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Hello everyone.

Greetings from Dallas.

It’s nice to finally be moving into autumn here in the Lone Star State. No leaves have changed yet—everything still bright green. But the oppressive heat has slacked off, so cooler days are on the way. Fall is my favorite time of year, so I’m looking forward to it.

Poll Responses, Emails, and Comments

My Plethora of Tabs

After last weeks picture of all the tabs on my main browser, I got an email from Zoe Harcombe. She wrote: “Hi Mike, After this week’s note—you may appreciate this!” She attached the link to this tweet:

As you might imagine, I found it hilarious. 20 tabs! What a piker. I had to respond.

On to something less hilarious.

Too Much Science?!?!

Receive the below via poll responses.

Well, what is it? Too much science? Or not enough?

If I go on about non-scientific topics, I get slammed for not staying in my lane. Now, for the first time, I’ve been castigated for too much science.

I’m probably going to pretty much stick with how I’ve been doing things. Just realize that some of our fellow readers don’t like all the science. Or maybe they just don’t like the way I explain it. I’ll endeavor to explain it as clearly as I can. And I’ll try not to repeat so much.

Commentary on SNAP (Food Stamps)

Received this through the poll responses.

I disagree. There is no free lunch (or there shouldn’t be) even if you’re poor. If I get in an automobile accident that was my fault, my premiums go up irrespective of whether I can afford it or not. My actions ended up costing the insurance company, so now I have to pay for it.

Obesity and related disorders are much more common among people in lower socio-economic classes. These issues result in vastly more medical expenses they can least afford themselves and that sometimes the rest of us end up picking up the tab for. In essence, those who pay taxes end up paying for these diseases. Why should we pay for both driving the disease plus treating the disease when it can be a least partially mitigated by not swilling one soft drink after another with that bag of chips.

Plus, there are other issues involved. If you read the linked article by Dale Saran, you learned that corn and high-fructose corn syrup gets just about more government subsidies than anything else. So to add insult to injury, we (the taxpayers) are also paying to grow and produce the raw materials for Coke, Pepsi, and all the rest to turn into cheap, non-nutritious junk.

Then Dale says,

And finally—and this is the part I had no idea about—those receiving food stamps in Appalachia, end up using cases of soft drinks as trading commodities. Or sell them for cash at fifty cents on the dollar. I’m sure it happens in other places as well.

Here’s how journalist Kevin Williamson described it as quoted by Dale Saran:

I’m not saying everyone who gets food stamps does this by any stretch, but apparently plenty do. I just don’t think we, the taxpayers—should be funding products that are clearly bad for one’s health. It would be unthinkable for food stamps to be legitimately used for purchasing cigarettes. I’m not sure sugar-sweetened soft drinks are much better. Both bring immediate pleasure, but kill over the longer term. Why subsidize them?

Speaking of Dale, he responded in the comments section re my comments on one of RFK, Jr’s proposals.

I hadn’t thought about it from that perspective. He has a point.

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The Carnivore Diet (continued)

I received a number of poll responses, comments, and even emails about last week’s carnivore diet section. All of them good. But there were a few questions.

Before I get to those, I need to post the rest of what I wrote last week. I had a couple of bizarre things happen to me in the final moments of putting The Arrow to bed last Thursday.

I had gotten most of it written, but knew I had to leave for a meeting. Usually, I write the whole thing, then turn it over to MD to read and vet (and clean up typos, etc.). After she’s through with it and gives it the okay, I go through the process of sending it, which requires multiple steps. Which MD doesn’t usually do on this platform.

So, since I knew the meeting was looming, I asked her to go ahead and vet what I had already written while I finished writing what I wanted to write about the carnivore diet. The plan was that by the time she had finished reading and vetting, I would be through writing what I had left to write. And it appeared that it would go according to schedule.

I finished just about the same time she finished. Then when I tried to paste what I had just written into The Arrow, it wouldn’t paste. A few words in the first paragraph pasted, but that was it. I tried again and again, to no avail. I then realized that the same thing had happened once before a few months earlier. Apparently this platform has a character limit, which is great for those who complain it’s too long.

After I dealt with that by trimming a bit here and there, I was able to put a brief explanation in to finish it off.

Then I started the process of sending the thing. And was then confronted with an entirely different problem.

Two weeks ago, I received a video from the platform telling of all the wonderful changes they had made to make my life easier. I watched the video and realize almost every navigational step was going to be changed, but it all seemed pretty intuitive, so I didn’t worry about it.

