The Stone and Water Book Series: I spent most of my career as an ICU doctor facing multi-organ failure, searching for the single cause driving it. When I began studying minerals and water, I found a different patient in multi-organ failure: global agriculture, where yields have been stalling almost everywhere. I went looking for the diagnosis, and I believe I found it in the degraded chemistry of the world’s water. I also believe there is a way to give that water back what it lost, and that is where this series is headed. If you want the backstory, it starts with my book series launch post.

Picture a wheat field in northern France in 1997. It is one of the most productive pieces of farmland on earth, worked by some of the best-trained farmers in the world, on soil that has been measured, mapped and fed for generations. For almost fifty years, that field gave a little more every year. Then, around 1997, it stopped.

Now picture a second plot, somewhere else in France. A plant breeder owns it, and it is planted with the same kinds of wheat, grown under ideal conditions to measure what each variety can really do. In that plot, the wheat kept climbing. Year after year, the genetic yield potential of French wheat kept rising.

The seed could still give more. But the field could no longer deliver it.

In the ICU, when a patient stops responding to a treatment that has always worked, you don’t blame the drug first. You ask what has changed in the patient. That question is what this post is about, because the French wheat field is not an oddity. It is a canary.

The Emergency That Gets All the Attention

Climate has everything an alarm needs. It has a single number, parts per million of carbon dioxide, that can be charted, targeted and negotiated. It has villains, summits, a global movement, and a steady supply of events cut to the length of a news cycle: a hurricane makes landfall in an afternoon, a wildfire crowns a ridge in minutes, a heat record breaks in a week. Water has none of that. An aquifer falling half a meter a year, or a soil losing its fertility over decades, never leads the evening news. Human attention, and the media built to hold it, is tuned to events rather than to slowly shifting baselines, so a catastrophe without a dramatic moment goes chronically unwatched.

I have measured that silence. Altmetric, a service that scores research by how much attention it draws, rates the 2024 State of the Climate report in BioScience at about 7,600, shared by nearly 10,000 accounts on X. The FAO’s AQUASTAT Water Data Snapshot, the UN’s own accounting of how fast the world’s freshwater is disappearing, scores 11. Yes, 11. A whopping fifteen accounts on X shared it in its first week, and none since.

Even the climate reports themselves look past it. The 2026 edition calls itself “no longer a warning for the future” but “a diagnosis of the present,” yet the present it measures is temperature records, ice extent, ocean heat and disaster tallies. It is a diagnosis of the sky, and of the future. Across the last three reports and tens of thousands of words, the word “yield” does not appear once. There is no crop trend, no soil fertility, no salinization, and although mentioned in passing in 2025 and 2025, by 2026 there was not a single mention of water quality. I recognize this from the ICU. When a patient arrives in septic shock, one number commands the room, the blood pressure, and whole protocols are built around pushing it up. But the blood pressure is the reading, not the disease, and you can chase the number until it looks better while the patient gets worse. Carbon has become that number.

I have my own doubts about how settled the climate story is, but they are not this post’s business. What matters here is what the UN itself names as the drivers of the world’s water losses: groundwater depletion, over-allocation, soil degradation, deforestation and pollution. We do all of those with pumps, plows, chainsaws, and drainpipes, and global heating only compounds the damage. We are not losing our water to the weather. We are spending it, draining it and, most of all, fouling it ourselves. Climate may be an accelerant, but the fire is in the water and in the food that depends on it. And because we caused it, I believe it is within our power to fix it.

The point is simple: we are watching one emergency so closely that we have stopped noticing the symptoms of another, and the place those symptoms are showing up first is the farm.

What follows is what a slowly failing food system looks like when you read it the way I was trained to read a failing patient. It does not present as a sudden collapse. It shows up as declining efficiency, rising inputs, weakening resilience, flattening yield curves, at the end of a half-century in which food got steadily more abundant and cheaper yet carried less biological potency.

The Yield Curves Bend

For several decades after the Second World War, cereal yields rose rapidly across much of Asia, above all in the irrigated wheat and rice regions where improved seed met fertilizer and reliable water supplies. Between 1965 and 1990, yields climbed by nearly 4 percent a year in China and Indonesia and by more than 2.5 percent across India, South Korea, Pakistan and the Philippines.

Then the curves began to bend. In 2012, Deepak Ray and colleagues analyzed yield trends from 1961 to 2008 across the world’s major maize, rice, wheat and soybean systems and found that roughly a quarter to two-fifths of harvested area showed stagnant or collapsing yields. A follow-up study found global yield gains of about 1.6 percent a year for maize, 1.0 for rice, 0.9 for wheat and 1.3 for soybean, all below the roughly 2.4 percent annual growth estimated as necessary to double crop production and feed the world by 2050.

Those figures stop in 2008. When I went back to the raw UN yield data and applied a similar method through 2024, the picture had not improved. By my analysis, three of the four staples have slowed further. Rice, the grain that feeds more people directly than any other (and is also the most water-thirsty), fell to roughly 0.6 percent a year.

Analysis after analysis now warns that current trajectories fall short of mid-century food demand without large changes in productivity or resilience.

A word on what these numbers can and cannot show. They are worldwide averages, and they do not separate food grown on rainfall from food grown on water that is not coming back. So they prove one thing cleanly: yields are slowing across the planet. On their own, they do not prove why. The numbers set the problem. They don’t name the cause.

Global averages are the broadest form of evidence. The most precise form is national data. Where a country has kept long, clean yield records, the bend has a date and a place. France is the clearest case, and I use it for one simple reason: its records are unusually good. French cereal yields climbed sharply from 1950 through the 1980s, two to six percent a year. Then, around 1997 and 1998, they stopped, flattening to near zero or falling for soft wheat, winter barley and oats, and holding there through the 2000s.

And the stall was not from the seed. In breeders’ test plots, the genetic yield potential of French wheat kept rising through the whole period. Varieties in carefully managed test plots could still yield more, but in the fields, they no longer delivered. The plant was not the limit. The ground it grew in was.

A single country can always be dismissed as a special case. But the same plateau is documented across the high-yielding wheat regions of northwest Europe, in Britain, Germany and the Netherlands as well as France, all bending in the same era. What is striking is that a generation of agronomists has not agreed on why. The proposed cause has moved from climate to farm management to no clear answer at all, and only one thing is ruled out with any confidence: that the crops reached their genetic ceiling. They did not. Something in the growing conditions is holding these fields below what they are capable of. Which is roughly where an ICU doctor wanders into a soil science debate uninvited.

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The Bill for Two Revolutions

Nature has always been able to bind, oxidize, and settle a certain burden of foreign material in water, keeping its lakes, ponds, rivers, and streams both clean and healthy. That capacity is real but finite, and for most of history whatever entered the water could be cleared from it again by the same mineral and biological processes, about as fast as it arrived. Rock, clay, iron, sulfate and time were enough.

What the Industrial Revolution began, and the Green Revolution accelerated, was not a poison that nature had never seen so much as a volume and novelty of load it had never had to clear at once. Hundreds of thousands of synthetic compounds with no established pathway entered the water. Soluble NPK fertilizer became the standard formula on the world’s farmland, and from the late 1990s glyphosate-tolerant crops allowed glyphosate to be sprayed across entire growing seasons across the planet. And the load grew with us. When the Green Revolution took hold, some two and a half to three billion people lived on Earth; the counter has since ticked past 8.3 billion. The same decades that multiplied our chemistry multiplied the mouths it fed and the waste it left behind. The capacity did not fail; it was overwhelmed.

That is the first bill. The second came from a change the history books mostly leave out. The Green Revolution’s story is told in seeds, fertilizer, and machines, but the new seeds and the new fertilizer were, in practice, a package, and the package only paid off where water could be controlled. The tube well, driven by cheap diesel engines and later rural electricity, provided that control. For the first time in history, over a few decades, the world’s breadbaskets stopped waiting for rivers and rain and began pumping water up from beneath their own fields, something agriculture had never done at scale. In the late 1940s, India irrigated around 19 million hectares; it now irrigates around 70 million. If rivers and rain are the water we spend as income, that was the day we started drawing on our savings account.

So two revolutions left two bills, one on the chemistry of our water and one on its quantity. They are not arriving at the same time, and that matters more than anything else in this post.

Two Hits, and the Timing That Tells Us Which Landed First

In medicine there is a pattern called the two-hit hypothesis: one insult primes the body, and a second compounds it. The world’s water has taken two hits. One is in water quantity: aquifers pumped faster than the earth refills them, wells chasing the water deeper until it is too far down, too costly to lift, or gone. The other is in water chemistry. As water tables drop, wells reach into deeper, older, more mineralized water; along the coasts, the sea slides in; and from above, a century of fertilizer and irrigation has laid down its own residue of nitrate and salt. I call the slow, combined change the Geohydrological Shift: the water beneath our farms becoming both scarcer and chemically different from the water agriculture was built on.

The yield data show which hit landed first, and the tell is in the timing. Across most of the world’s cropland, the wells still draw, and the fields still drink, yet the yields are already slowing. If the only danger were that the water is disappearing, the slowdown would still be ahead of us, waiting on the day the wells fail. That day has not yet come, but the slowdown has already started. So the blow doing the damage now is the quiet one, the chemistry, lowering the harvest while the water still flows.

The loud blow is still ahead, and it is the harder of the two, because chemistry slows a field down while scarcity shuts it off. When an aquifer finally fails, the crop comes off irrigation for good, and the region’s output collapses rather than merely bends. For many places, that wall already has a date. The loud crisis is coming. The quiet one is already here.

More Fuel, Less Distance

The clearest sign of a failing system, like a failing heart, is how hard it now has to work.

Global use of inorganic fertilizer reached about 190 million tonnes of nutrients in 2023, up from 142 million in 2002, and nitrogen use rose more than twentyfold across the second half of the last century. Agricultural glyphosate use climbed nearly fifteenfold between 1995 and 2014, and by 2023 some 355 million hectares were equipped for irrigation, while agriculture took roughly 72 percent of the world’s freshwater withdrawals. Around the weakening system, an entire parallel industry of corrective inputs has grown up: composts, microbial inoculants, biostimulants, humic acids, chelators and precision-agriculture sensors. The agricultural-biologicals market alone is projected to nearly double within five years, from about $18.4 billion in 2025 to $35 billion by 2030.

Those figures establish the expansion. What it means is a matter of interpretation, and I read it the way I would read a patient on three pressors: modern agriculture increasingly depends on layer upon layer of purchased intervention to reproduce what healthy, biologically integrated soil once did on its own.

That compensation shows up in the water as much as in the farm budget. The nitrogen, the salts from soluble fertilizer, the glyphosate and its breakdown products all move through the same water in the soil and the same water in the aquifers that are already being depleted and salinized. The effort spent outrunning a degrading water system is itself part of what degrades it further: more fertilizer forced into soil that no longer coordinates its own fertility, and the residue of that fertilizer added to the salt and nitrate load below. It is a treadmill: the farmer runs harder every year just to stay where he is, and this one speeds up the belt with every step.

The Price Stopped Falling

A theory earns its keep by predicting where else its evidence should turn up. If the water beneath the world’s food has been changing, the yield curves are the first place it would show. The second is the price.

For the last quarter of the twentieth century, food got cheaper. By the FAO’s own accounting, the real cost of the global food basket fell by almost half over the thirty years to 2006. That was not a mystery. It was manufactured. Cheap food was the direct product of rising yields, and the Green Revolution’s real output was not tonnage. It was affordability. So when the yield gains stalled region by region through the 1990s and early 2000s, the price decline bottomed out in the same window, in a commodity slump the FAO dates to 1995–2002. Then prices turned up, and analysts began using a phrase that would have been unthinkable a decade earlier: the end of cheap food.

Food prices move on many things: oil, export bans, biofuel mandates, war, speculation and the weather. No one can extract a water-chemistry signal from a commodity index, and I am not going to pretend otherwise. But the largest compensatory effort in the history of farming was mounted in exactly the period the price refused to fall, and at the end of it the world still cannot make food cheaper. A shock passes and the trend resumes. This one has not resumed in twenty-five years. The price is the reading on the treadmill’s display: it tells you how hard the runner is working, and how little ground is being gained.

As I write this, the world is living through exactly the kind of shock that makes headlines. Since the Iran war began on February 28, shipping through the Strait of Hormuz has been strangled. Middle East fertilizer exports fell roughly 70 percent in September, and Brent crude closed October above $113 a barrel. In the Black Sea, Russian and Ukrainian wheat exports just had their weakest summer since 2012. The FAO Food Price Index hit 136 in September, with cereals up 17 percent in a year, and the World Bank expects food prices to rise another 7 percent in 2027.

In the ICU, I learned to treat the acute crisis without losing sight of the chronic disease underneath it. Wars end. Straits reopen. Urea went from $420 to $910 a tonne and back under $400 in a single year. Shocks spike and pass. What does not pass is the floor they rise from, and that floor has been creeping up for twenty-five years while yields stall. Each new crisis begins from a higher baseline than the last one. That baseline is what this post is about.

Food That Weighs the Same and Carries Less

A field can put out plenty of plant material while the soil beneath it loses its microbial negotiation, its water retention, and its mineral mobility. Food can still look like food, weigh like food, ship and sell like food, and register as yield. But yield is not the same as vitality, biomass is not the same as nourishment, and tonnage is not the same as resilience.

The mineral data show the gap directly. A comparison of 29 raw fruits and vegetables against British food-composition tables for 1940, 1991 and 2019 found dry-weight declines of roughly 52 percent for sodium, 50 percent for iron, 49 percent for copper and 10 percent for magnesium. Because the figures were adjusted for moisture, the losses cannot be explained by produce simply holding more water. American data run parallel: Davis and colleagues compared USDA composition data for 43 garden crops from 1950 to 1999 and found consistent declines in calcium, phosphorus, iron, riboflavin and ascorbic acid.

The wheat record is sharper still. In the Broadbalk experiment, which, incredibly, has run for nearly two centuries, zinc, iron, copper and magnesium in the grain held steady from 1845 into the mid-1960s. Then they fell significantly once semi-dwarf, high-yielding cultivars were introduced, even as the minerals in the soil remained level or rose. The grain kept coming. The chain of transfer from soil mineral to edible food had weakened.

The usual name for this, the “dilution effect,” undersells it. A crop bred to produce more grain or fruit can lift its yield without taking up minerals in proportion, so the farmer sees more output, the market sees more supply, and the body gets less mineral per bite. I will openly admit that the evidence is not uniform across all crops and datasets, and analytical methods have shifted over the decades. But the direction across these records is consistent: modern agriculture has raised production while, in many systems, thinning the mineral density of the food itself.

The Machine Runs, and Asks for More

Put the vital signs together and the picture is one I recognize from the bedside. The weakening input-output ratio is the plainest signal of all. Each unit of food now demands more water, more fertilizer, more pesticide, more breeding, more machinery and more management just to hold current yields. The machine still runs. It simply requires more to deliver less. What modern farming has worn down are the living pathways that once kept rock, water, microbes, plants, animals and people connected, and that weakening is the symptom.

A canary is only worth having if the alarm is answered in time, and only if we read it correctly. So here is my honest hypothesis, stated as plainly as I can. The seed is not the limit, and the water has not yet run out. What has changed, everywhere these curves bent, is the chemistry of the water the crops drink: what it carries, what it lacks, and what it leaves behind in the soil. It is the one variable in this system that almost no one is measuring at the scale of a farm, and almost no one is watching.

I could be wrong. A hypothesis is only worth testing if it can fail, and I intend to treat this one the way I would treat any claim at the bedside: lay out the evidence for and against, grade it honestly, and tell you where it is strong and where it is thin. Hydrogeologists have spent decades documenting what is happening to our water, and many have tied it to the farm. What no one has done is the test a doctor would insist on: treat the suspected cause and see whether the patient recovers.

The canary went quiet twenty-five years ago. It is time to treat the water and see if the harvest answers.

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This series is about a solution, not just a crisis. Asao Shimanishi's Themarox, a mineral solution drawn from weathered rock, does quickly, in a glass, what rock and water once did slowly across whole landscapes: it is a geological shortcut. Two decades of records from Japanese agronomists and others convinced me it can help return the world's waters to a more biologically supportive state. Now it needs to be properly evaluated to modern standards and put to work at scale. I'm not an agronomist, so I need growers, researchers, and water managers willing to test it, develop it, and build on it. In full disclosure, I have a financial interest in products derived from this chemistry. But mine is one of several, the process is not proprietary, and I would be delighted to see others develop their own. The water belongs to all of us. You can learn more at The Stone and Water Series.

A potato half submerged in untreated tap water (left) and in treated tap water (right). One comparison, not a formal trial, which is exactly why it needs testing at scale.

From the Shameless Commercialism Department:

Aurmina is a volcanic mineral water purifier that cleans water the way the Earth always has. Add it to a pitcher. The minerals bind the contaminants, the burden clumps and settles, and you pour off the clear water. Unlike reverse osmosis, you don’t have to trade off purity for mineral breadth. Aurmina keeps the minerals in — producing one of the purest and most broadly mineralized waters on Earth. Check out our new website here (I also just learned that our 6 month return customer rate is over 45%, beating the top quartile target, an astounding testament to how much people love the water Aurmina produces).

Comparison with RO Systems

Primora Bio relies on the same mineral chemistry in the water that supports what we grow and love: plants, gardens, fish, and pets.

The “War on” Series

1. 2026 HEALING DEMENTIA SUMMIT

For the second year in a row, I gave an interview-style lecture for this summit. It presents the clinical responses that our Leading Edge Clinic, along with the solo clinics of our mentors, Drs. Rachel Wilkeson and Mitchell Liester, have seen in a range of neurological, cognitive, and neurodegenerative conditions treated with daily, low-dose, sublingual ketamine (non-psychoactive doses).

