One-hundred years ago aspirin was one of the few drugs that worked as advertised but the mechanism has been known only since the 1970s.\u00a0 The few other drugs included morphine and digitalis, both natural products from plants (poppy and foxglove) and both deadly when used improperly.<\/p>\n Tu Youyou (b. 1930) is a Chinese physician who used ancient texts to learn that extracts of sweet wormwood have antimalarial properties.\u00a0 After long and careful studies, she identified artemisinin as the antimalarial drug.\u00a0 She was awarded the Nobel Prize in Physiology or Medicine in 2015<\/a> (note that physiology comes before medicine) in one of the inspired choices of the Karolinska Institute.\u00a0 I have no idea if they work, but the generation of my grandparents and great grandparents in the late nineteenth and early twentieth centuries were still using traditional remedies<\/a> (other than natural opiates and ethanol) well into the 1960s.\u00a0 They were believers and the long gone local drugstore, where the proprietor was \u201cDoc\u201d in the little town of theirs also sold little wax paper bags of white clay for human consumption<\/a>.\u00a0 All that did was cause intestinal blockage and anemia.<\/p>\n Part the Second: PEPFAR May Yet Live<\/strong>.\u00a0 The President\u2019s Emergency Plan For AIDS Relief<\/a> was begun by that liberal radical George W. Bush and has saved as many as 25 million lives.\u00a0 It seems that the GOP has \u201cdefied\u201d the President for the moment and may preserve PEPFAR<\/a>, which has worked very well since its establishment:<\/p>\n Since PEPFAR\u2019s creation by Congress and Republican President George W. Bush<\/a>, the program has largely enjoyed support across the political spectrum \u2014 and gratitude from countries whose health systems have been poorly equipped to care for millions with HIV.<\/p>\n But misinformation has crept in. \u00a0The Heritage Foundation<\/a>, an influential conservative Washington think tank, accused the Biden administration of using PEPFAR \u201cto promote its domestic radical social agenda overseas.\u201d \u00a0Conservatives claimed there were efforts to integrate abortion with HIV\/AIDS prevention, a claim the Biden administration denied<\/a>. \u00a0Similar claims linger under the Trump administration.<\/p>\n Trump and his officials also claim widespread waste and fraud as they seek to dismantle U.S. foreign aid. But PEPFAR has been repeatedly scrutinized. Last year, the government said the State Department\u2019s Office of Inspector General had conducted 80 audits, inspections, and special reviews that included oversight of PEPFAR programs, \u201cincluding 21 thematic reviews and audits specifically focused on PEPFAR.\u201d<\/p>\n<\/blockquote>\n W-F-A, waste, fraud, and abuse, once again brought to you by the letters W-T-F.\u00a0 The primary motivation of DOGE and all this other performative nonsense is to just be mean, hateful, stingy.\u00a0 This is my nation at the moment but it is not my country and never will be.\u00a0 If DOGE had been a serious effort at stopping W-F-A, the first stop of those self-regarding 20-something berserkers would have been across the Potomac at the Pentagon.\u00a0 But the guards at those doors have guns and knew how to use them.\u00a0 Savings from the DOGE Boys<\/a> have been well short of the $2 trillion promised and will probably amount to less than zero in the end.<\/p>\n Part the Third: Life in Biotech World.<\/strong>\u00a0 In another episode of \u201cCash Out with a Unicorn<\/a>\u201d the employees of the gene therapy company Sarepta:<\/p>\n Sarepta Therapeutics laid off more than one-third of its workforce, or approximately 500 employees, the company announced Wednesday \u2014 a drastic cost-cutting move following the deaths of two teenagers<\/a> that forced the company to restrict usage of its gene therapy for Duchenne muscular dystrophy (DMD).<\/p>\n Alongside the cuts, the company also announced it was shifting much of its research, including pausing work on several gene therapies it had in development for limb-girdle muscular dystrophies, a collection of rarer and generally slower-moving diseases. \u00a0The company said the move will save the company around $400 million per year, lower operating expenses, and boost cash flow sufficient to maintain access to an existing loan agreement.<\/p>\n Three of Sarepta\u2019s top executives, including its No. 2 executive Ian Estepan, received promotions and salary increases, according to a filing with the Securities and Exchange Commission that accompanied the company\u2019s announcement of employee layoffs.