I kept waiting for these changes to take place, but they never did. I kept refreshing what I had done thinking that the changes would all pop up. But nada.

Then, right between when MD had vetted the thing and I had dealt with the running-out-of-space issue and was ready to send, the changes all hit. And the sending process was completely different than it had been. And I had absolutely no idea how to send the newsletter. It took me ten minutes to feel my way through the process and get it sent. And I was late to my meeting. And all the while had serious angst about whether it actually went out or not.

So, with that prelude, here is the rest of what I wrote in the carnivore diet section.

Here is how I finished off this section in last week’s Arrow.

By rejiggering some of the previous text, I generated enough space to be able to include Nick’s excellent video on the ability of a carnivore diet to resolve serious inflammatory bowel disease in a series of patients.

I’ll pick it back up where I left off.

One of the great benefits of a carnivore diet is that it is truly anti-inflammatory. If you have inflammation issues, the carnivore diet generally gets rid of them. Nick Norwitz recently posted a video about some research he did with Adrian Soto-Mota from Harvard on the carnivore diet in inflammatory bowel disease. IBD is a terrible disorder, and Nick discusses the symptoms near the start of his video, so I won’t got into them here. But no one would wish them on their worst enemy.

In the video, Nick discusses the complete remission that took place in ten patients with IBD after following a strict keto or carnivore diet. It’s amazing to watch.

Norwitz video link in case you missed it last week.

IBD is an overwhelming inflammatory disorder, so if a carnivore diet can fix that, it should fix most much more minor inflammatory issues.

We cut our evolutionary teeth so to speak on meat. Since those early Paleolithic days we’ve been subject to all kinds of dietary changes. And our genetics have changed a bit along the way. For instance, with the advent of agriculture we’ve developed a number of amylase genes allowing us to digest starches. But still some of us have issues with certain foods. And when we consume those foods, we experience inflammation of some degree. If we go back to the earliest form of human food—meat—we can generally reduce this inflammation. It seems like magic, but it is simply eating what we’re designed by the forces of natural selection over millennia to eat.

Back in the early 1980s when I first started encouraging patients to eat more meat and many fewer carbs, I was a bit apprehensive. At that time, I was naive enough to believe what I read in the mainstream medical literature. Which, at that time, was meat, especially red meat, was bad because it ran up LDL-cholesterol levels. Back then, before my brain transplant, I was a believer in the lipid hypothesis that LDL caused heart disease, and I was worried that although I was helping my patients lose weight, I could be putting them at risk. So I monitored lipid levels closely.

What I found was that lipid levels almost invariable got better when people cut the carbs and started more meat-heavy diets. All the lab work I kept getting back helped keep my anxiety in check, but I still wondered. I had checked my med school biochemistry texts to see if there was any rationale for why cholesterol levels would fall when people were loading up on the very foods that supposedly increased cholesterol levels.

In so checking, I discovered that HMG-Coenzyme A reductase, the rate limiting step in the cholesterol synthesis pathway, was stimulated by insulin and inhibited by glucagon. I knew that by cutting carbs and increasing fat intake, my patients were lowering their insulin levels and increasing their glucagon levels, so it made sense that cholesterol levels should fall. (BTW, the HMG CoA reducase enzyme is the same one statins act on, but I didn’t know that till later, mainly because they didn’t even exist back then.)

Figuring this out gave me some comfort, but with all the anti-red meat articles making the rounds, I still felt a little iffy about what I was recommending.

Then, in the late 1980s (1988, to be exact) I came across a paper that soothed my soul about what I was doing. This was before I got heavily into scouring the medical literature myself. MD and I were practicing in Little Rock, Arkansas at the time, and one of the medical journals I did read somewhat regularly was the Southern Medical Journal.

In the January 1988 issue of that journal appeared an article titled “Reducing the serum cholesterol level with a diet high in animal fat.” (Link is to a copy in my Dropbox)

I almost couldn’t believe my eyes.

The author was an allergist who put his patients on an elimination diet of primarily beef ribs. He found that almost no one had allergies to that meat, so he could start his patients on it then introduce other foods one at a time to see which ones caused the allergic issues.

I’m sure he had the same worries that I did in the era of the low-fat, high-carb diet Zeitgeist. He, as I did, checked his patient’s labs to see what happened. And, like me, he found that their lipid levels improved all the way around. But unlike me, he wrote it up and submitted it for publication. It hadn’t occurred to me to do that, since I was a clinician and not a researcher.