Here a couple of really short clips that were sent to me to wet your appetite:

At the risk of overstatement, I believe this method of treating with ketamine may be the most dramatic therapeutic advance in neurology in history. There, I said it. If someone you love has one of these conditions, I’d consider this a must-watch.

The 2026 Healing Dementia Summit kicks off November 3rd and is a completely online, virtual event. Sign up using this link: Healing Dementia Summit Registration

My interview is currently scheduled to air on Day 3, Thursday, November 5.

2. BAD MEDICINE DOCUMENTARY PREMIERE AND NATIONWIDE SCREENING

Mikki Willis, the award-winning documentarian, has made another hard-hitting film, this one about how COVID patients were treated inside American hospitals (even harder-hitting than the recent Senate panel I helped Senator Ron Johnson’s team organize called “Real Stories from Real People.” I’m told my interviews feature prominently in the film. I haven’t seen it yet, but I’ll be at the red-carpet premiere at the Malibu Film Festival in two weeks, my first ever.

From the filmmakers:

🎬 LA PREMIERE | Sunday, November 15

Malibu Film Festival, Writers Guild Theater, Beverly Hills
Red carpet 3 PM. Film 4 PM. Live Q&A moderated by Jimmy Dore, then a reception.
👉 Tickets: badmedicinemovie.org. Tickets: $20 premiere screening (plus $3.18 fee). $50 screening, awards and reception (plus $5.20 fee).

Can’t make it to LA? Bad Medicine may be coming to a theater near you.

🎟 NATIONWIDE SCREENING - ONE NIGHT ONLY | Wednesday, December 16

The film plays in theaters across the country for one night, but it needs YOUR help to get there! See map below. Each screening only happens if enough tickets sell in advance. If a theater doesn’t hit its number, the screening is canceled. 43 theaters are on the map, with more coming. Don’t see your city? Request a screening on the same page.

Mainstream outlets won’t be promoting this film. It reaches theaters only if they get filled first. Please get a ticket and share far and wide!

If you prefer to read the story instead of watch it, buy the book: Bad Medicine: How COVID Protocols Turned Hospitals into Death Traps, by Mikki Willis and Allyson Rimmer. #1 New Release in Epidemiology on Amazon. Order on Amazon

Tag: X, FB @mikkiwillis IG @mikkiwillisofficial

Hashtags: #BadMedicine #MalibuFilmFestival

3. Pastor Ricardo Beas

Ricardo first wrote to me as a reader. Every message he sent made me think deeply: he knew a great deal about several subjects I care about, including but not limited to minerals, water, and vaccines, and he kept pushing me toward angles I hadn’t considered. We finally met at a fundraiser for The Highwire. He offered me a ride to my hotel; we got stuck in traffic, and we ended up having a long conversation.

His path into the vaccine debate was unusual. When I became publicly critical of the vaccines, I noticed that the movement was led overwhelmingly by women, fierce and determined mothers, most of them fighting because their own children had been injured (who I privately admired as “Momma Bears” protecting their and others’ cubs). Ricardo came in from the other direction. His children were never injured. He studied the evidence to protect them before anything happened, and he concluded the risks were too high. He sprang into action, one of the rare men to do so, as evidenced by the picture below (he is in the lower left corner).

When California removed its religious exemption in 2015, he moved his family to Arizona.

In his own words:

If the Church’s principles (found here) reflect your own beliefs, which I can almost guarantee they do, you can join at https://thenaturallawchurch.com/become-a-disciple). In fact, I think it would be hard for anyone, once learning what this Church stands for, not to want to become a member, especially since it is free and refuses any donations (imagine that in this day and age). His church has been successful in all cases of religious exemptions from vaccines for work and school where the Pastor has been asked for assistance (which does not count those that were successful and never needed to ask him for additional assistance). The only exceptions were 2 occasions when the people involved first used other procedures, and when they were denied, they tried to use the church to obtain exemptions, which made their statements suspect to the employers.

I’d start with his most recent Substack post, his rebuttal to Dr. Malone’s calling the anti-vax movement a cult. Read it less for the rebuttal than for the history: it’s one of the better accounts I’ve read of how the modern vaccine-skeptic movement grew, from SB 277 to critical mass during COVID. 👉 ricardobeas.substack.com

Here is a short video that explains his church:

4. The Grenon Family

Regular readers know I’ve written extensively about chlorine dioxide, Jim Humble, and his longtime partner Mark Grenon. In my book The War on Chlorine Dioxide, I argue that the federal prosecution of Mark and his sons, a missionary family arrested and extradited after distributing chlorine dioxide for free in early COVID, represents one of the most unjust and punitive prosecutions by our Federal government (two of Mark’s sons, Jonathan and Jordan, are still serving the 4th longest “contempt of court” sentences in U.S History, for the crime of.. not answering a demand letter from the FTC). Jonathan’s letter to me from prison is, in my opinion, one of the most powerfully moving posts I have ever written, an unparalleled example of alignment: courage, service, humility, love, and dependence on God when every worldly support has been stripped away.

Mark has now told the family’s side of the story in a film. Part One of Mark’s movie called Silenced: A Missionary Family Saga is out on Rumble, link below, Part 2 is about a month away.

If you’d rather read, his latest book collects his clinical experience with chlorine dioxide as well as insights into many aspects of health and the world ruled by Pharma. Purchase here. Also in eBook form here.

One Last Thing: A Favor

Nearly everything I publish here is free. Today I’m asking for a different kind of payment. If you’ve read any of the books in the Stone and Water Series, please leave an Amazon review here. The books are selling well, both on Amazon and on my website, but almost no one is writing reviews. It doesn’t need to be long, and it doesn’t need to be kind. Honest and critical is fine. Reviews are how other readers decide whether to take a chance on a book.

👉 The Stone and Water Series on Amazon

Thank you.

*If you appreciate the late nights and deep dives I do down various health and medicine-related rabbit holes, a paid subscription is what keeps me going.

Subscribe now

From the Shameless Commercialism Department:

Aurmina is a volcanic mineral water purifier that cleans water the way the Earth always has. Add it to a pitcher. The minerals bind the contaminants, the burden clumps and settles, and you pour off the clear water. Unlike reverse osmosis, you don’t have to trade off purity for mineral breadth. Aurmina keeps the minerals in — producing one of the purest and most broadly mineralized waters on Earth. Check out our new website here (I also just learned that our 6 month return customer rate is over 45%, beating the top quartile target, an astounding testament to how much people love the water Aurmina produces).

Comparison with RO Systems

Primora Bio relies on the same mineral chemistry in the water that supports what we grow and love: plants, gardens, fish, and pets.

The Stone and Water Series

You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

The War on Chlorine Dioxide

Excerpted from The Silent Aquifer, Act V: The Evidence.

In a book about humanity’s largely unrecognized and fast-unfolding crisis in producing enough food and drinking water, a chapter on how modern medical evidence is manufactured and applied may seem a strange editorial choice. The reason is contrast: I wanted to set the folly, and the fraud, behind the evidence bases that guide medical decisions next to the evidence base for Themarox in agriculture, the mineral extract I propose as a potential solution to that crisis.

I spent a year assembling that evidence, including a trip to the other side of the world, and it is one of the more improbable bodies of evidence ever gathered behind a single claim. It includes four preclinical and clinical studies from two Soviet-era research institutes, one undated and apparently missing its authors. It includes two short-run, long out-of-print Japanese agronomy books, one of them (Rock-Water) assembled partly from notes taken while Shimanishi lectured in China. It includes exactly one peer-reviewed paper, one UN-funded controlled trial on damaged coastal farmland in Korea, two studies run by distributors who sell the product, a set of studies that Shimanishi-kaken commissioned from outside laboratories, and a stunningly compelling photo album in which growers documented the responses seen in the plants, bushes, flowers, cactuses, and crops that they treated with Rock-Water.

I could not make this sound less like a modern trial program if I tried. That is why I devoted two chapters to what modern trial programs are really like. This is the 2nd.

In my last post, “Insufficient Evidence,” I detailed how Pharma created medicine’s evidence hierarchy to systematically value only the most expensive studies while dismissing equally valid study designs that practicing physicians can produce cheaply.

Although I did not include this in the last post, for those who haven’t read it, I cannot encapsulate the core thesis behind it any better than using, as an example, a chapter I titled “The Big Six” from “The War on Ivermectin.” I showed how the Pharma-controlled institutions of society, namely the journals, the agencies, the professional societies, and above all the media, in a coordinated fashion, were able to dismiss and denigrate the entirety of the massive evidence for ivermectin using only six (later seven) highly manipulated “rigorous” RCT’s published in the top journals in the world. Hyper-focusing on only those trials, “they” got the entire world, including the vast majority of physicians, to ignore the actual evidence:

I hoped that book would allow History to record such an astonishing and deadly feat. Unless it becomes required reading in medical school curricula at some point in the future, alas, I fear it will not.

Now the question is: how much control does the company paying for a trial have over what the rest of us eventually read?

Far more than I understood during most of my academic career.

Industry Manipulation of RCTs

If only the most expensive trials count as actionable evidence, then whoever pays for those trials holds enormous power over what medicine believes. How that power is used has been documented in exhaustive detail by people who watched it from the inside.

Three consecutive editors-in-chief of the New England Journal of Medicine — Arnold Relman, Jerome Kassirer, and Marcia Angell, who between them ran the journal from 1977 to 2000 — have each said publicly that the profession has been bought. Relman told the BMJ:

Richard Horton, the longtime editor-in-chief of The Lancet, has written,

Four prominent physicians, Ben Goldacre, Peter Gøtzsche, Malcolm Kendrick, and Marcia Angell, have each written book-length critiques of the machinery that produces medical evidence.¹⁷⁻²⁰ In different voices and with different examples, they document the same recurring practices that steer a published result: selective publication, outcome switching, favorable comparators, statistical framing, cherry-picked subgroups, and the suppression or marginalization of inconvenient findings. And they show these practices are structural, not isolated.

It was that exact list of tactics deployed in the “Big Six” ivermectin trials that finally woke this 20-year clinician and researcher up to what was really going on in medicine.

Yet I had already lived through one massive fraud, early in my career. When I began my fellowship in pulmonary and critical care medicine, American ICU patients with septic shock were being infused with a drug called Xigris, to a degree nearly identical to the patients infused with Remdesivir in Covid.

The Xigris Affair

Having written the books “The War on Ivermectin” and “The War on Chlorine Dioxide,” I consider myself deeply versed in the dark arts of Pharmaganda, the sophisticated tactics that industry deploys from its well-worn Disinformation Playbook. Even so, after everything I have seen, I am still astonished when I took a look back at the sophistication, power, and coordination behind the approval and promotion of Xigris from a quarter century ago.

In short: Eli Lilly promoted an expensive and ineffective drug that caused bleeding, on the strength of one unusually favorable and heavily manipulated trial. It then helped finance the influential guidelines recommending its use, until confirmatory trials finally showed no survival benefit and ended its reign.

Xigris (drotrecogin alfa, activated) was recombinant activated protein C. It was meant to counter the inflammation and microvascular clotting of severe sepsis, but the same anticoagulant action that made it work also made patients bleed.

A Dramatic First Trial

Lilly’s PROWESS trial enrolled 1,690 patients and was stopped early for benefit. Reported 28-day mortality:

• Xigris 24.7% vs placebo 30.8%, an absolute reduction of 6.1 percentage points

• Serious bleeding 3.5% vs 2.0%

That implied one life saved for every 16 patients treated, which would be an extraordinary result in sepsis.

But regulators and intensivists had reasons to be uneasy:

• The finding rested on a single pivotal trial.

• The trial was stopped early, which tends to exaggerate treatment effects.

• Eligibility criteria were changed after about 720 patients had enrolled.

• The manufacturing process and drug lots changed mid-trial.

• The benefit was not uniform and appeared mainly after those changes.

• The eventual “high-risk” indication leaned heavily on subgroup analyses.

• The drug caused clinically important bleeding.

The FDA advisory committee split 10–10. The FDA approved Xigris anyway in November 2001, for adults with severe sepsis at high risk of death, and required further studies.

A four-day course cost about $6,800 in 2001 dollars. That was an enormous expense for an ICU drug at the time, and not far from the $3,120 commercial insurers paid for a five-day course of Remdesivir.

The Scandal

Sales disappointed. Hospitals were wary of the evidence, the price, and the bleeding (imagine that: caution prevailed). So Lilly mounted an unusually sophisticated campaign. According to a widely cited 2006 New England Journal of Medicine exposé by NIH critical-care physicians:

• Lilly hired a PR firm, Belsito & Company, to raise awareness of severe sepsis and Xigris.

• Lilly gave a reported $1.8 million grant to a task force on “Values, Ethics and Rationing in Critical Care” (VERICC).

• That campaign recast limited access to Xigris as an ethical rationing problem, so hospitals unwilling to pay could be portrayed as denying patients lifesaving treatment.

• Lilly funded the “Surviving Sepsis Campaign.” Its goal was good, IMO. Sepsis is among the most common causes of death, doctors vary widely in how quickly they recognize it, and early treatment is literally the difference between life and death. Great idea, crap motives. Lilly supplied more than 90 percent of the funding for the groups that wrote the original Surviving Sepsis guidelines.

• Many guideline authors had financial ties to Lilly.

• Shocker: the guidelines recommended Xigris, turning a commercially important drug into “evidence-based” standard practice.

The striking feature was the convergence of marketing, medical ethics, professional-society guidelines, quality-improvement “bundles,” and potential hospital performance measures. That last item was a weaker forerunner of the much more powerful “government reimbursement incentives” later used to promote the use of Remdesivir in Covid. Either way, Xigris showed that a commercial message could thus reach physicians disguised as independent professional consensus.

Meanwhile, the follow-up trials kept coming back negative: no benefit, more bleeding. In 2011, after PROWESS-SHOCK found no survival benefit, Lilly withdrew Xigris worldwide. Analysts had once forecast $1 billion in annual sales; by its last full year, the drug was selling about $100 million.

Then and Now

One detail shows how far professional capture has advanced since then. In the early 2000s, the Infectious Diseases Society of America (IDSA) declined to endorse the Surviving Sepsis guidelines, citing concerns about the development process, the evidence grading, and industry sponsorship. Ah, the good old days, when doctors took a professional and ethical stand. Twenty years later, during COVID, the same IDSA proved as captured as any other medical society in the world. It enthusiastically endorsed Remdesivir and the vaccines while specifically recommending against early treatment with repurposed drugs, especially ivermectin and hydroxychloroquine.

My take: Lilly took a fragile result from a stopped-early, mid-course-amended, company-sponsored trial, turned it into an approved blockbuster candidate, and then amplified it through a company-financed guideline and ethics campaign before anyone had confirmed it worked.

What makes Xigris infamous is not that a drug was eventually proved ineffective; medicine reverses itself all the time. It is that the company selling the drug financed much of the machinery that defined it as recommended, even ethically obligatory, care, while the evidence was still contested and patients were bleeding. It remains one of the clearest cases for why manufacturers should never fund or organize the guidelines, treatment bundles, educational campaigns, or performance metrics that govern their own products.

Fun fact: although Xigris was used everywhere in academic ICUs during my first five years in critical care, I never once gave it to a patient. My mentor, Paul Mayo, called bullshit from the start. He told me that drugs targeting the same pathways had been tested and had failed for decades, and that this was marketing, not medicine. He refused to use it. So did I.

Industry Manipulation of RCT’s

A 2005 NEJM survey found that 80% of academic medical centers would accept contracts giving sponsors ownership of the trial data, and 50% would allow sponsors to ghostwrite the resulting studies.²¹ 82% of institutions reported conflicts with sponsors even after contracts were signed; in one case, a company withheld final payment because it disliked the results. Contracts were typically kept secret. 69% of administrators said funding pressure often forced them to accept terms they considered unethical.

A 2005 report estimated that publishing a favorable paper could be worth up to £200 million to a pharmaceutical company, with a share of that value flowing to doctors who promote the company’s products.²² When the BMJ ran a 2003 cover depicting doctors as pigs at a banquet served by drug reps, companies reportedly threatened to withdraw £75,000 in advertising.^{23 24} The Annals of Internal Medicine lost an estimated $1–1.5 million in advertising after publishing a study critical of industry advertising.²⁵

As I documented in my book The War on Ivermectin, when the pharmaceutical industry wants to bury evidence of efficacy for an inexpensive, off-patent medication, it is highly adept at designing trials to fail before they begin.²⁶ Enroll patients who are too healthy or enroll them too late. Set the dose too low to work. Cut the treatment course too short to have an effect. Change the endpoint mid-trial.

These aren’t hypotheticals; major universities worldwide used them against ivermectin during Covid. Because ivermectin’s effect was so large, the standard tricks often weren’t enough; the trials kept coming back positive anyway, so the tactics grew even more brazen. Tony Fauci’s NIH-funded ACTIV-6 trial changed its primary endpoint well into the trial's conduct—“sus,” to say the least, and, in my view, clear scientific misconduct.²⁷

The original secondary endpoint of clinical progression at fourteen days was highly statistically significant, so they changed it to 28 days, where it lost statistical significance. It gets even worse. 5 months after the trial ended, the heavily NIH-funded principal investigator from Duke, Dr. Susanna Naggie, gave a presentation at the NIH, where one of her slides still showed the highly statistically significant difference at seven and fourteen days. Yet, when the study was formally published less than three months later, the exact same findings “missed” statistical significance by a hair.²⁸ Shucks.