<\/p>\n While painful, investors viewed the restructuring as a positive move, ensuring the company would survive the recent string of bad news. Sarepta\u2019s stock price rose more than 36% to $25 per share in Wednesday\u2019s after-hours trading session. The stock closed the day at $18 per share, down 85% this year and a nine-year low.<\/p>\n<\/blockquote>\n Everything that does not work about Pharma\/Biotech is included in this excerpt.\u00a0 I remember when the DMD gene for dystrophin was cloned.\u00a0 Gene therapy was to follow forthwith.\u00a0 The money has been disappearing through that incinerator for a long time.\u00a0 One day, maybe it will work.\u00a0 But as a matter of principle, gene therapy can work only when the functional therapeutic gene (including regulatory elements essential for proper gene expression) can be delivered to the precise location required.<\/p>\n Dystrophin is a very large skeletal muscle protein required for the maintenance of structure during cycles of contraction and relaxation.\u00a0 Without a complex anchored by dystrophin and other proteins, the muscle eventually falls apart because it lacks the struts necessary to withstand contraction.\u00a0 The therapeutic gene is a micro-dystrophin delivered by an adeno-associated virus vector.\u00a0 These vectors work in the liver for clotting factor genes because the liver cells are tractable and the proteins are secreted into the blood.\u00a0 What is tractable in liver may well be intractable in skeletal muscle.\u00a0 Which is not to say that the therapy should not be pursued.\u00a0 But it is unlikely to ever be that unicorn worth billions.\u00a0 And cashing out while laying off one-third of your employees should be impossible.\u00a0 But with Hayek\u2019s Bastards<\/em><\/a> all things are possible, even required, in business.\u00a0 Still, this is no way to do science.<\/p>\n On a related note, when the CFTR gene responsible for about 75% of cystic fibrosis cases was finally cloned, there was joy and celebration throughout the land.\u00a0 There is no gene therapy after all these years.\u00a0 Targeted therapeutic CFTR gene therapy delivery is basically unimaginable for CFTR.\u00a0 But treatment with a trio of drugs that help the mutant protein fold and get to its normal place in the cell, many cystic fibrosis patients respond well<\/a>.\u00a0 These drugs are not a cure but they are a treatment.\u00a0 However, without the thousands of research papers that explain the workings of CFTR, the drugs would probably not have been developed.\u00a0 But they have and they cost a lot<\/a> ($300,000 per year, $822 per day).\u00a0 There are better, more efficient, and more effective ways to do this research and develop these drugs, but I repeat myself.\u00a0 Again.<\/p>\n Part the Fourth: Our American Israel<\/strong>.\u00a0 Or how did we get here?\u00a0 The relationship between the United States and Israel is a puzzle that requires serious study.\u00a0 This does not include listening to or reading the usual sources<\/a>.\u00a0 An unusually useful source is Our American Israel: The Story of an Entangled Alliance<\/em><\/a> (Harvard University Press, 2018) by Amy Kaplan<\/a> (1953-2020), who was the Edward Kane Professor of English at the University of Pennsylvania.\u00a0 Harvard University Press issued the paperback in 2025, which is the edition discussed here.<\/p>\n The book is very good on the \u201cwhy\u201d and the \u201chow\u201d of the State of Israel.\u00a0 It is largely forgotten but the popular American understanding of Israel was transmitted through the novel Exodus<\/em> (1958) by Leon Uris<\/a> and especially the film Exodus<\/em><\/a> (1960) starring Paul Newman and Eva Marie Saint and directed by Otto Preminger.\u00a0 The movie\u2019s theme<\/a> won an Academy Award for Ernest Gold.\u00a0 Pat Boone\u2019s lyrics<\/a> (1963) are seldom heard today, but they were a staple of school choruses throughout the 1960s, when I sang it in the sixth grade and eighth grade.\u00a0 It was a big hit when the Six-Day War<\/a> was a recent event.\u00a0 In Kaplan\u2019s convincing presentation, the emergence of the State of Israel:<\/p>\n Reenacted the primal myth of the American frontier as a tale of regeneration through violence\u2026the barbarism of the other \u2013 whether Indian or Arab \u2013 (forces) the hero to become violent as he adopts their methods\u2026Both film and novel effaced the violent dispossession of Palestinians, with glorified interpretation of Israel\u2019s founding as an event unparalleled in human history.