His study was small and included only seven patients. But those patients experienced the same changes that my many, many more had experienced. His patients lowered their triglyceride levels by 39 mg/dl, lowered their total cholesterol levels by 74 mg/dl, and saw an increase in their HDL levels. All these were similar to the changes I had seen in my own patients, none of whom were on total carnivore diets. So I experienced much relief to know that someone else had basically replicated what I had found. And that a medical journal had peer-reviewed his findings and published them.

I’m sure some of you have heard of (and if so are wondering about) an interesting group of people known as lean-mass hyper responders, whose cholesterol levels soar when they go on low-carb diets. These folks do exist, but are few and far between. I had a handful later on in my practice, but none early on. Most people who came to see me were not lean; they were obese. And in virtually all of these cases, their lipid levels improved markedly.

Now, to the questions about the carnivore diet…

Here is one from the comments

There are two major problems that crop up with the carnivore diet: constipation and it’s total opposite, diarrhea. Most people can tolerate the former much better than the latter.

By its very nature, a carnivore diet is high in fat. The digestive tract deals with fat differently than it does with carbohydrates. The wall of the small intestine is covered with what is called a brush border that basically captures carbohydrates and breaks them down to sugars and allows them to be absorbed into the enterocytes, the cells lining the small intestine.

Fat is basically emulsified when it hits the small intestine. The gall bladder contains bile acids, which are released under the stimulation of fat entering the small bowel. Also, the pancreas releases lipase enzymes that, like the bile acids, help emulsify fat. In addition, the brush border helps, but not a lot.

Most of the fat consumed in the diet does not reach the colon, which is good as the colon isn’t designed to deal with fat. If a load of fat does reach the colon, a nasty diarrhea is typically the consequence.

For example, people who have had their gall bladders removed surgically end up with diarrhea if they’re not careful. Why? Because the gall bladder is the repository for bile acids, which are made in the liver and sent to the gall bladder for storage.

When fat comes down the pipe, the gall bladder squirts out a load of bile acids to help with emulsification. No gall bladder, no squirt of bile acids, and incomplete breakdown and digestion of fat. Which then hits the colon and you know the rest.

The pancreatic amylase helps a bit, but without the bile acids, it’s tough to completely emulsify the fat.

In the case of the missing gall bladder, the body ultimately compensates by kind of reforming a rudimentary gall bladder out of the stump of one of the ducts and dilation of the common bile duct. And the liver produces more bile acids, which are dumped more directly into the small bowel.

The liver makes the bile acids and the pancreas makes the lipases. Both are created in a step by step fashion along enzymatic synthesis pathways. I haven’t looked it up, but I remember from med school that the bile acid synthesis pathways contains around a dozen steps (I just looked it up, there are 14 enzymes involved). I also can’t remember how many enzymatic steps in the pancreas, but I would assume around the same number.

In each enzyme synthesis pathway, there is always one enzyme, called the rate-limiting enzyme, that sets the pace for the entire enzymatic pathway output. Each enzymatic synthesizing pathway is like an industrial assembly line. In an assembly line, the end output is set by the slowest worked on the line. Partially completed product stacks up in front of that person, and those down the line are twiddling their thumbs waiting to get product. If you replace that person with a faster, more efficient worker, then the output increases.

Same with enzymes. There is always one that sets the pace. In the cholesterol synthesis pathway it is the aforementioned HMG CoA reductase enzyme. If you can increase or decrease the efficiency of this rate-limiting enzyme, you can increase or decrease the product at the end of the assembly chain. In the case of statins, those drugs inhibit the rate limiting enzyme, so the body’s production of cholesterol, the end product, falls.

Enzyme don’t just come out of nowhere. They have to be made. They are made when the body needs them by sending word to copy the strip of DNA that codes for that enzyme, then sending that code via messenger RNA to the ribosomes in the cells where the proteins are put together. Then the protein (all enzymes are large proteins) is built one amino acid at a time. This is a complex process and the body, being very efficient, doesn’t go through this process unless it needs the enzyme. And in the case of bile acids, it needs not just one but 14 enzymes.

It’s not going to make those enzymes just in case. It does to a certain extent, but it doesn’t overdo it.

Which is why it takes a bit of time to become low-carb adapted. From days to weeks to even months in some cases. If you’re habituated to using carbs for energy because you eat a lot of them, then you’ll have plenty of enzymes for processing carbs. When you switch to fat as your primary fuel, it takes the body a bit to catch up. How long depends on your body and its enzymatic command forces (for lack of a better term).