The Oxford University PRINCIPLE trial went even further. When investigators found a highly statistically significant improvement in time to recovery—two full days—they invented a previously undescribed (and unintelligible) statistical metric they called “the Probability of Clinical Meaningfulness,” which they used to support the conclusion written in the study abstract: “Ivermectin is unlikely to provide a clinically meaningful improvement in recovery.”²⁹ So kudos to them: they did not lie, because in the new statistical world they had just created, a two full days faster recovery was indeed, “not clinically meaningful” as per their definition. But it meant that, at that point in my career as a physician, I was forced to accept a new definition of recovery, a “clinically meaningful” one, or the old one—whatever that was. They didn’t stop there either. The very next sentence of the abstract’s interpretation was something I had never seen before in a study abstract: a research-policy recommendation: “Further trials of ivermectin for SARS-CoV-2 infection in vaccinated community populations appear unwarranted.” You don’t say.

And don’t even get me started on the McMaster University TOGETHER trial.³⁰ First, their study began by treating Covid-19 patients with a single dose of ivermectin. Yep, a single dose. After about a month, they realized this approach wouldn’t “prove” anything, so they changed the protocol to a three-day course, even though no other antiviral is used for less than five days. The shenanigans they continued to pull only got worse from there, numbering in the dozens; I have extensively detailed them elsewhere.^31–33 But get this, that trial won the “David Sackett Trial of the Year Award” from the Society for Clinical Trials.³⁴ An award named after the father of Evidence-Based Medicine. I wish I were making this up.

Conversely, when RCTs are conducted to demonstrate efficacy for a profitable, patented pipeline product, they will run the numbers on 34 post hoc subgroup analyses until something crosses the significance threshold, and publish that slice as if it were the plan all along.

Once a trial is running, the machinery continues. Stop early when interim results happen to look favorable, locking in a statistical fluctuation before it regresses. Carry the last recorded measurement forward for every dropout, and since patients who drop out are often the ones being harmed, their last good number gets averaged into the final result. Recode adverse events: Merck reclassified deaths, Eli Lilly recoded suicide attempts as overdose, a child in the Pfizer Covid vaccine trial was left permanently disabled, yet investigators entered her injury as functional abdominal pain.

Then publish. Repeatedly. A single olanzapine trial was published 143 times, sometimes with different author lists. Place the favorable abstract in a high-impact journal whose editors, in half the cases surveyed, had taken payments from pharmaceutical companies (by the way, you don’t have to take money from Pharma to know that rejecting a study they want published will not bode well for your tenure as editor). Ghostwrite the paper, attach a credentialed name, and retain the data so no one can check. One internal Pfizer document stated that their studies “belong to Pfizer” and exist “to support marketing.”

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When Belief Becomes Law

Everything to this point has been about belief. What counts as knowledge, what counts as proof, which evidence is permitted through the gate and which is turned away at it. That is an epistemological problem, and if it stopped there, it would be a quarrel among academics, conducted in journals, with nothing at stake but reputations.

It does not stop there.

Between the evidence hierarchy and the patient in the bed sits a document, and that document is where the whole apparatus finally touches a human being. It is called a clinical practice guideline, and its logic is simple enough to fit on a card. For condition X, begin with treatment A. If A fails, move to B. Avoid C. Anyone hospitalized with Covid in recent years knows them all too well.

Who writes them? In Covid, it was the government that wrote the treatment guidelines, yet historically the private specialty societies write the overwhelming majority: the American Heart Association, the American College of Cardiology, the American Diabetes Association, the American Psychiatric Association, and their counterparts in every field. These are private membership organizations. They hold no statutory authority of any kind. And their recommendations govern the practice of American medicine, along with much of the medicine practiced in the many countries that adopt American guidelines more or less wholesale.

Technically, they are recommendations. In practice, they are the rules.

Here is why. A guideline determines what an insurer will reimburse. It determines what the hospital protocol says and what the electronic medical record prompts the physician to order. It determines what residents are taught to treat with first. And — this is the part that does the real work — it is used in malpractice litigation as a proxy for the standard of care.

That last one hurts the most. Take it from me, I have spent hundreds of hours, pro bono, in the past 6 years serving as an expert witness for doctors across the country and world whose licenses were being threatened for treating Covid patients with ivermectin, an act that regulators deemed, “outside the standard of care.” I can recall helping win only one case, that of the Canadian physician Dr. Charles Hoffe, which I wrote about in this prior post.

I want to be clear about the mechanism, because it is the hinge of this entire chapter. The evidence hierarchy decides what may be believed. The guideline converts that belief into the standard of care. The standard of care determines what a physician can safely do. Which means that the hierarchy does not merely decide what is true. It decides what is permitted. Dr. Wojak says it more compactly than I can: the guidelines are not the guardrails; they are the cage.

Now recall the word that was used on me, and what it was used to dismiss. Anecdotal — applied to a clinician’s observation of the same cause producing the same consequence, again and again, across hundreds of patients.

But know that roughly half of the recommendations in clinical practice guidelines are based not on high-quality evidence but on the guideline authors’ opinions.¹,²

Half. The system that told me my bedside observations were anecdote fills half of its own rulebook with expert opinion — and not opinion standing in for trials that could not be run, but opinion standing in for trials that simply were not. That opinion, once written down and voted through by a committee, becomes the legal standard of care for tens of millions of people.

So expert opinion is permitted to establish medical truth after all. It simply has to be the right experts, seated in the right room, funded by the right people. . That is not an evidence standard. It is a credentialing standard, and the two have almost nothing to do with one another. I ain’t “the right expert,” apparently.

That raises the obvious question: who those experts are.

Of the American physicians who authored clinical practice guidelines in 2020, seventy-four percent received payments from industry. Only thirty-seven percent disclosed them.³⁵ Among guideline chairs — the people who set the agenda, select the panel, and run the room — eighty-two percent had financial conflicts of interest, and not one of them disclosed those conflicts accurately.

Above the panels sit the organizations that appoint them. In 2020, seventy-two percent of the leaders of major American medical associations had financial ties to industry; among the physicians in those leadership roles, eighty percent did.³⁶ Across the ten largest disease areas, payments to those leaders approached $130 million over five years. Not one organization had a leadership free of industry ties. NOT ONE.

Fun fact: I have never in my entire career had a true financial conflict of interest (outside of doing two hours of paid consulting with a GE ultrasound engineer on a super-cool probe he was designing for lung ultrasound, an opportunity I simply could not intellectually resist). This may be the reason why AMD has always told me they find it remarkable that, of all the Covid dissident physicians, I am the only one that has not (yet) been accused of being “controlled opp.”

It gets even worse. The organizations themselves are funded by the same companies whose products their guidelines evaluate. The American Heart Association receives roughly forty million dollars a year from pharmaceutical and device manufacturers.³⁷

The American Diabetes Association receives tens of millions. These bodies write the cardiovascular and diabetes guidelines.³⁸ And when researchers examined the financial relationships of guideline-producing organizations directly, they found that only one percent of guidelines disclosed the producing organization’s own financial relationships.³⁹ Most of those organizations had conflict-of-interest policies. Few had any procedure for enforcing them. The policy existed. The enforcement did not.

The reasonable objection here is that money is not the same thing as influence — that these are serious people, capable of holding a payment in one hand and a recommendation in the other.

That has been tested as well. Guidelines written by panels with financial conflicts were twenty-six percent more likely to recommend the sponsor’s product.⁴⁰ Industry-funded trials were thirty-four percent more likely to report conclusions favorable to the funder.⁴¹

Notice how those two figures sit on top of one another, because the same stacking applies. The biased trials feed the systematic reviews. The systematic reviews feed the guidelines. By the time you can measure a twenty-six percent tilt at the panel, the evidence arriving at that panel has already been tilted upstream, and the panel’s tilt is applied to a body of work that was bent before it got there. Twenty-six percent is not an estimate of industry influence on guidelines. It is the floor.

There is one further bias is built into the guideline system that has nothing to do with any individual’s conflict of interest, which makes it, in some ways, the more serious problem (and one of the most relevant to the MAHA movement), because no disclosure form ever written could catch it.

Guidelines systematically favor drugs over everything that is not a drug. The reason is not scientific. It is structural. A drug has a company behind it — a company that will fund the trials, pay the statisticians, sponsor the conferences, and populate the panel with specialists whose entire careers were built on that class of compound. Diet has no company. Neither does exercise. Neither does sunlight, or sleep, or a mineral, or a glass of well-balanced mineral water. Nobody convenes a panel to write the guideline for something that cannot be sold, and nobody funds the trial that would qualify it for the top of the pyramid. The resulting body of recommendations is not so much wrong as lopsided: exhaustive about every intervention with a sponsor, and close to silent about every intervention without.

If you want to see how early that asymmetry is installed, look at what physicians are taught. Across four years of American medical school, nutrition receives roughly twenty hours of instruction.⁴²

Twenty hours, in total, on the substance every one of our patients puts into their body three times a day, every day, for the whole of their life. My students could recite the mechanism of a dozen antihypertensives. Very few of them could tell you what magnesium does. And don’t even get me started on the importance of drinking water chemistry, or the health importance of its mineral composition. It has only one consensus document: a 2005 WHO review that set minimum levels for calcium, magnesium, bicarbonate, and total dissolved solids. This Substack is also transitioning into that field; over the next few months, I plan to post numerous excerpts, repurposed for Substack, from the 768-page encyclopedia I wrote called, “Earth’s Living Water: Its History, Its Ruin, and The Way Back.” This chapter is one of them.

Not Just a Few Bad Apples

Every industry has its scandals. Wall Street has paid more in total penalties than the drug companies have, and the oil industry has racked up more cases. If the question were only who has paid the most, Pharma would not top the list. The question that matters is a different one: what does a company do after it has been caught, has paid, and has signed a written promise to stop?

Start with the industry as a whole. Public Citizen tracked every federal and state settlement with drug manufacturers from 1991 through 2021: 482 settlements and $62.3 billion in penalties. Companies with two or more federal settlements accounted for 87.5 percent of all federal penalty dollars. Pfizer alone settled 15 separate federal cases, Novartis 12, and GlaxoSmithKline and Bristol Myers Squibb 9 each.⁶⁴ A study in JAMA of the 26 largest drug companies found that 22 of them were penalized for illegal activity between 2003 and 2016, and that nearly all of those engaged in it for at least four years, a pattern the authors said suggests intent rather than accident.⁴⁵ You don’t say.

Then look at what happens after the promise. When a company settles a federal health care fraud case, it usually signs a Corporate Integrity Agreement with the Inspector General of Health and Human Services: years of monitored good behavior, a kind of corporate probation. Pfizer signed one in 2004, after its Warner-Lambert subsidiary pleaded guilty to the fraudulent promotion of Neurontin. In 2007 another Pfizer subsidiary, Pharmacia & Upjohn, pleaded guilty to paying kickbacks. In 2009 Pfizer was back again, settling charges over the illegal promotion of Bextra and other drugs for $2.3 billion, including what was then the largest criminal fine in American history, with some of the same marketing tactics that had appeared in the Neurontin case. The acting U.S. Attorney said plainly that among the factors his office weighed in setting the penalty was “Pfizer’s recidivism.”⁶⁵

Peter Gøtzsche found the same pattern across the industry. In 2012 he searched for fraud cases involving each of the ten largest drug companies and found serious crimes committed between 2007 and 2012 by every one of them. He also noted that as of July 2012, nine of the ten were operating under Corporate Integrity Agreements; only Roche was not. He titled the full report with his conclusion: corporate crime in the pharmaceutical industry is “common, serious and repetitive.” Crimes that are widespread and repeated, he argued, suggest they are committed deliberately.⁶⁶

That is where the organized-crime comparison comes from, and it is more precise than it sounds. In his foreword to Gøtzsche’s book, Richard Smith, the former editor of the BMJ, noted that U.S. law defines racketeering as engaging repeatedly in certain kinds of offenses: extortion, fraud, federal drug offenses, bribery, embezzlement, obstruction of justice, obstruction of law enforcement, witness tampering, and political corruption. Gøtzsche, he wrote, presents detailed evidence that drug companies have committed most of them. Smith judged the comparison “not entirely fanciful.”⁶⁷ The insiders have said it more bluntly. Peter Rost, a former Pfizer vice president, quoted by Gøtzsche, put it this way: “It is scary how many similarities there are between this industry and the mob.”⁶⁶

Why would companies keep doing it? Because the arithmetic rewards them. A 2026 study in JAMA Network Open found that in kickback cases, companies paid a median penalty equal to 2.2 percent of the U.S. revenue the drugs earned during the period of the violation.⁴⁴ Public Citizen set its $62.3 billion against the $1.9 trillion in net income earned by the 35 largest drug companies between 2000 and 2018 alone. And the people who make the decisions almost never pay. The settlements, Public Citizen found, rarely involve admissions of guilt by individuals or companies, and federal prosecutors brought only six cases under the doctrine that allows executives to be convicted without proof of intent between 2000 and 2021.⁶⁴ A fine that small, paid by shareholders, with no one going to prison, is not a punishment. It is a cost of doing business, and the settlement record shows the companies treat it as one.

So I will not claim that Pharma has paid the most. Wall Street has paid more, and its biggest banks rival the drug companies as repeat offenders. But the two are not the same kind of criminal. When a bank breaks the law, people lose money. When a drug company breaks the law, people lose their health and/or their lives. An FDA scientist estimated that Merck’s Vioxx was linked to between 88,000 and 139,000 excess cases of serious coronary heart disease in the United States.⁶⁸ GlaxoSmithKline’s 2012 guilty plea included a charge of failing to report safety data on its diabetes drug Avandia to the FDA.⁶⁹ Purdue pleaded guilty to federal crimes over the marketing of OxyContin twice, in 2007 and again in 2020, while the opioid epidemic it helped set off killed Americans by the hundreds of thousands.⁷⁰ A fraud that empties a pension fund can be repaid. A fraud that hides a drug’s harms cannot.

That is why I call it the most criminal of all industries. Not because it has paid the most, but because its largest companies keep committing the same crimes after being caught, after paying, and after signing written promises to stop, and because the cost of those crimes is counted in bodies. That is the comparison Gøtzsche drew, and it rests on the companies’ own settlement record.

So hold all of that in mind: the stopped-early trials, the switched endpoints, the guideline panels on the payroll, the fines paid as a cost of doing business. Because over the next several posts, I am going to show you a very different kind of evidence.

It was gathered decades ago by Japanese agronomists and growers, Korean and Mexican university researchers, and a Russian institute of restorative medicine, along with the lectures Shimanishi gave in China. They studied Themarox in rice paddies, eel ponds, wastewater lagoons, and laboratory rats. None of them had a billion-dollar product to protect, a guideline panel to capture, or a journal to buy. Most of them were simply curious about what this strange mineral water was doing, and they wrote it down.

By the standards of modern medicine, almost none of it counts. You will soon be asked to judge for yourself what those standards are worth.

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From the Shameless Commercialism Department:

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The War on Chlorine Dioxide

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39. Paul Campsall, Kate Colizza, Sharon Straus, and Henry T. Stelfox. “Financial Relationships between Organizations That Produce Clinical Practice Guidelines and the Biomedical Industry: A Cross-Sectional Study.” PLoS Medicine 13, no. 5 (2016): e1002029. DOI:10.1371/journal.pmed.1002029.

40. Camilla H. Nejstgaard, Lisa Bero, Asbjørn Hróbjartsson, et al. “Association between Conflicts of Interest and Favourable Recommendations in Clinical Guidelines, Advisory Committee Reports, Opinion Pieces, and Narrative Reviews: Systematic Review.” BMJ 371 (2020): m4234. DOI:10.1136/bmj.m4234.

41. Andreas Lundh, Joel Lexchin, Barbara Mintzes, et al. “Industry Sponsorship and Research Outcome.” Cochrane Database of Systematic Reviews 2, no. 2 (2017): MR000033. DOI:10.1002/14651858.MR000033.pub3.

42. Kelly M. Adams, Martin Kohlmeier, and Steven H. Zeisel. “Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey.” Academic Medicine 85, no. 9 (2010): 1537–1542. DOI:10.1097/ACM.0b013e3181eab71b.

43. Amy Finkelstein, Petra Persson, Maria Polyakova, and Jesse M. Shapiro. “A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise.” American Economic Review: Insights 4, no. 4 (2022): 507–526. DOI:10.1257/aeri.20210591.

44. Tobias Liu, Joseph S Ross, Christopher J Morten, and Reshma Ramachandran. “Pharmaceutical Manufacturer Kickback Resolutions and Associated Financial Penalties, 2000–2025.” JAMA Network Open, 13 March 2026. DOI: 10.1001/jamanetworkopen.2026.1735.

45. Denis G Arnold, Oscar Jerome Stewart, and Tammy Beck. “Financial Penalties Imposed on Large Pharmaceutical Firms for Illegal Activities.” JAMA, 17 November 2020. DOI: 10.1001/jama.2020.18740.

46. John P. A. Ioannidis. “Evidence-Based Medicine Has Been Hijacked: A Report to David Sackett.” Journal of Clinical Epidemiology 73 (2016): 82–86. DOI:10.1016/j.jclinepi.2016.02.012.

47. Trisha Greenhalgh, Jeremy Howick, and Neal Maskrey. “Evidence Based Medicine: A Movement in Crisis?” BMJ 348 (2014): g3725. DOI:10.1136/bmj.g3725.

48. Jon Jureidini and Leemon B. McHenry. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Adelaide: Wakefield Press, 2020).

49. Richard Smith. “Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies.” PLoS Medicine 2, no. 5 (2005): e138. DOI:10.1371/journal.pmed.0020138.

50. Thomas R. Frieden. “Evidence for Health Decision Making — Beyond Randomized, Controlled Trials.” New England Journal of Medicine 377, no. 5 (2017): 465–475. DOI:10.1056/NEJMra1614394.