<\/p>\n<\/blockquote>\n More recently Zionism has been seen through the lens of Christian Zionists for whom:<\/p>\n The establishment of the State of Israel in 1948 proved to believers the accuracy of the ancient prophecy that God would restore Israel to Zion and that this ingathering would trigger a chain of events culminating in the end of days\u2026the significance of Israel\u2026(manifested God\u2019s sovereignty and made)\u2026it possible for some Jews to convert to Christianity to correct the fatal mistake they had made in rejecting Christ two millennia ago\u2026before the final battle of Armageddon in which Christ vanquishes the Antichrist to inaugurate God\u2019s kingdom on earth.<\/p>\n<\/blockquote>\n This premillennial dispensationalism<\/a> is an interesting theology and very real to many Americans, even those Christians who have not gone quite that far down the rabbit hole.\u00a0 Tim LeHaye of the Left Behind<\/em> series of novels and movies<\/a> (>50 million books sold) goes on to point out that:<\/p>\n Identification with Israel did not mean identification with actual Jews, however \u2013 either in America or Israel\u2026(because Jews as a group)\u2026have often yielded to secularistic, even atheist spirt.\u00a0 Brilliant minds have all too frequently been dedicated to philosophies that have proved harmful to mankind.\u00a0 Consider for example, Karl Marx, Leon Trotsky, and Sigmund Freud.\u201d<\/p>\n<\/blockquote>\n Trotsky, who was murdered by Stalin\u2019s men in Coyoac\u00e1n?\u00a0 Okay, then.\u00a0 One profound regret for Tim LeHaye must be that Charles Darwin was only a lapsed Anglican who used his sand walk at Down House on Sundays while his family went to church.\u00a0 In any case, it is not difficult to see the real, thoroughgoing antisemitism here despite the current redefinition of the concept to mean \u201cany criticism of the State of Israel for anything.\u201d\u00a0 These people are not allies of the State of Israel.\u00a0 Rather they see the State of Israel as a precondition for the Rapture, when the vast majority of Jews will be left behind to fight it out in the post-Rapture maelstrom.<\/p>\n Part the Fifth: Our American Israel, Continued<\/strong>.\u00a0 Other recent useful books on Israel in our world (there are many, several covered here before<\/a>) include On Settler Colonialism: Ideology, Violence, and Justice<\/em><\/a> (Norton, 2024) by Adam Kirsch<\/a> and One Day, Everyone Will Have Always Been Against This<\/em><\/a> (Knopf, 2025) by Omar El Akkad.\u00a0 Kirsch has been lauded for his clearheaded analysis.\u00a0 As far as I could tell, the bulk of his argument is that the State of Israel is not a Settler Colonialist State because the result has not (yet) recapitulated the utter devastation of indigenous communities perpetrated in North America and Australia by settler colonialists.<\/p>\n That is one way to look at it.\u00a0 And then we have two quotes (taken from Our American Israel<\/em>) from the most famous Israeli leaders of my generation, pre-Likud.\u00a0 In the first the war hero Moshe Dayan asks and answers:<\/p>\n Why should we complain at their fierce hatred of us.\u00a0 For eight years (now nearly eighty) they have been dwelling in refugee camps in Gaza, and before their very eyes we are turning the land and the villages where their forefathers dwelt into our home.<\/p>\n<\/blockquote>\n This was spoken at the funeral of Roi Rothberg, a kibbutz security officer who was killed and mutilated while on patrol in Gaza.\u00a0 History sometimes more than rhymes.<\/p>\n The other quote is from Golda Meir, Prime Minister of Israel from 1969 to 1974.\u00a0 When she was asked about Palestinian fighting forces, she responded:<\/p>\n There were no such things as Palestinians.\u00a0 It was not as though there was a Palestinian people in Palestine considering itself as a Palestinian people when we came and threw them out and took their country away from them.\u00a0 They did not exist.<\/p>\n<\/blockquote>\n Actually, they did exist<\/a>.\u00a0 Kirsch apparently agrees with Golda Meir.\u00a0 In his book he refers to something called the \u201cPalestinian Liberation Organization\u201d in the second paragraph of his Chapter 6, \u201cWhy Israel Can\u2019t Be Decolonized.\u201d\u00a0 This organization does not exist, but the Palestine Liberation Organization does.\u00a0 Despite confusing the adjective for the noun, which is dispositive of something, Kirsch is an excellent writer who tells a very good half-story when he is not engaged in \u201cwhataboutism.\u201d<\/p>\n\n
\n
\n
\n
\n
\n
\n
![\"Print](\"https:\/\/cdn.printfriendly.com\/buttons\/print-button-gray.png\")
<\/a><\/div>\n<\/div>\n