If you have diarrhea on a carnivore diet, then you haven’t made the enzymes to make the conversion. Undigested fat is making its way to your colon. It will take a while to increase the enzymes necessary to prevent this from happening. And like low-carb adaptation, it can take a while.

One of the things you can do is eat leaner cuts of meat and eat smaller meals throughout the day at first so the enzymes you do have won’t be overwhelmed. You can also consume some bone broth and/or bouillon, both of which contain a fair amount of salt, which helps. I would add some potassium as well.

Also in play—though, in my view, anyway, it makes less difference than the speed at which enzymes can be up-regulated—is the microbiome in your gut. If you’ve been following a high-carb diet, you’re microbiome is crawling with bugs that love carbs. Take those away and replace them with fat, and all those carb-loving bugs die. And are ultimately replaced with those that will dine happily on fat. But it takes a while. And I don’t know how much the die-off of the carb-loving bugs contributes to the diarrhea, but I suspect is does to some degree.

So, smaller meat meals of less fatty cuts for a while. Titrate to what prevents the diarrhea. Then add fattier cuts and larger meals as tolerable.

As to constipation, that one is easier. Eat fattier cuts of meat and fewer meals and drink plenty of water. More fat will reach the colon, and the skids will be greased, so to speak. That usually solves the problem. But it, too, can take a bit of time till things are normalized, and you can eat the meals on the schedule and the cuts at the sizes you prefer.

Okay, let’s move on from the colon.

I had a bunch of cool stuff I was going to write about today, all saved among my zillions of tabs. I was going to put part of it behind a paywall, but two things happened to me yesterday that infuriated me with my fellow docs, so I’m postponing all the cool stuff (and the paywall) till next week. Instead I’m going on a major medical rant.

Medical Malpractice

When I say I’m infuriated with my fellow docs, I’m not talking about all the physicians I know and respect. I’m talking about physicians who deal with patients in the way I’m going to describe.

I encountered two cases yesterday that totally infuriated me. One was the write up of a case in Medscape; the other was a real person I encountered who has been horribly mistreated.

Let’s look at the Medscape one first.

I’ve posted a number of Medscape articles over the years I’ve been writing The Arrow. Most of you know Medscape is a newsletter for physicians that is sometimes behind a paywall. It’s mission is to provide updates on therapies and studies of interest to practicing physicians.

From time to time, Medscape puts forth diagnostic quizzes to allow docs to test their own diagnostic skills. Medscape encompasses all the different specialties, and, consequently, the quizzes involve questions about patients with Illnesses one might usually see in different specialities from ones own.

I always take these quizzes just to see how my knowledge base stacks up. Depending upon the specialty, I do okay, but sometimes I suck if it’s a specialty I know little about. Especially if newly-minted medications are involved.

There was a quiz this past Tuesday that I didn’t see until yesterday. And I’ve been pissed since.

The diagnosis was so obvious you would have to be brain dead not to get it (if you were a physician with any sense at all). I’m going to provide you with the background. You can try your luck at making the diagnosis. What I’m pissed about is the treatment this poor guy got and the hell that awaits him as a consequence

Here are the findings on exam, labs, and X-ray.

The chest X-ray looked normal to me, but it is difficult to see detail as it is a small photo.

The quiz asked what would be your diagnosis given these labs and physical findings? The choices are:

• Acute myocardial infarction (heart attack)

• Pulmonary embolism

• Acute pericarditis

• Esophageal adenocarcinoma

• Perforated peptic ulcer

I’ve bolded the signs above that should nail it. Here is how the quiz came out.

It’s amazing to me that 54 percent of my colleagues did not get this correct. The article goes on

The Medscape discussion of this case goes on for a couple more pages, which you can read here if you are interested. I have to ask: why did fewer than half the doctors answering the quiz get the correct answer? That stunned me.

But what has gotten me so riled up is the treatment this poor guy has received. Now maybe he is one of those types of people who say, “Just give me a pill, doc. I don’t want to make any lifestyle changes.” But even then, it is a physician’s job to tell such a patient that he will still be at risk even if he controls the symptoms. Based on my many years of experience, however, I suspect his doctor treated his symptoms as they occurred. The doc might have mentioned something along the lines of, You really need to lose some weight. And might even have given him a 1,200 Calorie (probably low fat) diet sheet.