51. Andrea S. Gershon, Peter K. Lindenauer, Kevin C. Wilson, et al. “Informing Healthcare Decisions with Observational Research Assessing Causal Effect. An Official American Thoracic Society Research Statement.” American Journal of Respiratory and Critical Care Medicine 203, no. 1 (2021): 14–23. DOI:10.1164/rccm.202010-3943ST.

52. Shirley V. Wang, Sebastian Schneeweiss, et al. (RCT-DUPLICATE Initiative). “Emulation of Randomized Clinical Trials With Nonrandomized Database Analyses: Results of 32 Clinical Trials.” JAMA 329, no. 16 (2023): 1376–1385. DOI:10.1001/jama.2023.4221.

53. Miguel A. Hernán. “The C-Word: Scientific Euphemisms Do Not Improve Causal Inference From Observational Data.” American Journal of Public Health 108, no. 5 (2018): 616–619. DOI:10.2105/AJPH.2018.304337.

54. Marcus R. Munafò and George Davey Smith. “Robust Research Needs Many Lines of Evidence.” Nature 553 (2018): 399–401. DOI:10.1038/d41586-018-01023-3.

55. Raywat Deonandan. “Resist the Randomized Controlled Trials Fetish: Different Questions Require Different Pyramids of Evidence.” Canadian Medical Education Journal 16, no. 1 (2025). https://www.erudit.org/fr/revues/cmej/2025-v16-n1-cmej09965/1117323ar.pdf.

56. Alexander C. Fanaroff, Robert M. Califf, Stephan Windecker, Sidney C. Smith Jr, and Renato D. Lopes. “Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008–2018.” JAMA 321, no. 11 (2019): 1069–1080. DOI:10.1001/jama.2019.1122.

57. Howard Balshem, Mark Helfand, Holger J. Schünemann, et al. “GRADE Guidelines: 3. Rating the Quality of Evidence.” Journal of Clinical Epidemiology 64, no. 4 (2011): 401–406. DOI:10.1016/j.jclinepi.2010.07.015.

58. Maria Popp, Miriam Stegemann, Maria-Inti Metzendorf, et al. “Ivermectin for Preventing and Treating COVID-19.” Cochrane Database of Systematic Reviews, no. 7 (2021): CD015017. DOI:10.1002/14651858.CD015017.pub2.

59. Michael T. M. Wang, Mark J. Bolland, Greg Gamble, and Andrew Grey. “Media Coverage, Journal Press Releases and Editorials Associated with Randomized and Observational Studies in High-Impact Medical Journals: A Cohort Study.” PLoS ONE 10, no. 12 (2015): e0145294. DOI:10.1371/journal.pone.0145294.

60. Paul Ruich. “The Use of Cause-and-Effect Language in the JAMA Network Journals.” AMA Style Insider, September 19, 2017. https://amastyleinsider.com/2017/09/19/use-cause-effect-language-jama-network-journals.

61. Noah A. Haber, Sarah E. Wieten, Julia M. Rohrer, et al. “Causal and Associational Language in Observational Health Research: A Systematic Evaluation.” American Journal of Epidemiology 191, no. 12 (2022): 2084–2097. DOI:10.1093/aje/kwac137.

62. Andrew Hill and Manya Mirchandani. “The Dangers of Non-Randomized, Observational Studies: Experience from the COVID-19 Epidemic.” Journal of Antimicrobial Chemotherapy 78, no. 2 (2023): 323–327. DOI:10.1093/jac/dkac437.

63. Issa J. Dahabreh and Kirsten Bibbins-Domingo. “Causal Inference About the Effects of Interventions From Observational Studies in Medical Journals.” JAMA 331, no. 21 (2024): 1845–1853. DOI:10.1001/jama.2024.8107.

64. Michael T. Abrams and Sidney M. Wolfe. “Thirty-One Years of Pharmaceutical Industry Criminal and Civil Penalties: 1991 Through 2021.” Public Citizen, May 21, 2024. https://www.citizen.org/article/thirty-one-years-of-pharmaceutical-industry-criminal-and-civil-penalties-1991-2021/.

65. Gardiner Harris. “Pfizer Pays $2.3 Billion to Settle Marketing Case.” New York Times, September 2, 2009. See also U.S. Department of Justice, “Justice Department Announces Largest Health Care Fraud Settlement in Its History,” September 2, 2009.

66. Peter C. Gøtzsche. “Big Pharma Often Commits Corporate Crime, and This Must Be Stopped.” BMJ 345 (2012): e8462. DOI:10.1136/bmj.e8462. Full version: “Corporate Crime in the Pharmaceutical Industry Is Common, Serious and Repetitive.” Nordic Cochrane Centre, December 14, 2012.

67. Richard Smith. “Is the Pharmaceutical Industry Like the Mafia?” The BMJ Opinion, September 10, 2013. https://blogs.bmj.com/bmj/2013/09/10/richard-smith-is-the-pharmaceutical-industry-like-the-mafia/.

68. David J. Graham, David Campen, Rita Hui, et al. “Risk of Acute Myocardial Infarction and Sudden Cardiac Death in Patients Treated with Cyclo-Oxygenase 2 Selective and Non-Selective Non-Steroidal Anti-Inflammatory Drugs: Nested Case-Control Study.” Lancet 365, no. 9458 (2005): 475–481. DOI:10.1016/S0140-6736(05)17864-7.

69. U.S. Department of Justice. “GlaxoSmithKline to Plead Guilty and Pay $3 Billion to Resolve Fraud Allegations and Failure to Report Safety Data.” Press release, July 2, 2012.

70. U.S. Department of Justice. “Justice Department Announces Global Resolution of Criminal and Civil Investigations with Opioid Manufacturer Purdue Pharma and Civil Settlement with Members of the Sackler Family.” Press release, October 21, 2020. On the 2007 plea by the Purdue Frederick Company: Barry Meier, “In Guilty Plea, OxyContin Maker to Pay $600 Million,” New York Times, May 10, 200

A note before we begin: Epistemology is the branch of philosophy concerned with knowledge: what we know, how we know it, and what justifies our belief that something is true. This framing in the latter part of this post was inspired by an anonymous physician writing as Dr. Wojak, whose Substack series Epistemic Capture of Medicine masterfully shows what the phrase means in medicine (a must-subscribe IMO). For years, this Substack has exposed regulatory capture. But within it lies a subtler nexus of power, and probably the most potent one: epistemic capture. That’s what I want to drill down into today.

I have only one tattoo, which I got in 2023, two words on my left arm in big block letters:

It started as a joke. After enough years of newspapers, critics, and colleagues reminding me that the treatments I used and advocated for (and against) in Covid had “insufficient evidence,” I kept joking I should get it tattooed on my arm as I figured I could save everyone the bother of attacking me. Acknowledge the objection in advance. Perhaps then we could get on with discussing what happened to the patients.

That was the thinking, anyway.

Then one day, on vacation in Puerto Rico with my three daughters and ex-wife, my doppelganger (our middle child) snuck off with her older sister and came back to the beach with her first tattoo (and now, unfortunately, many more). It was the word “Angel” in cursive on the back of her arm, the word I use whenever I address my daughters, so she used that to defend her decision, as some sort of “ode” to me. “Aren’t you happy?” she asked. After her mother and I got over our shock, I went over to her and whispered, “Evie, you got a tattoo guy? Take me to him.” Off we went.

But you don’t permanently mark your body over a joke alone. During Covid, the question of sufficient versus insufficient evidence became central to my career, my bedside decisions, and eventually my understanding of what it means to be a doctor. It became almost existential. What was I allowed to conclude from what I saw? What evidence justified acting? What justified waiting—and who bore the consequences while we waited?

I had spent decades making those decisions in intensive care, where uncertainty came with every admission and doing nothing was a decision with consequences of its own. You used the available research, your knowledge of physiology, your experience, and the response of the patient in front of you. You kept questioning yourself. You changed course when you needed to. You rarely had the luxury of certainty.

Yet “insufficient evidence” was increasingly presented as if it settled the question.

Insufficient for what? To establish a mechanism? To recommend a treatment to every patient? To justify offering it to one desperately ill person? Those are different decisions. They require different judgments.

And sufficient according to whom?

That latter one is the question behind the tattoo. It is also the question behind this post: who gets to decide when the evidence is enough for a doctor to act?

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It's hard to get a man to understand something when his salary depends on not understanding it. —Upton Sinclair

Experts will reject the Evidence Act chapters which appear in my new books “The Silent Aquifer: Humanity’s Accelerating Food and Water Crisis” and Earth’s Living Water: Its History, Its Ruin, and the Way Back, where I present evidence showing dramatic improvements when Themarox (e.g., Aurmina, Primora-Bio) treated water is used across all of biology – soil, microbes, plants, fish, rats, and humans, repeated demonstrations in the yield, growth, and vitality. They will reject the evidence I present almost as soon as they begin reading it, not after weighing it, but the moment they recognize what kind of evidence it is.

The words will be familiar: small, uncontrolled, observational, old, translated, anecdotal, hypothesis-generating only. They sound scientific, and sometimes they are. They can also do the opposite of science when a descriptor meant for a single flawed study is turned against dozens of converging studies at once, before anyone asks whether a plausible mechanism could explain why they line up.

I say this after twenty years inside academic medicine. I analyzed myriad published clinical trials, taught guidelines, sat on committees, and helped decide whether to adopt therapies at the bedside. I also spent those years as a clinician, which meant I learned medicine in a way the modern evidence hierarchy no longer values.

Although I was a clinical leader within one of the largest academic medical centers in the country, I was never one of the highly recruited “physician-scientists,” or what my clinician colleagues and I derisively called “lab rats.” You know, the kind who spend most of their time writing major research grants, running basic science labs, and publishing in journals that bring institutions money and prestige. I belonged to a different class: the clinician-educators. We cared for patients, worked closely with nurses, taught students, residents, and fellows, held units together, communicated with families, and helped them endure the worst hours of their lives while keeping the ICU running day and night. The ICU-trained lab rats would (try to) do the same, but for far, far fewer weeks a year.

That primary clinical role built a different kind of expertise. Clinicians who live at the bedside see far more patients than most physician-scientists do. Volume builds pattern recognition, and pattern recognition is one of, if not the, defining qualities of an expert. For my first five years out of training, I worked in a really busy hospital in lower Manhattan; I saw an unusual amount of volume. The department I initially joined was chronically short-staffed (every time we hired someone, we lost someone else), and for long stretches my partner Sam Acquah (now ICU Director at Mount Sinai) and I held the service together, each of us carrying far, far more than a full clinical load.

The sheer number of patients, diseases, and complications that passed through our hands in those years set us apart, even from other hard-working physicians in what is considered one of the hardest-worked specialties; it compressed a career’s worth of cases into a handful of years. As an ICU and pulmonary physician, I regularly encountered respiratory failure, shock, infection, and multi-organ collapse in every form and at every stage, where I learned from timing, physiology, response patterns, and consequences.

Over the past few decades, the academic hierarchy (specifically, the conceptual framework called “Evidence-Based Medicine”) has come to dismiss that kind of knowledge as “anecdotal evidence.” I still remember the first time the word was aimed at me. I gave a lecture on the lifesaving benefits of intravenous vitamin C in septic shock that I had observed, and a physician (err, lab rat) dismissed it as “anecdotal.” I recoiled. How could something I had watched happen again and again, where the impact of what I did, or failed to do, was clearly written into whether a patient recovered or died, be waved away as an anecdote? I had seen it with my own eyes, more times than I could count. It was my lived experience, and I knew it to be true.

And yet here that knowledge was, filed under a word that means a story told once and never validated. I have chafed at the term ever since. An anecdote is a single tale; what I was describing was a pattern: the same cause and the same consequence, observed over and over until the link between them was as firm as anything a trial could hand me. I would learn, much later, that roughly half of all recommendations in clinical practice guidelines rest on nothing sturdier than the opinion of the people writing them.^{1 2} Expert opinion was permitted to establish medical truth after all. It just had to be those of the right kind of experts (e.g., the bought-and-paid-for ones). In critical care, relying on my expert opinion meant the difference between acting while the patient could still be saved and waiting for evidence that might never arrive (or worse, before those “opinions” told me I was wrong).

The gate that “Evidence-Based Medicine” (EBM) would later become could not have been built on open ground. It had to be cleared first. The 1910 Flexner Report, funded by the Carnegie Foundation and supported by the Rockefeller Institute, standardized American medical education on a single model. Within two decades, roughly half of US medical schools had closed.³ When hundreds of competing schools existed, no single set of institutions could define what a doctor learned; once the field narrowed, influencing a small number of institutions was sufficient.⁴

EBM is a younger idea than it feels. The phrase was coined in 1991 by Gordon Guyatt and colleagues at McMaster University in Canada, and set out the following year in a landmark paper that proposed a new way to teach and practice: that clinical decisions rest, wherever possible, on the best available research evidence, meaning on systematic, published study, rather than on tradition, authority, or a physician’s unexamined experience. It was, at bottom, a demand that medicine show its work.⁵

It began as a necessary corrective. Medicine needed discipline, and physicians needed humility. We needed protection from our tendency to remember a treatment’s successes more vividly than its failures, and, most of all, from the delayed harms we are poor at identifying. But the need went further than protection. We needed a disciplined way to compare two treatments and determine which was genuinely better. We also needed a way to detect benefits too small, too subtle, or too slow to show themselves at the bedside: effects that unfold over years, across a distance between cause and consequence too wide for any one clinician to trace by eye.

That distance is the crux. When cause and consequence sit far apart in time, or when the effect is small or subtle, a large, carefully conducted trial can see what no single observer, however seasoned, can, and I have never doubted it. The trouble begins only when that narrow, genuine usefulness is mistaken for a universal one.

The original model was built on three pillars on which clinical treatment decisions should rest: (1) the best available evidence; (2) clinical experience and expertise; and (3) patient preferences and values. It was a brilliant construct, and I still believe that. But over time, all three pillars weakened. Clinical expertise was downgraded to anecdotal evidence. Patient values were acknowledged politely only after the treatment decision had already been made. “Best available evidence” narrowed so severely until it meant only one thing: a large, prospective, randomized controlled trial (RCT), funded by an institution or company with enough money to run one.

The evidence pyramid stopped acting as a rational guide and started acting as a gatekeeper. The most expensive RCTs rose to the top and stayed there. Today they are very nearly the only evidence that can change a guideline or a treatment recommendation. Everything else- clinical experience, observation, case series, and the accumulated record of what works at the bedside- can grow as large and consistent as it likes and still do almost nothing to change how patients are actually cared for. Does the case of ivermectin in Covid ring a bell?

When the Wrong Tool Becomes the Standard

In the ICU, there is a deeper objection to the hegemony of RCTs than unfairness; they rarely even work. Over decades, dozens of RCTs kept returning “negative” results, with intervention after intervention yielding statistically insignificant findings, including many interventions that worked right in front of our eyes. Jean-Louis Vincent, one of the most respected critical care physicians in the world, put the case as sharply as anyone. In a 2010 article titled “We should abandon randomized controlled trials in the intensive care unit,” he argued that RCTs often fail in critical care because the ICU is too complex for crude trial design to capture: the timing of treatment, the severity of illness, and the choice of endpoint can each decide the result, and heterogeneous patients may respond in opposite directions to the same intervention.⁶

Vincent named what many bedside clinicians already knew. In critical illness, the right therapy given too late can look useless, and the right therapy given to the wrong subgroup can disappear inside a neutral average. A trial can be methodologically impressive and clinically blind. Vincent defended evidence by refusing to worship one form of it when the clinical environment demands judgment, physiology, observation, and better tools.

I am not saying that randomized trials do not have a critical place in science and medicine. In laboratory experiments, animal models, pharmacology, toxicology, and many human clinical questions, randomization can clarify cause and effect in ways other designs cannot. When a therapy produces small differences in outcomes that accumulate over time across large populations, and when those differences cannot be detected reliably any other way, a well-designed randomized trial may be the right tool.

Its usefulness narrows when human illness becomes heterogeneous, time-sensitive, syndromic, and biologically unstable: exactly the terrain of critical care, chronic complex disease, and many integrative or metabolic therapies.

When a therapy produces large, rapid, multidimensional effects like the kind an experienced clinician can observe across different patients, a randomized trial is simply not necessary, because the effect is already obvious. The trouble happens when the large, expensive randomized trial becomes the only instrument medicine will accept: it stops functioning as a tool for discovery and starts functioning as a gate controlled by whoever can afford to pay for it.

Pharma’s Most Powerful Epistemic Weapon: The Unmeasured Confounder

If the randomized trial has become a gate, the natural defense is that it is at least a gate worth having, that it keeps unreliable evidence out. That defense rests on a single erroneous assertion that has been taught for decades and now pervades all of academic medicine.

A randomized controlled trial (RCT) takes a group of patients and randomly assigns them to a treatment group and a placebo or control group, then prospectively follows both groups over time and compares their outcomes. A retrospective observational controlled trial (OCT) works the other way around: it identifies patients who were already treated and compares them with similar patients who were not treated.

The most important difference between the two study types is that “high quality,” “rigorous” RCT’s require tens of millions to conduct, while OCT’s, in the modern era, require nothing more than a committed group of clinicians, an electronic database, and the sweat equity of “nights and weekends” work. Keep that in mind.

Unsurprisingly, a pervasive narrative in academia developed which belittles the epistemic value of OCTs. The narrative goes like this: Because its groups were assembled by observation rather than by randomization, they may differ in ways the investigators never measured: hidden differences known as unmeasured confounders. And if the two groups differ from the start, any difference in their outcomes might be due to hidden factors rather than the treatment, so any apparent benefit cannot be trusted.

Thus, the dogma is that only RCTs can protect us from incorrect conclusions driven by unmeasured confounders. OCT findings are considered “hypothesis-generating” only or, more accurately, simply ignored. The claim gets repeated so often it starts to sound like a scientific law of physics. It is not physics. It is a belief, and when researchers tested it systematically, they quietly debunked it. Too quietly, I might add.

Multiple reviews, including a landmark Cochrane study from 2014, compared OCTs with RCTs that tested the same clinical questions in the same disease areas.^7–10 If the dogma were true, the OCTs should have routinely misled us. They should have found benefits where RCTs found none, or minimized or exaggerated harms in such a way that they would frequently produce conflicting findings.

That is not what happened. Across nearly every disease model, OCTs and RCTs almost always agreed. Direction of effect, magnitude of benefit or harm, and the overall clinical picture generally aligned. In the rare cases where they disagreed, the Cochrane authors subtly noted that “factors other than study design” needed to be explored.

That sentence should have shaken the world of evidence. If study design alone does not explain the mismatch, something else does. And when you have lived long enough inside the machine, one candidate stands out: money. By money I mean more than the funding line; I mean everything that gathers around it: the institutional incentives and market gravity that decide which trials get built and which never do, which questions get asked and which stay buried, how a protocol is written, and how its results are told. Study design is what the evidence pyramid ranks. Money is the current running beneath it.

The reason the two designs yield similar findings is that modern observational science no longer relies on crude comparisons. Using advanced statistical methods, large clinical databases, and modern computing power, we can now balance groups across age, sex, disease severity, comorbidities, socioeconomic factors, baseline risk, and medication history. It can emulate target trials, adjust for time-dependent bias, use propensity methods, and test sensitivity to hidden assumptions. The old caricature of observational evidence as uncontrolled anecdote has long been made obsolete. Who knew?

What I came to call “The Church of RCT Fundamentalism” is now thoroughly entrenched, not in one institution or one country, but across modern medicine worldwide. It is preached from the journals, repeated in the medical-school classroom, and enforced most zealously by the biostatisticians who have become the field’s arbiters of what is allowed to count as real. It is one reason I left academia for private practice. I had come to feel that medicine was turning its back on reality, on truths I could see at the bedside, truths that could help patients, and that it did so most predictably at the very moment a cheap and safe therapy threatened the market for a costlier, more profitable one, and at times a dangerous one.

There is a bitter joke buried in that arrangement. In 2015, researchers put a straightforward statistical result in front of a group of epidemiologists—a p-value above 0.05—and asked what it meant. Roughly four in five got it wrong, concluding that the treatment had made no difference.¹¹ Four of five. Wow. Absence of proof was read as proof of absence, by the very people appointed to guard the distinction. The arbiters of what counts as real cannot even read the instrument they enforce. Complete epistemic collapse.

Trial Grading and the Evidence Hierarchy

The hierarchy first sorts by trial design alone: RCTs on top, OCTs far beneath them. But a second layer of gatekeeping follows, and it is more consequential. Every trial is then graded: scored on its “risk of bias” and its “study quality” by a battery of metrics that look mathematical and objective.

In principle, the quality grade is blind to design: it scores each study on how well it was actually run, so even a randomized trial can be downgraded (for weak blinding, heavy dropout, a switched endpoint), and now and then one is. Observational trials arrive at the grading table already labeled as the lower form of evidence, and the grading vocabulary (bias, low quality, serious limitations) attaches to them almost by default. Sorted down once by design and marked down again by score, they rarely climb back to a level where they can influence a treatment decision or enter a clinical guideline.

Of course bias exists. Of course small studies can mislead. Of course blinding, allocation concealment, follow-up, and outcome selection matter. But the scores those factors feed into look far more objective than they are. How much a stretch of missing follow-up or an unblinded assessor should count is a judgment call, and turning that call into a number does not make it less of one. It only lends the judgment an aura of mathematical certainty.

And that certainty, like the conviction that RCTs are superior to observational trials, has also been proven wrong.

Among these observational studies, grading them for quality changed nothing. A 2016 analysis in nutritional epidemiology took fourteen meta-analyses of diet and cancer: nearly three hundred observational studies, each scored on the Newcastle–Ottawa Scale, the most widely used quality-grading tool in the field.¹²

When only the studies that the scale called “high quality” were pooled, the result matched what you got from the full set sorted by design alone: same direction, same magnitude, same conclusion. Restricting to “high quality” added nothing. And the reason is almost embarrassing: the grade barely distinguished the studies to begin with. The scale rated ninety-one percent of the cohort studies “high quality” but only a third of the case-control studies, so “quality,” as the instrument measured it, was very nearly just a restatement of study design. The second filter was the first filter wearing a lab coat.

Now stack the two findings. In the last section, study design did not affect the conclusions: randomized and observational trials asked the same questions and gave the same answers. Here, among observational studies, the quality grade did not differ either. Neither the design of a study nor its quality score changed the evidence’s conclusion, and those are the two levers the entire hierarchy uses to decide which evidence counts.

The practical effect is predictable. Large, expensive, multicenter trials rise. Smaller, independent, clinician-led, observational, or field-based studies sink. A therapy that cannot attract enough capital to run a large RCT is never taken seriously, no matter how revealing the clinical observations are.

The Heretics Inside the Church

If what I have described so far were only the grievance of a clinician who walked away from academia, it would be easy to dismiss. It is not. For more than a quarter of a century, some of the most respected names in medicine have said much the same thing, in the field’s own journals. Former editors of the New England Journal of Medicine, the Lancet, and the BMJ have described medical journals as instruments of pharmaceutical marketing, and John Ioannidis, among the most cited critics of research quality alive, titled a 2016 paper simply: “Evidence-based medicine has been hijacked.”⁴⁶

The case for observational evidence has been made just as long and just as forcefully: in two landmark papers in the New England Journal of Medicine in 2000, by a former director of the CDC, by the American Thoracic Society, my own specialty’s society, and by Harvard’s leading causal-inference methodologist, Miguel Hernán.^7,8,50,51,53

So the argument has been made, loudly and from the inside. What did it change?

In the place where it matters, almost nothing. The rules that grade evidence for guidelines are the same rules that were in force when these critiques began. GRADE, the system used by the WHO, Cochrane, and well over a hundred guideline organizations, still assigns every body of observational evidence a starting grade of “low” certainty and every body of randomized evidence a starting grade of “high.”⁵⁷

Cardiology’s guideline writers still reserve their top level of evidence for randomized trials. And when a 2019 review co-authored by Robert Califf, twice commissioner of the FDA, examined every current cardiology guideline from the ACC/AHA and the European Society of Cardiology, it found that only 8.5 percent of American recommendations rested on that top tier, and that the picture “does not appear to have meaningfully improved from 2008 to 2018.”⁵⁶ A decade of critique, and the guidelines were still largely built on expert opinion, while the observational evidence that could have filled the gap was still graded down at the door.

Then came Covid, the real-world test of whether any of it had sunk in. The Cochrane review of ivermectin restricted itself to randomized trials and set every observational study aside.⁵⁸ The WHO’s guideline panel likewise built its recommendation against ivermectin on randomized trials alone, and even though they found a highly statistically significant 81% reduction in mortality in the RCT’s (yes, 81%) when patients were treated with ivermectin, they refused to recommend its use, claiming the RCT data (yes, they even downgraded the RCT data) was of “very low-certainty” (just another way of saying very low-quality). The advocates like me had won the argument in the journals. We lost it in the guidelines, which is the only place it counts.

Published, but Muzzled

I expected to find that the journals simply refuse to publish observational studies. The data show something subtler, and in some ways worse. They publish them, in large numbers. What they withhold is the right to say a treatment works.

Consider one analysis of every clinical study published over three months of 2013 in seven of the most influential general medical journals, including the NEJM, JAMA, the Lancet, the BMJ, and the Annals of Internal Medicine.⁵⁹ Half of those studies were observational: 86 of 171. Yet when the journals chose which studies deserved an accompanying editorial- their way of telling clinicians, “pay attention to this,” they gave one to about seven in ten randomized trials and fewer than half of the observational studies.⁵⁹ This was not because the observational studies were weaker. Most enrolled more than a thousand patients, and nine in ten measured hard clinical outcomes, compared with fewer than half of the trials.

Where the observational studies did get attention was in the journals’ press offices. They were nearly three times as likely as the trials to be promoted with a press release. The pattern is consistent: observational findings are welcome as news, but not as medicine. I can think of no better example than my review of all the emerging ivermectin trials in 2021, which, to date, has a final Altmetric score of 15,356, placing it sixty-sixth among the almost 28 million research outputs that Altmetric has ever tracked—one of the hundred most-discussed pieces of research, in any field, in the service’s history. Did it change standard practice? You know the answer.

Then look at the language rules. JAMA and the rest of the JAMA Network journals, following AMA style, allow cause-and-effect language only for randomized clinical trials and controlled laboratory experiments. For every other design, in the words of the AMA’s own style guidance, “the expression and ultimate interpretation of the findings can’t be causal.”⁶⁰ An observational study may find that patients given a treatment died half as often as patients who were not. It may not write that the treatment reduced deaths. It must say only that treatment was “associated with” lower mortality, and every reader who has absorbed the hierarchy knows what that phrase is meant to signal: interesting, but not actionable.

The rule works exactly as designed. A 2022 analysis of 1,170 non-randomized studies published from 2010 to 2019 in 18 leading health journals found that the word “cause” was the main linking word in fewer than one percent of them, while “associate” appeared in nearly half. Papers in the journals with explicit restrictions, including JAMA, were less likely to offer any recommendation for action at all, and JAMA had the weakest causal language of any journal studied.⁶¹ Yet a third of all these abstracts still recommended an action, and three quarters of those recommendations implied a causal effect. The ban did not make the inference go away. It made it deniable, which was Hernán’s point: a euphemism does not improve causal inference, it only hides it.

During Covid, the pressure went further. In 2023, my former (and later captured) colleague Dr. Andrew Hill proposed in the Journal of Antimicrobial Chemotherapy that every observational study be labeled “non-randomized” in its title, and that such studies “should not be used independently for making regulatory approval decisions.”⁶² Not that bad observational studies be excluded. All of them, labeled at the front door.

To be fair, there is one crack in the wall. In 2024, JAMA’s own editor-in-chief co-authored a framework acknowledging that “many medical journals, including JAMA, restrict the use of causal language to the reporting of randomized clinical trials,” and proposing conditions under which well-conducted observational studies might be allowed to speak causally.⁶³ It remains a proposal, and its authors note that putting it into practice will require cooperation among editors, authors, and reviewers. It also concerns wording, not weight. Nothing in it changes how a guideline panel scores the evidence, and nothing in it has yet moved a single recommendation.

That is the pattern across thirty years. The critics are published, cited, invited to give lectures, and occasionally honored. The rules stay exactly where they were. A system that can absorb its critics this completely without changing is not one that has weighed their arguments and found them wanting. It is one that is not, in the end, listening to arguments at all.

There is a word for the study of how we know what we know: epistemology. I had to look it up the first time I saw it. It is the branch of philosophy that asks not what is true but how we decide what to believe is true — what counts as proof, and who is permitted to say. It is the subject of this chapter.

And there is a phrase for what happens when that machinery is taken over. “Regulatory capture” is when an agency comes to serve the industry it was built to police. “Epistemic capture” is the deeper version: the capture of the institutions through which knowledge itself is created, legitimized, and passed on.¹³ I take the phrase from an anonymous physician writing as Dr. Wojak, whose series on it is the best review I know.¹⁴

The difference matters. When a regulator is captured, you can appeal over its head — to the journals, the universities, the experts. When those are captured too, there is no higher authority to appeal to. Pharma has even captured the courts: using the POW pomegranate juice trial, they have literally made the legal definition of sufficient evidence for the manufacturer of any compound or health or food product to make any health claim as one supported with large, double-blind RCTs and whose findings have been adopted as a consensus by some society or institution.

This weighting system captured Evidence-Based Medicine. The industry that controls the hierarchy systematically underweights observational evidence, moving it down in ways that coincide with its interests. The entities that can fund the approved form of proof end up controlling more than the marketplace. They control the definition of medical truth.

Follow that logic to the bottom, because it is not subtle. Restrict medical truth to the large randomized trial, and you restrict it to whoever can pay for one: tens of millions of dollars, an institution, a sponsor with a product to sell. The alternative costs almost nothing: a good observational study needs little more than database access, statistical discipline, and the nights-and-weekends labor of clinicians who already have the patients in front of them. The barrier is so low that almost any motivated physician could clear it, and that is exactly why it cannot be allowed to count. If bedside observation were permitted to establish truth, truth could be established by people with nothing to sell, and the questions worth asking would no longer be confined to the ones a sponsor is willing to fund. A hierarchy that discounts the cheapest evidence is not protecting rigor. It is protecting a monopoly.

And that monopoly is not paid for in money alone. When the only therapies patients are treated with are those profitable enough to have bought their own proof, the cheap, the widely available, and the off-patent never get used: however safe they are, however well they work. This is not just about epistemology. Somewhere downstream of every discounted signal is a person who could have been helped by a treatment that was safe, available, and inexpensive, but it was not employed because the evidence for it was the wrong kind, produced by the wrong people, and therefore declared not to exist. They suffer, and many of them die, for a rule about what counts as proof.

Let me be clear about what I am claiming, because the next post runs hot and I would rather be understood than agreed with. Epistemic capture does not mean that everything coming out of academic medicine is false. It means that institutional consensus should never, by itself, make a claim more credible — that where a claim comes from tells you nothing about whether it is true, and that the answer has to be found in the evidence rather than in the degrees and titles attached. Nor does any of it require a conspiracy. It only requires that the incentives be arranged so everyone inside the system does what the incentives reward. The student who keeps their head down gets the residency. The resident who prescribes like their attending gets the fellowship. The senior physician who stays on message gets the speaking fees. Nobody has to be told.

That is how the hierarchy protects itself. But deciding which kinds of evidence count is only the beginning. Someone still has to produce that evidence, publish it, and turn it into instructions for the doctor standing at your bedside.

In the next post, I’ll follow that process: the contracts that give sponsors control over trial data, the journals that depend on pharmaceutical revenue, and the expert panels that turn the resulting literature into treatment guidelines. Along the way, I’ll return to the ivermectin trials I spent years investigating.

Because the final consequence of this system is much more concrete than a dispute over scientific evidence. It determines which treatments your doctor will offer—and which ones they may never be allowed to try.

If you appreciate the late nights and deep dives I take down various medical rabbit holes, your paid support helps keep me going.

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Bonus Clip: Many of you enjoyed my recent post about the day I spent with the Nobel Prize-winning discoverer of ivermectin, Japanese Professor Satoshi Omura. After that post, I received this short (45-second) clip of our initial introduction from Mr. Kenji Torii, which I find both painfully awkward and incredibly moving (I think I see tears forming in my eyes, but I can’t remember). Enjoy; I will title it “How (Not) to Meet a Nobel Laureate.”

From the Shameless Commercialism Department:

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You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

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68. David J. Graham, David Campen, Rita Hui, et al. “Risk of Acute Myocardial Infarction and Sudden Cardiac Death in Patients Treated with Cyclo-Oxygenase 2 Selective and Non-Selective Non-Steroidal Anti-Inflammatory Drugs: Nested Case-Control Study.” Lancet 365, no. 9458 (2005): 475–481. DOI:10.1016/S0140-6736(05)17864-7.

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Now on to the other half of this slide-show travel diary. As I explained last time, two Japanese researchers inspired the trip. Ōmura’s work became the high point of my former career, then helped end it. Shimanishi’s work launched me outside of medicine (sort of, but not really) into a new career and mission. Without trying to sound grandiose, that mission is twofold: to raise awareness of the world’s rapidly unfolding food and water crisis, and, more importantly, to spread the word about Shimanishi’s 1977 discovery. My books lay out the evidence for how the world could scale up Themarox and deploy it widely, preserving and expanding our food and water supplies and sparing immense suffering in the process.

I suspect few people really “get” what I’m talking about yet. I’m hoping to change that, which is why I took the 768-page, 71-chapter, 230,000-word behemoth that is Earth’s Living Water: Its History, Its Ruin, and the Way Back and wrote a more focused, concise version called The Silent Aquifer. It’s hard to get a message across with an encyclopedia these days. So, another plug:

The Stone and Water Series

You can buy the series, whole or in part, from my website (where all books are stamped with my hanko) or from Amazon.

So it’s no exaggeration to say I’ve gone from pulmonologist and intensivist to self-taught agronomist and environmentalist. Heck, I titled the flagship book The Silent Aquifer to echo Rachel Carson’s 1962 Silent Spring, widely credited with helping launch the modern environmental movement and arguably the most influential environmental book of the 20th century (my grandiosity returns).

Now, the man behind my career pivot: Asao Shimanishi. Where Ōmura is world-famous, Shimanishi was his mirror opposite: deeply obscure and intensely private. History, with a capital H, somehow failed to record the significance of his unprecedented achievement: extracting an aqueous mineral solution from volcanic black mica, one of the most broadly mineralized and abundant minerals in the Earth’s crust.

After seeing the solution’s effects in my own clinical practice, I quickly became obsessed with his story. First there was the path to the discovery itself: nearly fifteen years of one man working alone on a technical problem until he finally solved it. Then I discovered how far his mineral extract reaches across biology, from soils to microbes to plants to animals to people, and how it can both purify water and restore biological properties to the world’s altered and rapidly shrinking freshwater supply. The Industrial Revolution degraded those waters first, and the Green Revolution degraded them far more. I call that change the Geohydrological Shift: a global alteration in water chemistry that, around the turn of the century, began driving annual crop gains down.