He is obese, has type 2 diabetes (T2DM), and high blood pressure, which have required two medications to control. He is on sliding scale insulin injections for his T2DM, which means he had a prescribing physician. Sliding scale insulin means he checks his blood sugar and then gives himself an insulin injection depending upon what his blood sugar is. In my view, based on the lengthy work of Roger Unger, no one should be given insulin injections for T2DM. It only makes things worse. What they end up doing is chasing their blood sugar first with insulin and then with carbs in a vicious cycle of poor blood sugar control.

Had this patient gone on a low-carbohydrate diet, he would have solved all of his issues. Every single one of them.

He is obese. It would have solved that. His blood pressure would have normalized (that’s the only thing that’s iffy—high BP resolves in about 75 percent of cases on low-carb (at the very least he could have reduced meds)—and his T2DM would have resolved. And his GERD would have resolved.

As it stands now, this poor guy, who is only 53 years old, has a tough, tough row to hoe. The treatment for esophageal cancer is brutal. And the follow up side effects from the treatment are brutal. After going through all that, he still has only a 19 percent chance of living for five years. And the first two or three of those years—if he makes it that far—will be horrible.

When I read this case history, I really want to weep. It so terrible, and yet so preventable.

Obesity in males is such a risk factor for esophageal cancer. Combine that with GERD, and you run the risk up even further. Granted esophageal cancer isn’t as common as some other cancers (4.2 per 100,000 per year), but it’s growing right along with the increase in obesity.

I don’t even know this guy, but I feel terrible for him. Had he fallen into the hands of someone who cared enough for him (and who had the knowledge to know to do it) to sit him down and get him on the right diet, he wouldn’t have such a grim future. Multiply his cases times many, many others, and you can imagine how much misery could be avoided and lives saved. 53 years old. Terrible.

The next case that crossed my path occurred right while I was reading the case report above for the first time. I was sitting at my laptop reading when a knock came on our front door.

I went to the door and there were a couple of young people, whom I took at first glance to be political canvassers. Instead they were trying to sell me new internet service. ATT&T had just installed their fiberoptic service in our neighborhood, and they were going door to door asking people if they wanted to sign up.

Our internet service is terrible. Keeps cutting out all the time. And is slow despite upgrades the company said would make it blazing fast. I had read about AT&T’s new service, so I was a willing customer. (They installed it today while I’ve been in the middle of writing The Arrow, and I can confirm it is blazing fast. At least comparatively so.)

They came in to take the order and in the discussion the female of the pair mentioned that she had type 1 diabetes (T1DM). She was at least 80 pounds overweight! And, of course, was on insulin. Anytime you see anyone with T1DM who is overweight, you know they’re on too much insulin. And when they are hugely overweight, they are hugely over insulinized.

At first, I was sure she must have meant T2DM, but upon probing I realized she really did have T1DM and that she was a fairly brittle diabetic. She had experienced diabetic ketoacidosis and had gone into insulin shock a number of times. She had even had her driver’s license revoked because of passing out. Given her degree of obesity, I was stunned.

She told me she was under the care of an endocrinologist who helped her adjust her insulin dose. A frigging endocrinologist and this poor girl (she looked to be in her late 20s) is 80 pounds overweight!

She told me how she had to be careful with her diet and always have carbs at hand, so she doesn’t pass out.

This situation is fairly typical and is almost beyond belief. Many doctors treat insulin with carbs. They give patients enormous doses of insulin and encourage them to eat a lot of carbs to keep their blood sugar from going too low. Jesus wept!

With these folks, it’s best to put them on a very-low-carb diet and let their blood sugar stay a little high. In other words, reduce their insulin as their weight and blood sugar levels decrease. It’s a little touchy right at the start, because if they simply go on low-carb and don’t decrease their insulin levels, they will fall out in pretty short order. Potentially for good, if they don’t get carbs.

It takes some management to help these people reduce their insulin doses at the correct rate. In my view, it’s better to allow their blood sugars stay a little bit higher to reduce the risk of insulin shock. As the weight decreases, so will the insulin doses.

I think about Dr. Richard Bernstein and how he has just turned 90 after meticulously managing his own T1DM for 78 years. And then this poor girl whose life will be shortened dramatically by her disease simply because she fell into the hands of an endocrinologist who is treating her insulin with carbs.

I told her about Dr. Bernstein’s book and gave her a copy of Protein Power that we happened to have laying around, so she could get some idea of what’s going on. I desperately hope she gets the help she needs. But I despair of it.

Odds and Ends

• Why does this never happen to me. Woman finds interesting rock while on a walk. Takes it home and uses it as a doorstop for decades. Ends up being worth $1.4M. Crazy.