If you read my last post, you’ll remember the problem that haunted me while writing the books: how little record of the man survives. One textbook chapter, a 12-page manual and a single interview. Almost everything else I learned about him came thirdhand, from people who knew people who knew him. Heck, I couldn’t even find a record of his death. The people at the company told me they hadn’t seen or heard from him in many years. He would be 100 this year, and given how famously long-lived the Japanese are, I tried to find out whether he was still alive. I couldn’t confirm whether he was, or wasn’t.

Japan was my chance to change that: to finally sit down with the one person I could find who had known him directly, and to meet in person the Shimanishi-kaken executives I had spent months corresponding with through careful, translated email.

And beneath it all was the question I raised last time and still can’t shake. Why did two career-altering obsessions, ivermectin and Themarox, both lead back to two Japanese men of the same era, both trained in pharmacy and chemistry, both choosing nature’s chemistry over the synthetic chemistry where all the money was?

By Way of Maui

We actually left for Maui a full ten days before flying to Japan. Why, you ask? Easy: we’re lucky to have a good friend, Gavin de Becker, who, in my opinion, is one of the most interesting men in the world. An expert in both personal protection and vaccine (non) safety, he wrote the bestselling The Gift of Fear and, more recently, a tour de force of an investigation, Forbidden Facts: Government Deceit & Suppression About Brain Damage from Childhood Vaccines. To understand why I call him “the Most Interesting Man,” listen to his interview on Joe Rogan's podcast. His life story and accomplishments are among the most uniquely remarkable I’ve ever come across.

Most importantly, he is one of the kindest, smartest, and most generous men I have ever met. He lives on Maui and keeps more than one “guest house” there, where his friends are always welcome to stay. Coolest. Friend. Ever.

Lisa and I have probably abused this. Lisa is infatuated with Maui and keeps asking me to ask Gavin if we can come “visit” (err, stay at his house). The crazy part is that every time I test the waters by texting him that we’re thinking about visiting around a certain date, he immediately replies, “The house is yours.” The one he gives us sits on a small cliff above the ocean, with a view unlike anything I’ve ever seen. I can sit on that deck listening to music for hours. Here’s the view:

One of my favorite activities is watching the most amazing clouds form and dissipate. I call out to Lisa every time I see something anthropomorphic, ranging from various animals leaping, couples about to embrace, and semi-erect phalluses. To wit:

The path to the secluded beach a stone’s throw from the house

Me hanging out with a buddy at the beach:

Here we are on one of our daily rounds of gold, on this day with Dr. Joel Friedman, not only the best physician on Maui, but one of the most impressive I have ever met:

Not-so-fun fact: if you think I was having fun that day, you would be sorely mistaken for one simple reason: Lisa is an insanely good golfer; we are competitive, and I get my ass kicked regularly. Here I managed to break a smile (just kidding).

So, after ten days of paradise (except for the terrible Kona Low Storms, which visited, albeit sparing us and the house we stayed in), we finally headed to Japan.

Even leaving from Hawaii, the flight was brutally long.

We landed at night and walked what felt like three miles through the airport to reach a taxi, easily the longest walk I’ve ever taken inside an airport. Then came the modern awkwardness: a driver with no English, the two of us holding our phones up at each other, and somehow, even with my translation app set to Japanese, he was struggling. It worked out, the way it always does now. Just far less efficiently than I’d assumed.

We stayed at a very Western hotel, the Cerulean Tower in Shibuya, about a five-minute walk from the massive Shibuya station. In hindsight, staying somewhere so Western probably cost us a better feel for the city. I should say plainly: apart from the food and a couple of memorable restaurants, this was not a sightseeing trip. We spent it working and meeting the people we had come to meet. That turned out to be the whole point.

Practicing My Japanese Manners

For me, the best part of the trip was meeting Yoshio and Yasushi, the CEO and President of Shimanishi-kaken.

I had been so careful with them over months of formal email that I decided to prepare properly, and here I confess I took artificial intelligence a bit too seriously as a cultural tutor. I brushed up on my bowing. I bought a new suit, because I had read that business meetings require one. I learned how to toast with your hosts over drinks, where everyone sits at the table (by rank and age), and the importance of bringing gifts, and which kinds. And I learned that a business card is presented with both hands, which I practiced so many different ways that I still don’t think I have it right.

When I confessed all of this to them, they laughed immediately, and within minutes we were getting along like old colleagues.

Yoshio and Yasushi are both retired Toshiba executives who spent years in Canada and the United States, so they were entirely comfortable with English and with Westerners. I got an enormous kick out of what they told me the next day. They had been very nervous about meeting me, a “famous doctor” with a public profile, and were a little intimidated. Then they laughed and said that within minutes they were completely disarmed and realized I was an easy guy to talk to. That put me at ease, too.

Off we went to their offices in another district of Tokyo: humble, modest, a bit cramped. They made coffee, and we sat and talked for hours. I told them what I’d been discovering in my book research and asked a lot of questions. They took notes and asked even more questions about our US businesses, Aurmina and Primora Bio, and our plans.

They explained how the Themarox business works in Japan, which I found fascinating: it splits almost exactly into thirds. One third water purification, one third agriculture, one third mineral baths. They also walked me through the company’s history and some of the hard stretches it has survived.

Then we went to dinner, and not a Japanese one. Once Yoshio learned of Lisa’s dietary restrictions (no dairy, no eggs, no gluten), he concluded that most Japanese restaurants would make it nearly impossible, so we ended up at an American hotel (the Westin, I think) with a sprawling buffet she could actually navigate. We had drinks. We talked about spirituality. We talked about our shared mission, and how we all understood it had a humanitarian dimension.

It was a lovely evening, and I went to bed genuinely looking forward to the next day: a full day with them, touring the extraction plant. My friend and colleague Matt Bakos told me he had never known them to extend that honor to any visitor he knew of.

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Fukushima

It was a full day. Yoshio and Yasushi met us at the hotel, and we took the subway, then a train, then a private car on the long drive to the plant in Fukushima Prefecture. We stopped for lunch at another very American place, again the only option that could handle gluten-free and dairy-free.

Then we arrived at the little factory, and the tour was a joy.

We first settled in the front room of the small office building, where Mr. Kiyokata Ishii, the plant manager, gave us a short lecture on where Themarox comes from and how it’s made:

You can see the real-life results in the photo below.

At the top is the starting material: crushed biotite-derived vermiculite, flecked with black, iron-rich specks. Below on the right is the golden-amber mineral solution that comes out of the reaction. On the left is what gets left behind: the whitened, brightened silicate skeleton of the mineral, which won’t dissolve.

Then we followed the process from end to end. The raw material, it turns out, is gravel: tailings from a vermiculite mine on the other side of the mountain, the stuff they throw away! Shimanishi-kaken collects it and spreads it out in a large, tent-like hangar to dry and exfoliate, driving off as much moisture as possible (middle picture below).

From the green tent, the hydrobiotite/vermiculite goes into this receiving container in the plant’s foyer:

A conveyor belt carries it up into the factory:

There it’s fed into an enormous milling and crushing machine:

Unfortunately, we didn’t get to see the crusher running, since it apparently makes a terrific racket. The rock comes out as a very fine sand.

That sand is loaded into this barrel-like chamber and mixed with sulfuric acid until the leachate, the aqueous solution, comes out carrying a broad array of minerals.

Most of the rest of the process is filtration: three stages that remove impurities and particles, including a medical-grade filter to catch any fungi or spores carried in from the rock.

The Man Who Saved Themarox

I found all of it fascinating. But the most important part of the day came at the end, when I finally sat down one-on-one with Mr. Ishii and understood who he really was. He was the one man I had found who knew Shimanishi well. Until recently he had been Shimanishi-kaken’s longtime majority shareholder, and at eighty-six he is still, remarkably, running the plant.

He told me Shimanishi’s gifts did not lie in business or operations. Around 2000, a bitter rupture developed between Shimanishi and the company’s president at the time, and that conflict ultimately led the owners to dissolve the company and sell off its assets.

When the plant went up for auction, Shimanishi asked Mr. Ishii, apparently the only friend with the means, to buy it and keep Themarox in production. Mr. Ishii did. Shimanishi stayed on for a few months afterward, but his heart no longer seemed to be in it. He told his colleagues he wanted to retire, which was highly unusual in Japan, even at seventy-four. They later learned he had tried, and failed, to find investors to start a company of his own. No one has heard from him since.

The years that followed were hard. Shimanishi-kaken barely survived several near-bankruptcies. Mr. Ishii leaned on people like his younger brother, another retired Toshiba executive, whom he asked to work for the company without pay. Learning how dedicated and resourceful Mr. Ishii had been in keeping the company alive, I came to respect him almost as much as Shimanishi himself, which is saying a great deal.

Even now, I believe salaries remain modest, and the company’s leadership is still largely retired Toshiba executives. Corporate men of that era in Japan were often forced to retire at sixty, yet many still needed to work, since pensions alone weren’t enough to live on.

Matt Bakos, my collaborator on the central theories behind the Stone and Water Series, first met these men more than twenty years ago, when they were working without pay. When he asked them why, they answered, “Because we believe what you believe.” Matt has never forgotten that. Nor has he forgotten that in their very first conversation, when he asked about sourcing Themarox, they agreed to make him the sole importer for North America. It was an agreement sealed with a handshake, and they have honored it ever since.

I saw that same loyalty firsthand. Yoshio told me that a Japanese firm had recently approached them to buy Themarox directly. When they discovered the firm was acting for an American buyer, a potential customer of ours who had developed a sudden interest, Yoshio’s answer was simple: “We do not sell to customers of our customers.” I was moved. Knowing that this partnership had run peacefully for twenty years on nothing more than a handshake deepened my trust in what we’re building, and my sense of responsibility to carry the mission forward.

Bullet Trains

Then it was back in the car and on to the long trip home to Tokyo. A long day, but a lot of fun, and I have to put in a word for Japanese trains. They are superb. The bullet train is genuinely amazing. I loved watching it go by almost as much as riding it, and the ride was incredibly smooth.

While we waited on the platform, I kept trying to film one racing past, but I simply wasn’t quick enough. They were so quiet and so fast that by the time I knew one was coming, it was too late to start recording. Wild.

Best of all, you can swivel the seats around and turn a row into a four-seat living room. It made a great setting for talking and getting to know each other.

The Book

Last but not least, the most important find of the whole trip was the copy of Rock-Water that Kenji Torii gave me (see Part 1): an original, pristine copy of the book that supplied the evidence I was missing to finish my own. It was written by a group of Japanese and Chinese agronomists and edited by people who had taken notes at Shimanishi’s lectures.

I’ve now devoted a good part of my recent life to Themarox and to the water it creates, what Shimanishi called “Rock-Water.” Connecting with the generation now running his company felt like laying more foundation for what comes next. With a small group of colleagues, I’m trying to demonstrate what this mineral extract can do for the world’s failing crop yields and, more urgently, for treating and recovering our wastewater. Then the goal is to get that in front of anyone who will listen: agronomists, policymakers, Big Ag, politicians. Who knows.

A Detour: Chlorine Dioxide in the Suburbs

The following day, we had lunch at a classic Japanese bento place with Mr. Izumi, a tireless advocate for health freedom and repurposed therapies in Japan, and part of the global network Lisa helped bring together for Children’s Health Defense Europe during COVID. He had asked me to lecture at an independent health-freedom clinic in the Tokyo suburbs, where colleagues gather each month to discuss new findings, so after lunch we headed out.

They treated me as an honored guest, partly because Izumi had been a major source of ivermectin in Japan, so many in the room already knew who I was. A couple of Americans were there, too. I spoke on chlorine dioxide, which fascinated them. There were lots of questions, though several of them already knew about it and were using it.

The next day was the unforgettable visit with Professor Omura and his friends and colleagues, and soon after, we headed home: happy, stimulated, and motivated.

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From the Shameless Commercialism Department:

Aurmina is a volcanic mineral water purifier that cleans water the way the Earth always has. Add it to a pitcher. The minerals bind the contaminants, the burden clumps and settles, and you pour off the clear water. Purity and mineral breadth almost always trade off. Unlike reverse osmosis, Aurmina keeps the minerals in — producing one of the purest and most broadly mineralized waters on Earth. Check out our new website here.

Primora Bio relies on the same mineral chemistry in the water that supports what we grow and love: plants, gardens, fish, and pets.

The Stone and Water Series

You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

OK folks, today I’m going to try my hand at travel writing and photography journaling: part Bill Bryson, part 1970s living-room slideshow :).

Why Japan?

It’s hard to overstate how important visiting Japan had become to me. It comes down to two Japanese researchers I came to admire deeply, whose work had literally taken over my career. One of them cost me part of my old career; the other gave me a new one.

The desire started early in COVID, when I learned that Professor Satoshi Ōmura, who shared the Nobel Prize for discovering ivermectin, had been admiring the work Paul Marik and I were doing with the FLCCC to spread the word about ivermectin as a treatment for COVID. It wasn’t long before I thought to myself, “How cool would it be to meet Professor Ōmura? I’ve just got to make sure I visit Japan someday.” As you’ll learn below, that desire only grew over the next few years.

What made the trip urgent this year was a second Japanese researcher: Asao Shimanishi, a deeply obscure, extremely private man who, I believe, made history in 1977 when he successfully extracted an aqueous mineral solution from volcanic black mica, one of the most broadly mineralized and abundant rocks in Earth’s crust.

As my readers know, I believe his work is of historic and global importance, which led me to write three books, the Stone and Water Series, available on my website (personally stamped) or on Amazon. But eight months into writing them, I was increasingly weighed down by how little written record existed from or about him.

Given the magnitude of what he accomplished, how little exists is beyond shocking: a single chapter in an agronomy textbook (which I only discovered while in Japan), a 12-page company manual he wrote, a transcript of the only public interview he ever gave, and a five-second appearance in a ten-minute news clip (at the 2:10 mark) from when his Themarox was used to purify and clarify a famous Shinto pond that had turned brackish. Beyond that, I had only oral histories, almost all passed on to me by people who knew people who knew him, rather than by anyone who knew him directly. (That would change in Japan.)

I also wanted to meet the executives of Shimanishi-kaken, Shimanishi’s legacy company, which has manufactured Themarox in the twenty-five years since he left. Since starting Aurmina and Primora Bio, we had corresponded by email for months, but everything had to be translated, and it was formal and careful, as translated business email always is. I wanted to get to know them personally, and they felt the same. (That visit gets its own post.)

Underneath all of that, honestly, was something I still can’t fully explain: I had become fascinated with Japan, and a little mystified by how many threads of my life ran through it. Ōmura. Shimanishi. Ivermectin. Themarox. Two separate obsessions that led to two career-altering trajectories, both ending on the same island. My career has always been marked by periods of intense research into novel therapies, but these last two sprang from the work of two Japanese men of the same era, both trained in pharmacy and chemistry; Shimanishi got his initial pharmaceutical degree in 1950, Omura in the late 50s. But get this: both made a determined decision early in their careers to study “nature’s chemistry” instead of the synthetic petrochemical research that was all the rage back then (and still is), and where all the money was. Omura’s biography describes his field as “natural product organic chemistry,” while Shimanishi devoted himself to what he would have described as “natural product inorganic chemistry.” Why had my career, and more accurately my entire life, become so deeply connected to those two men, that era, and those fields?

Lastly, I had always heard about the quirks and idiosyncrasies of Japanese culture, and about the country’s strange and outsized presence in modern history, and I wanted to see it for myself.

The Dream

When Paul Marik and I were leading the FLCCC, a Japanese Doctor of Pharmacy named Morimasa “Mori” Yagisawa reached out to me. Through Mori, I came into contact with the people around Professor Ōmura.

Ōmura’s laboratory discovered the soil organism that gave the world avermectin, and from it, ivermectin. My COVID work had intersected with his, if not nearly duplicated it. Like me, he did not stay quiet during COVID. From the very beginning of the pandemic, he reached out to Merck, imploring them to fund trials. Like me, he and his colleagues published a major, highly positive review of the dozens of ivermectin studies available at the time. He also wrote a book about ivermectin’s role in COVID, though its title, Ivermectin: Can It Become a Lifesaving Treatment for COVID-19?, was more optimistic than mine, The War on Ivermectin.

The world’s press, which had been perfectly happy to celebrate him in 2015, decided it didn’t want to hear from him in 2021. Only when I met him did I learn how complete that silence had been, even at home. His book became a bestseller in Japan, yet the Japanese media barely covered it, and no one invited him to give a single interview. No major publisher would take it. A Nobel laureate in his own country, writing about the drug that won him the prize, couldn’t find a mainstream publisher.

I had seen a glimpse of that silencing from the other side of the world, years before we ever met. Because of my highly public advocacy for ivermectin and my role in the FLCCC, I slowly became fairly visible on Twitter, reaching over 600,000 followers. My single most popular tweet to date was me reporting that YouTube had taken down an interview with Ōmura about using ivermectin. Check out the retweet count, for a man not named Elon Musk:

That tweet was paired, in an old post, with a video clip I want to reshare: a fiery diatribe by Professor Masanori Fukushima, Professor Emeritus of Kyoto University, delivering a scathing and scientifically accurate critique of pretty much every aspect of the COVID vaccine campaign. The world had only a handful of truly prominent academics bold enough to publicly criticize their country’s COVID response, and no one came close to Fukushima’s fury (it’s even angrier than my ivermectin Senate testimony). When I watch it, I feel like I did as a kid watching the training montage in Rocky, with the theme music cranked up. Best line: “a bunch of incompetent scholars who cannot be called scholars... a total disregard for science and medicine.” Amen.

But the biggest reason I couldn’t wait to meet Professor Omura was to thank him in person for one of the greatest gifts I have ever received. It came when I was lost, no longer employable in any ICU, and feeling down (a feeling I rarely, if ever, suffer), and it lifted me up when nothing else could.

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The gift was an extraordinarily beautiful collotype photograph of Streptomyces avermitilis, the soil organism that secretes avermectin. It is one of my most cherished possessions and has hung above my desk ever since:

My favorite line in the accompanying letter carries far more power and elegance than this foul-mouthed New Yorker could ever muster:

I can recall tears coming to my eyes as I stared at the gift and letter.

So off we went, despite the Iraq War being only weeks old and being bombarded with doomsday scenarios across social media and from friends. Ignoring the risks of an unstable world, my six-months-pregnant wife Lisa and I were excited as all get out.

Meeting Professor Ōmura

Mori arranged everything. He told me Professor Ōmura wanted to host a private dinner for Lisa and me, and he also invited us to tour his laboratory and institute.

Mori picked us up from the hotel in a private car along with Kenji Torii, the man who helped Ōmura self-publish his book. A couple of words about Kenji. Kenji is known for making and selling the Tiger gyroscope, a Japanese icon. It was first made in Nagoya in 1921 and became a household name in the 1960s and 70s, when vendors demonstrated it at festivals and children and adults alike were captivated by it. It nearly vanished in 2015, when its maker closed because the aging craftsmen had no one to take over. Kenji was one of those craftsmen that revived it, and today it is cherished as a nostalgic collectible and still used in classrooms to teach the physics of the gyroscope. Check it out:

Kenji also gifted me a pristine copy of “Rock-Water,” an agronomy and wastewater textbook that contained the vast majority of the data and insights that allowed me to finish my books and launch my mineral products.

The first thing we did was stop to see the cherry blossoms, which had just begun to bloom across Tokyo (we were about a week or two before peak bloom).

On the way, I learned that Mori, like his father, was a doctor of pharmacology (another Japanese pharmaceutical scientist, what is happening :), and that Ōmura had been his father’s student. Mori and Ōmura had known and worked with each other for years, particularly during COVID.

Arrival At Kitisato Institute

We were led to Ōmura’s office, into an anteroom with a long conference table surrounded by bookcases full of textbooks and journals. Mori, his colleague Dr. Patrick Forster, a pediatrician who has practiced in Tokyo for many years and co-authored Ōmura’s ivermectin papers, and the researchers who had guided us all stepped back, leaving me alone in the center of the room as Ōmura emerged from his adjoining office, smiled gently, and walked over. We bowed and shook hands.

Having studied Japanese customs in preparation for the trip, I knew that there are three types of bows in Japanese culture, and one in particular, deep and long, is reserved for men of Ōmura’s stature. It might be an exaggeration to say my nose almost touched the floor :).

His kindness and warmth shone through immediately, along with an easy smile. He invited me to sit down and talk. I honestly can’t remember everything he said, but early on I thanked him for the letter he had sent me, told him it arrived when I was down and how much it helped, and tears started pouring out of my eyes. I’m not making that up, and I’m not going to dress it up. I was simply overwhelmed to be sitting across from him (and, actually, a little embarrassed). See how everyone moved away from us to the far corner of the room:

I quickly recovered. The conversation shifted to our voyage and lodgings, and to Lisa, visibly pregnant, whom he was clearly happy to meet; he asked about the impending Lazlo. Lisa asked him a few questions, and we learned he was 90 years old, worked full time, still directed the Institute, and oversaw no fewer than 70 active research studies.

(If you look closely, you can see my eyes are still red from crying, ugh.)

Tea was brought out, and we began exchanging gifts. Despite my studying Japanese etiquette, I still felt I’d gotten it wrong. All I brought was a signed copy of The War on Ivermectin, which felt thin in front of him. I also think I gave him a bottle of American whiskey, which I had learned was an appreciated gift in Japan, but I can’t remember exactly because I had already given several as gifts to others that week.

I was embarrassed by the number and thoughtfulness of the gifts I received, each more amazing than the last. First, he gave me an inscribed copy of his book, Ivermectin: Can It Become a Lifesaving Treatment for COVID-19?, along with an inscribed copy of Ivermectin: Testimonials by Clinicians Worldwide, which Paul Marik edited and for which Ōmura wrote the foreword. He also gave me a signed copy of his and his colleagues’ masterful review of what I believe were 42 ivermectin trials at the time:

The promotional band on his book says: “Nobel laureate and Distinguished Professor Satoshi Ōmura answers all your questions.” And the back jacket reads:

I also received several recent publications related to the Kitasato Institute, each cover inscribed with a little note from Ōmura, cookie replicas of the 1,000 yen bill featuring Ōmura’s hero, Shibasaburō Kitasato (more on him below), and another box of cookies:

The magazine featuring Ōmura is “a monthly magazine for studying human character.” The main headline reads: “No ability surpasses gratitude.”

If that wasn’t enough, I then received... a beautiful blue tie printed with the molecular structure of ivermectin, made by who else... Ōmura!

There are no words for the last gift, as I can’t express its importance briefly enough for this post (for that, you’d have to read The Blueprint of Life, which is part memoir). It was a shikishi, a traditional square calligraphy board, which he had brushed for me with his favorite phrase, along with the English translation:

His signature is the smaller column at the bottom left, and his personal seal in red is beneath it. In Japan, the closest thing to a signature is a seal, a small carved stamp called a hanko (or, more formally, an inkan). For centuries it has carried more weight than any signature. Most adults own several: an everyday seal for signing for packages, a bank seal, and a jitsuin, registered with the city government and reserved for life’s biggest moments, like buying a home or signing a major contract. A Japanese person’s hanko is usually just their name in kanji, hand-carved in an ancient, highly stylized script that makes it nearly impossible to forge. Artists and calligraphers go a step further, adopting an artistic name and pressing their seals in red ink beside their work, as Professor Ōmura did here. (I came home with a hanko of my own. More on that at the end.)

The Tour of Kitasato Insititute

I had read a great deal about Ōmura before the trip, but I learned far more on the tour he arranged for me through the Kitasato Institute and museum, led by a professor and a postdoc who were likely two of the country’s brightest chemists (even though they looked like teenagers IMO). From left to right: Morimasa Yagasawa, Dr. Patrick Foster, me. Lisa, and the young chemists.

What Came Out of the Soil

The scientists first took us to the room holding the actinomycete biobanks, and it was a sight to behold. Thousands of test tubes in trays, stacked in eight-foot-high racks, filled the room, with growth visible atop the culture medium in each one: soil organisms, collected and cataloged.

Then came a room of sophisticated-looking equipment, which I believe separates and identifies the metabolites the organisms secrete (I could be wrong, but either way it was impressive to look at).

Ōmura’s method of discovering therapeutic compounds in nature, the method that found ivermectin, is traced in the image below: collect microorganisms, isolate them by species, preserve them, ferment them, extract the fermentation broth, then analyze the metabolites produced and test them for antimicrobial or enzymatic activity.

Ōmura’s methods have brought eighteen drugs to the human market, and twenty-six if you count veterinary medicines. I had known about ivermectin. I didn’t know his laboratory also discovered staurosporine, the first potent protein kinase inhibitor ever found, a compound that helped open the door to an entire class of cancer drugs, including Gleevec (imatinib). Gleevec blocks the BCR-ABL protein that drives chronic myeloid leukemia, and it transformed a frequently fatal disease into one many patients now live with for decades. The three most important therapeutic metabolites are highlighted below:

One man, one method, one patient habit of picking up dirt.

As we walked through the institute and hospital, his name, image, and legacy were everywhere:

Then we came across a replica of the famous bronze statue, Sightless Among Miracles, which depicts a common sight in parts of Africa for most of the last century: a boy leading, with a stick, an elder blinded by onchocerciasis (river blindness).

Around 50% of men under 40 had been blinded in some West African communities in the 1970s, according to the WHO. By the early 1960s, the disease was driving whole villages to abandon fertile river valleys for drier, poorer land, according to the World Bank. Communities had to choose between going blind and going hungry.

The statue commemorates ivermectin’s role in preventing river blindness and preserving the sight of millions, the work for which Ōmura and William Campbell of Merck shared the 2015 Nobel Prize. The best-known casting stands at WHO headquarters in Geneva, where it was dedicated in 1999.

Photo of Nobel Prize Ceremony hangs in the museum:

The Nobel Gold Medal:

Healing Art

Ōmura is also one of Japan’s most respected citizens, a devoted philanthropist and a patron of the arts. He gave away much of what he earned in royalties from ivermectin and his other discoveries: he built the hospital itself with patent royalties from his work, chiefly ivermectin, and also built the Kitasato Museum adjoining the institute.

He didn’t just help fund those buildings; he filled them with art, because he believes beauty helps people heal and that people need it around them. The concept is called “Healing Art,” and it began at the Kitasato University Medical Center, which opened in 1989. His collection hangs throughout that hospital, which is known across Japan as “the hospital with paintings.” The city of Kitamoto describes the idea as combining modern medicine with nature and art, under the theme of “healing the heart through paintings.” I’ll admit that on the hospital tour, I spent most of my time looking at the art in the corridors.

His collecting and philanthropy extend further still. In 2007, he donated a museum and much of his collection of roughly 3,500 works to his hometown, which became the Nirasaki Ōmura Art Museum. He told me I have to visit it next time. He loves that place, he said, because from his house there he can see Mount Fuji when he wakes up in the morning. He has said, “Works of art are the common property of all humankind.”

The Kitasato Museum

We were warmly greeted by a guide (who may have been the museum director) who gave us a private tour; no one else was in the museum. She was a wonderful young woman who said she was really nervous that her English wasn’t good enough (it was!). I honestly loved that museum; I stopped and looked at every single item. Enjoy:

This one is about pneumonic plague, the form of plague that spreads from person to person through the air (and which apparently killed someone in Russia this month).

Top scene: a sick man coughs a visible spray straight into an elderly woman’s face. A young woman holds him up and a small child sits at his feet, so the whole household is exposed.

Bottom scene: responders in full-body white suits, hoods and face masks enter a crowded room of coughing, collapsing patients. Hmm, where have I seen that before.

These posters document the scientific lineage Ōmura belongs to, starting with his hero, Shibasaburō Kitasato, the father of Japanese bacteriology. Kitasato grew the world’s first pure culture of the tetanus bacterium in 1889, then developed antitoxin serum therapy with Emil von Behring, work that helped found serum therapy and modern immunology. He was nominated for the very first Nobel Prize in Physiology or Medicine in 1901, but the prize went to von Behring alone.

During the 1894 Hong Kong outbreak, he identified the plague bacterium at essentially the same moment as Alexandre Yersin, whose name the organism bears today. He founded Japan’s first infectious-disease research institute in 1892 and the Kitasato Institute in 1914, and he trained the generation of researchers who built Japanese medicine. Since July 2024, his portrait has appeared on the 1,000 yen banknote (the one depicted on my gift of cookies).

A century after he founded it, his institute finally won the Nobel Prize that had eluded Kitasato himself.

One of Lisa’s and my favorite memories came as our group left the Institute for dinner. A beautiful blue Bentley was parked right outside the front doors, on a little plaza clearly not meant for cars, with a driver standing beside it. Mori told us it was Professor Ōmura’s car, and that the license plate matched his birthday. Ōmura with some swagger! Love it, just love it.

The Dinner

Dinner was at a grand Western hotel with several restaurants. We went to the traditional Japanese one, where he had reserved a private room for the whole group.

I lost count of the courses. They kept arriving, with long, unhurried stretches in between, which meant hours of real conversation: about what each of us had gone through during COVID, and about his life and career, which Lisa and I both had lots of questions about.

Two moments I will never forget.

The Hat

Lisa absolutely adored him, thought he was the “cutest and kindest man ever”, and even fell in love with the hat he was wearing. She asked where she could get one. He smiled and told her, warmly and with a smile, “You cannot find this hat anywhere. It was made for me. It is the only one of its kind.”

I still don’t know whether he was joking, but we believed him completely, and we thought it was wonderful.

The Golf

In the museum there is a small diorama behind glass: a figure crouched at the edge of a golf green, digging in the soil. That is the famous story of how ivermectin was found.

Over dinner, I learned that he had been a formidable table tennis player and a cross-country skier of some local renown. But the most amazing fact was that he had been a scratch golfer, playing until he injured his wrist a few years ago. I could hardly believe it. A vanishingly small number of people ever reach scratch, and here was a world-famous chemist who had done it alongside everything else.

So I asked the question I had been turning over since I walked past that display case: since you were such a serious golfer, and since you’ve said you sometimes collected samples while you played, did you discover ivermectin during a round of golf?

He looked at me. He smiled. And he said:

Which means it is entirely possible that a compound which won the Nobel Prize and has been given to billions of human beings was scraped out of the ground while its discoverer stood waiting for a playing partner to finish putting. So cool.

Another diorama showing Omura at work in the field:

The evening stayed easy and pleasant throughout. I spent a stretch of it talking with Dr. Patrick Forster, who knows the ivermectin history cold, and I learned a great deal from him about how medicine is actually practiced in Japan, and how, as everywhere else, it is tightly fenced in terms of what a doctor is permitted to do.

Of all the traveling I’ve done, the best trips have always been the ones where I knew people in the country. That is where you can immerse yourself and get a real feel for it. Otherwise, you are just a sightseer.

This was one of the finest immersions I’ve ever had: in medicine, in discovery, in Japan, with unparalleled hospitality and generosity, and in the company of a humble, kind, extraordinarily generous Nobel laureate whom I admire more than I can comfortably express.

My last memory of the night is walking out of the restaurant with Lisa as we went up to our room in the hotel. Professor Ōmura was beside me. He stopped, looked at me, and said, “How is Paul Marik doing?” From the way he asked, I could tell he knew of Paul’s suffering and was sincerely concerned for his welfare. He then grabbed my arm and said, “Please give him my deepest regards.”

Tears filled my eyes again as I walked away.

P.S. My Own Seal

Foreigners face a puzzle the Japanese don’t: our names have no kanji. So we choose characters whose sounds match our names and, ideally, whose meanings say something about who we are. The stamp maker broke “Kory” into its Japanese sounds, k≈ç and ri, and offered me a menu of characters for each. For k≈ç: high, public, scent, craft. For ri: benefit, hometown, pear, and reason. I chose È´òÁêÜ. È´ò means high or lofty; ÁêÜ means reason, principle, the natural order of things, and it is the same character the Japanese use for science. “Higher order.” After a year spent trying to understand the order hidden in stone and water, I couldn’t imagine a better name to carry home. Check it out (I also think it looks like a man boogeying down):

Next up: my visit to Shimanishi-kaken, and what I learned from the people who knew him about the man behind Themarox.

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From the Shameless Commercialism Department:

Midway through writing my most recent books, I started a company that sells an aqueous mineral solution derived from Shimanishi’s discovery, Themarox.

Aurmina is a volcanic mineral water purifier that cleans water the way the Earth always has. Its chemistry is drawn from volcanic rock: an aqueous solution of at least twenty-nine individually measured elements, extracted — not synthesized — from a black mica documented to carry more than forty. Each is in sulfate form, which lets it dissolve and carry a charge.

Add it to a pitcher. The minerals bind the contaminants, the burden clumps and settles, and you pour off the clear water. Purity and mineral breadth almost always trade off. Unlike reverse osmosis, Aurmina keeps the minerals in — producing one of the purest and most broadly mineralized waters on Earth. Check out our new website here.

Primora Bio relies on the same mineral chemistry in the water that supports what we grow and love: plants, gardens, fish, and pets.

The Stone and Water Series

You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

OK folks, today I’m going to try my hand at travel writing and photography journaling: part Bill Bryson, part 1970s living-room slideshow :).

Why Japan?

It’s hard to overstate how important visiting Japan had become to me. It comes down to two Japanese researchers I came to admire deeply, whose work had literally taken over my career. One of them cost me part of my old career; the other gave me a new one.

The desire started early in COVID, when I learned that Professor Satoshi Ōmura, who shared the Nobel Prize for discovering ivermectin, had been admiring the work Paul Marik and I were doing with the FLCCC to spread the word about ivermectin as a treatment for COVID. It wasn’t long before I thought to myself, “How cool would it be to meet Professor Ōmura? I’ve just got to make sure I visit Japan someday.” As you’ll learn below, that desire only grew over the next few years.

What made the trip urgent this year was a second Japanese researcher: Asao Shimanishi, a deeply obscure, extremely private man who, I believe, made history in 1977 when he successfully extracted an aqueous mineral solution from volcanic black mica, one of the most broadly mineralized and abundant rocks in Earth’s crust.

As my readers know, I believe his work is of historic and global importance, which led me to write three books, the Stone and Water Series, available on my website (personally stamped) or on Amazon. But eight months into writing them, I was increasingly weighed down by how little written record existed from or about him.

Given the magnitude of what he accomplished, how little exists is beyond shocking: a single chapter in an agronomy textbook (which I only discovered while in Japan), a 12-page company manual he wrote, a transcript of the only public interview he ever gave, and a five-second appearance in a ten-minute news clip (at the 2:10 mark) from when his Themarox was used to purify and clarify a famous Shinto pond that had turned brackish. Beyond that, I had only oral histories, almost all passed on to me by people who knew people who knew him, rather than by anyone who knew him directly. (That would change in Japan.)

I also wanted to meet the executives of Shimanishi-kaken, Shimanishi’s legacy company, which has manufactured Themarox in the twenty-five years since he left. Since starting Aurmina and Primora Bio, we had corresponded by email for months, but everything had to be translated, and it was formal and careful, as translated business email always is. I wanted to get to know them personally, and they felt the same. (That visit gets its own post.)