• Beta male Thierry Breton, lover of censorship, suddenly resigns from EU Commission. Was it because of his threat to Elon Musk? Whatever the reason, good riddance.

• New studies describes the neurologic underpinnings of why we choke under pressure and provides suggestions on how to avoid it.

• Is the appendix a vestigial organ, or does it have a function?

• The US sucks at ship building. in 2022, the U.S. had just five large oceangoing commercial ships on order, compared to China’s 1,794 and South Korea’s 734.

• Are we living in a parasite culture? According to one of my favorite writers, we are. See below for another example.

• Only Fans, the do-it-yourself porn platform earned more money last year than the combined salaries of all the players in the NBA, with a huge chunk going to the owner of the platform. Who was not a creator, just a platform provider.

• Ford’s CEO drives a Chinese EV and realizes that they are way ahead of the US and everyone else in the EV biz.

• Vultures are the garbage collectors of the natural world. If they die off, serious problems develop, as they discovered in India when the residue of a commonly used pain medication killed off all the vultures. The law of unintended consequences in action.

• Science improves when people realize they were wrong. Science means being able to change your mind in light of new evidence. Strange article for Scientific American as they have gone totally woke.

• Was someone with the unlikely name Biffy’ Wilfred Dunderdale the real life model for Ian Fleming’s James Bond?

• I’m not sure how reliable this research is, but here is a ranking of the rudest cities in the US. For what it’s worth, I’ve been to everyone of these cities and never noticed the residents of any of them to be particularly rude.

• Top 50 recipes from the NY Times over the past decade as decided by readers. Most are pretty carb heavy, but some not so carb heavy look spectacular.

• Are industrial and/or agricultural chemicals fueling the ‘brain-wasting’ disease in the US’s so-called Parkinson’s Belt?

• One of the many dark secrets of the CIA emerge: Multiple sexual abuse cases emerge from the shadows.

• Still thrusting after all these years. 47-year-old Voyager 1 spacecraft just fired up thrusters it hasn’t used in decades

• The greatest threat to American spies is their own leadership. This from my favorite ex-spook. Almost all of his stuff is behind a paywall, so I rarely post. This one isn’t.

• Governments are pushing the public to switch to smart vehicles to reduce fossil fuel consumption, but there is also a second motive: surveillance. This September, Ford filed a new patent to eavesdrop on riders.

• You can certainly see where the health trend is turning. Hershey is turning its candy into energy drinks and protein powders with C4. These flavors sound dreadful. To me, at least.

• Want to make a quick $10K? Simply head to the Everglades and remove 20 Burmese pythons and the money could be yours. What a great deal!

Newsletter Recommendations

Video of the Week

Okay, the video of the week today is a strange but hilarious one. And it is a great argument for the utility of social media. Thirty years ago, if you were a talented person, you would have a means to record, use an expensive program to edit any video you were able to make. Then you could show it to a few friends, if they had a way to play it. One or two of them might show it to other friends, and that would be about it.

Now with Twitter, YouTube, Instagram and all the rest, you can do a video on your smart phone, post it to social media, and become an internet sensation. Which is something that would have been virtually impossible 30 years ago.

Today’s video is just such a phenom.The guy who did it is incredibly talented. It’s a video based on one of Trump’s statements in his debate with Kamala Harris a week or two ago. He talked about pets being eaten by migrants in Springfield, Ohio. This guy took just a few words and converted them into an infectious melody that I just can’t get out of my mind. It’s a total ear worm.

The best part of it is that although it was derived from a political debate, it is apolitical. I’ve talked to a bunch of people about it from both sides of the political spectrum, and no one knows whether it is pro-Trump or anti-Trump. Which is a part of its genius.

Since it kind of broke the internet, you’ve probably already seen it, but just in case you haven’t, here it is. Enjoy! And realize this same guy with the same talent could not possible have done this not all that long ago. 5.5 million views as of this posting.

I’ve got to quit before I run out of space.

Time for the poll, so you can grade my performance this week.

That’s about it for this week. Keep in good cheer, and I’ll be back next Thursday.

Please help me out by clicking the Like button, assuming, of course, that you like it.

This newsletter is for informational and educational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

Thanks for reading all the way to the end. Really, thanks. If you got something out of it, please consider becoming a paid subscriber if you aren’t yet. I would really appreciate it.

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And don’t forget my newest affiliate sponsor Jaquish Biomedical. Highly recommended to increase your lean body mass.