Underneath all of that, honestly, was something I still can’t fully explain: I had become fascinated with Japan, and a little mystified by how many threads of my life ran through it. Ōmura. Shimanishi. Ivermectin. Themarox. Two separate obsessions that led to two career-altering trajectories, both ending on the same island. My career has always been marked by periods of intense research into novel therapies, but these last two sprang from the work of two Japanese men of the same era, both trained in pharmacy and chemistry; Shimanishi got his initial pharmaceutical degree in 1950, Omura in the late 50s. But get this: both made a determined decision early in their careers to study “nature’s chemistry” instead of the synthetic petrochemical research that was all the rage back then (and still is), and where all the money was. Omura’s biography describes his field as “natural product organic chemistry,” while Shimanishi devoted himself to what he would have described as “natural product inorganic chemistry.” Why had my career, and more accurately my entire life, become so deeply connected to those two men, that era, and those fields?

Lastly, I had always heard about the quirks and idiosyncrasies of Japanese culture, and about the country’s strange and outsized presence in modern history, and I wanted to see it for myself.

The Dream

When Paul Marik and I were leading the FLCCC, a Japanese Doctor of Pharmacy named Morimasa “Mori” Yagisawa reached out to me. Through Mori, I came into contact with the people around Professor Ōmura.

Ōmura’s laboratory discovered the soil organism that gave the world avermectin, and from it, ivermectin. My COVID work had intersected with his, if not nearly duplicated it. Like me, he did not stay quiet during COVID. From the very beginning of the pandemic, he reached out to Merck, imploring them to fund trials. Like me, he and his colleagues published a major, highly positive review of the dozens of ivermectin studies available at the time. He also wrote a book about ivermectin’s role in COVID, though its title, Ivermectin: Can It Become a Lifesaving Treatment for COVID-19?, was more optimistic than mine, The War on Ivermectin.

The world’s press, which had been perfectly happy to celebrate him in 2015, decided it didn’t want to hear from him in 2021. Only when I met him did I learn how complete that silence had been, even at home. His book became a bestseller in Japan, yet the Japanese media barely covered it, and no one invited him to give a single interview. No major publisher would take it. A Nobel laureate in his own country, writing about the drug that won him the prize, couldn't find a mainstream publisher.

I had seen a glimpse of that silencing from the other side of the world, years before we ever met. Because of my highly public advocacy for ivermectin and my role in the FLCCC, I slowly became fairly visible on Twitter, reaching over 600,000 followers. My single most popular tweet to date was me reporting that YouTube had taken down an interview with Ōmura about using ivermectin. Check out the retweet count, for a man not named Elon Musk:

That tweet was paired, in an old post, with a video clip I want to reshare: a fiery diatribe by Professor Masanori Fukushima, Professor Emeritus of Kyoto University, delivering a scathing and scientifically accurate critique of pretty much every aspect of the COVID vaccine campaign. The world had only a handful of truly prominent academics bold enough to publicly criticize their country’s COVID response, and no one came close to Fukushima’s fury (it’s even angrier than my ivermectin Senate testimony). When I watch it, I feel like I did as a kid watching the training montage in Rocky, with the theme music cranked up. Best line: “a bunch of incompetent scholars who cannot be called scholars... a total disregard for science and medicine.” Amen.

But the biggest reason I couldn’t wait to meet Professor Omura was to thank him in person for one of the greatest gifts I have ever received. It came when I was lost, no longer employable in any ICU, and feeling down (a feeling I rarely, if ever, suffer), and it lifted me up when nothing else could.

** If you're considering a paid subscription, know that after an extended period of infrequent posting, I have tons of posts generated from excerpts of chapters from my three books that I am going to start sharing regularly…

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Senator Ron Johnson’s panel titled “COVID-19 Hospital Protocols: Real Stories from Real People” will take place in the Kennedy Room today at 1 pm, and will be live-streamed on the Senator’s website.

Lately I've joked with readers that Medical Musings has a new mission. Not entirely abandoning COVID and the corruption it exposed, but moving largely beyond it, toward what I believe is an even bigger story: the geohydrological shift. Over the past century, the chemistry of the world's water has changed, and that change is quietly driving the food crisis now unfolding across the globe. I've written about it in my Stone and Water Series books.

Today is not that day. Today is the opposite.

Senator Johnson has once again asked me to help expose one of the worst catastrophes of this country’s pandemic response: what happened inside our hospitals.

Over the past several years, I have spoken with countless survivors and grieving families, and with the nurses and doctors who witnessed it firsthand. What they described was not isolated. It was pervasive, systemic, and cruel beyond belief. And it was almost entirely devoid of scientific inquiry: no questioning, no weighing of evidence, no willingness to change course as patients deteriorated. It defied logic, reason, and basic compassion. I credit Senator Johnson for dragging it into public view today, in a way I hope the country never forgets.

Here is just some of what they told me:

• Remdesivir infused over the documented refusals of patients and their families.

• Isolation policies that cut patients off from family and advocates, leaving them alone, defenseless, and without a voice.

• Every request for repurposed drugs, above all ivermectin, denied. Every plea for a change in treatment refused, even as patients deteriorated.

• Worse: ivermectin stopped in patients who were clearly improving after a caring doctor had started it.

• Vicious comments spoken to patients and families who had chosen not to be vaccinated.

• Patients placed on mechanical ventilators with no pressing need for it.

• Any doctor, nurse, or staff member who dissented was targeted, harassed, and driven out.

And that is only the beginning.

Ralph Lorigo, the attorney who sued on behalf of 200 patients denied ivermectin, is one of the central witnesses to the most egregious abuse of all: the near-total lockout of ivermectin, one of the safest drugs in all of medicine and one of the most effective treatments for COVID, if not the most effective.

I devoted years of my life to documenting how the world's scientific and public health institutions worked to restrict ivermectin. That record became my book, The War on Ivermectin. I later came to see it as just one chapter in a much broader campaign against cheap, repurposed therapies, which led me to write the next book in the series, The War on Chlorine Dioxide. Today is a chance to bring that story to a much wider audience.

So I’m handing this post to my colleague Michael Capuzzo, the New York Times bestselling author and investigative journalist who has covered Ralph Lorigo’s case extensively, along with ivermectin and the efforts Paul Marik and I made to guide the world in using it to save lives.

Please check out his post below; it is a must-read.

RESCUE with Michael Capuzzo

Ralph Lorigo and the American Dream

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a month ago · 48 likes · 7 comments · Mike Capuzzo

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

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From the Shameless Commercialism Department:

I now write about minerals and water. Midway through writing my most recent books, I started a company that sells an aqueous mineral solution of the two.

Aurmina is a volcanic mineral water purifier that cleans water the way the Earth always has. Its chemistry is drawn from volcanic rock: an aqueous solution of twenty-nine individually measured elements, extracted — not synthesized — from a black mica documented to carry more than forty. Each is in sulfate form, which lets it dissolve and carry a charge.

Add it to a pitcher. The minerals bind the contaminants, the burden clumps and settles, and you pour off the clear water. Purity and mineral breadth almost always trade against each other. Unlike reverse osmosis, Aurmina keeps the minerals in — producing one of the purest and most broadly mineralized waters on Earth. Check out our new website here.

Primora Bio relies on the same mineral chemistry for the water that supports the things we grow and love: plants, gardens, fish, and pets.

The Stone and Water Series

You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

A note before this post. I went back and forth about whether to post it at all.

Today is September 12th, 2026. I was in Brooklyn on this day in 2001 — then a medical student, close enough to see the towers from my bedroom window until they disappeared the day before — and I spent the whole of the next day down there. Somewhere in thinking about that yesterday, I remembered that I had written what happened that day.

Not for publication. I was not a writer then and had no notion of becoming whatever I suppose I am now. I went to medical school in the Caribbean, at a time when the cost of a phone call was prohibitive, which meant email was the only way I spoke to anyone I loved, so I wrote a great many of them and received a great many back. If there is a place where my writing career started, it was probably then.

What follows is what I sent that week. The people I sent it to — close family, a few friends — have told me over twenty-five years that they never forgot it. They still bring it up. That is the only reason I am posting it.

It is uncut and unedited. The punctuation is bad, the sentences run on, I swear a little, and it ends without deciding anything. I corrected a handful of typos so you don't trip over them, and I added the dates each part was written. Nothing else has been touched — the parts I would want to fix now are the parts that make it true.

One man’s vantage point, from before I understood what I was looking at. Here it is, if you want it.

I wrote this first part on Tuesday, September 12, 2001 in the evening, in Park Slope Brooklyn, where I lived at the time.

September 11, 2001

I’m fine, everything is very very crazy around here, normally I can see the towers from my bedroom window but now I can’t anymore... I spent the first couple of hours getting ahold of all I knew in lower Manhattan, my first cousin works in the building right next to the Towers and I just got word that he is fine, hadn’t gone in to work.. My parents are fine, my father at his hospital in the Bronx, mother in her apartment on 33rd St., she hadn’t gone out this a.m....Here in Brooklyn, all Attendings, Residents and Students are on standby at all the area hospitals (students are doing so volitionally, I live across the street so I have been checking in periodically, but our hospital is very very quiet, almost nobody is allowed in unless you have an I.D, they are only taking the sick, and the very sick at that, it is only now that some of the victims from Manhattan are starting to be transported out to Brooklyn, my hospital expects their first patients to arrive tonight, but we have 150 residents to handle that and at least as many Attendings..(none ever came by the way, one of the unquestionably sad facts of the disaster, the fact that after the first rush of victims in the morning, there were very very few, if any others to get out and require medical help) All surgeons are supposed to be at the hospital in a disaster and they are patiently waiting, I just sat in the cafeteria with a couple of ‘em, everyone is really, really sad, many people there had at least one person they knew in those towers.. We are about 4 miles from the towers but all the bridges are closed for the time being..... The blood donor lines here are 5 hours long at my hospital, there is nothing I can do to help as you need to be a certified blood taker, which I was very surprised to learn that no resident or even Attending physician knows how or is allowed to do..(we draw blood and start IV’s all the time, but draining a pint into a bag takes some special sort of skill requiring a blood donor technician..)... So, basically, the situation here is that many, many more people want to do something than have something to do at the moment.. Very strange feel to everything... That’s all the news I got except to say that I am fine, don’t worry about me, I’m just sitting here trying to figure out how to help, like almost everyone else who is not downtown...

P.S Although no one has yet made the suggestion on radio or television, I am sort of thinking that it might be smart to not use the phone around here unless absolutely necessary, just in the hopes that one less unimportant call might help one more important call go through.. just a hunch, so I am trying to stay off the phone...

Thursday, September 13, 2001 — written about Wednesday the 12th, the day I went down.

So, that day I spent like almost everyone else, shuttling back and forth to the hospital, hoping and waiting to be of help as it was too maddening to sit and watch all those horrible images on the television over and over again.. but I did so anyway, all of us at the hospital were doing so.. rumors flew that patients were to arrive but none did.. you couldn’t get into the city for quite a while as all inbounds were closed.. they opened the subways later in the day and I found out later some of my fellow students went in, and were on the scene for a couple of the much publicized rescues (i.e the amputation rescue), a few stitched up some cuts, but many were in the smoke and rubble.. difficult night, woke and went to work at the hospital, was busy in the morning doing Neurology consultations and then I ran into a trauma surgeon I worked with last year and he told me and a couple of other students I was with to get ready as he needed us to go in with him... I changed into my scrubs, got some equipment, and off we went, hurrying out of the hospital, jumped on the subway, and headed in.. Got out on the East side in Chinatown, and jogged west with the others.. all the barricades were passable for us, and we rushed down there.. Approaching the disaster area was mind-blowing and then it wasn’t in a way.. It was sort of like any other time when I get out of the subway into Manhattan and you hit the street, you are always left with the feeling you are somewhere new and have never been before, even though I have lived in and around here all my life... same for yesterday, it was simply like approaching an area of the city that I had never ever seen before (and hope to never again).. Most of the previous landmarks in that immediate area were barely recognizable so you didn’t really compare it to what you knew before, you just were overwhelmed with the amount of destruction around you.. the approach was drastic, starting about 5 blocks away, the streets all turned white with rubble and the ground was full of papers and ash, one cemetery of a church down there had ash and papers piled to the tops of tombstones...many, many burned out, black, charred, and crushed cars, most police cars or fire engines... the area was covered in smoke with heavy rubble dust in the air, all enveloped in a mild burnt rubber smell, so at this point we all put on our surgical masks..

as we approached the WTC plaza (that is the 4-5 block square area which held the towers, the square in between, and the surrounding buildings to the east which abutted the approaches to the towers on the plaza itself), at first all we could see was dark grey smoke and haze in the middle rising far above the plaza.. these first buildings which are directly on that plaza to the east were all charred and burnt out, hollow, no windows, and very, very black..... at times you could barely see the outlines of the sides of the tower bases behind them, but what you did see were mountains of rubble in and around where they used to be... scaffolding rods, concrete chunks, girders, beams all jutting out in huge piles everywhere, huge portions of building could be seen laying horizontally, surrounded by mazes of metal and steel debris….many of the other buildings within the whole 5 square block area had every single window blown out, while others had random windows blown out up to the thirtieth and even higher floors.. one building diagonally across from the plaza was completely gone, all you could see was rising girders with huge piles of rubble 40-50 feet high in the air.. there were tons of firemen all over in there with saws and blowtorches..

We got to the medical triage area and hooked up with nurses and orthopedic surgeons from NYU and St. Vincents.. No medical care was being given to anyone at the time, although many tables and IV bags were set up.. All medical personnel at triage were simply watching the excavation activities and searches, simply being ready.... the night before was busier, mostly with students giving many eye washes to the firemen and cops , but the eye washes were not as great a problem yesterday as a lot of the smoke and dust had lessened... I was there for 20 minutes, just taking in the whole area, totally blown away.. we then got an order to move the triage area away from “ground zero” as more space was needed for equipment and men, so I helped move many of the tables and supplies... The really demoralizing fact of the day was that, even with the hundreds at work and on the scene, there had been no reports of ANYONE having been brought out alive since 7:00 that morning...

After moving that East Triage area, me and a couple of guys circled around to the southern approach of the plaza, to where another triage area was, the whole rubble and surrounding streets on these East and South sides were filled with hundreds of men from every conceivable agency and of type of uniform.. Nat’l guard, police, SWAT, Green Berets, Search and Rescue, paramedics from every conceivable private and public ambulance, fire department guys from every town within 50 miles, court officers, army soldiers, etc,etc.. many “bucket brigade” lines had formed and were forming which began on the periphery and snaked into and up and around the mountains of rubble into the interior, near the bases of the towers from this South approach where I spent most of my day.. We were given heavy gloves and we jumped into these brigade lines and began simply handing all objects and material that were being passed back from the forward areas.. melted computers, air conditioners, concrete blocks, 20 foot-long, twisted, bent scaffolding rods, buckets of rubble, huge steel girders and beams, with ten of us under it stumbling down the hills to take to the outer side street entrances where the bulldozers were working in removing all that we brought out by hand.. the crazy thing was that a lot of times, they would yell out “Hot piece” and we would be handing things along, that were still really hot from the fire....at other times they would yell to put one of the pieces in a special pile on the outer street, not far from a dump truck which had spray painted on the side “airplane parts”, as something about the piece must have suggested an airplane (not that I could see)..

anyway, at that rate of human removal, it would take literally months to remove it all.. we were standing on all this destruction, all of it plastered with paper, paper and more paper.. saw tons of resumes ( we sort of joked that we hoped they hadn’t got the friggin job), tax returns, cancelled checks, etc, etc,..the snail paced rate of work was necessary based on the assumption that there were people underneath us, and possibly alive so no cranes or bulldozers were being used in the rubble interior and only on the periphery.. there was a lot I did not understand though, as all these brigade lines were long and snaked over many piles and hills of rubble which weren’t being dug out or searched through and I did not know why all attention was being directed to the center of all the destruction with no efforts at the periphery.. (perhaps they had already sniffed or “sensed” the periphery, I dunno, I suppose they wanted to get to the lobby or something but I just felt that there was a high possibility that we were standing atop possibly many survivors who had been on the plaza when it went down.. (I quite possibly may have been right as today’s big news of firemen walking out were all in an SUV, which was definitely on the periphery of the plaza, I just don’t know what side they came out from).. anyway, work continued for several hours, handing all the destruction backwards while handing empty buckets forwards.. this was interrupted periodically with two types of shouts, which rippled backwards from deep in the interior.. we just heard them and yelled them backwards.. they were either for “Dogs!” (the firemen in those forward areas felt they were on to someone, so they called for dogs, the shouts went down the line to the outside and the handlers would run up, most often carrying the dogs in their arms as the dogs couldn’t navigate the rubble with their little feet... if the call wasn’t for dogs then it was for “Body Bags!” which were handed up the line only to be followed a short while later with men coming out and over the tops of the hills carrying a stretcher with a body... then there were a lot of saws being handed back, either broken or needing a blade replacement, and at other times we were just handing small stacks of saw blades forward.... the night before, one of the students who had been there wrote the following today:

“there were were often calls for “Quiet” which hundreds of workers would echo down the line until it became absolutely silent - they were listening for any sounds coming from underneath the rubble. At one point one of the canine units had signaled a specific area and fiber-optic cameras showed a leg underneath two feet of rubble - we dug feverishly (with an audience) only to realize the grimmest of our fears - it was just a leg, mangled and shattered. It was placed in a bucket and passed on.”

So, work continued until late afternoon, at one point, our first injured rescuer came back from a forward area.. A stretcher was called for and moments later a huge fireman was being handed back, hand by hand, on the stretcher.. He was conscious, but in a lot of pain, although I saw no obvious injury or bleeding... At the end of the line was a waiting ambulance with paramedics, which soon left...

Very soon after, suddenly, all hell broke loose really.. I didn’t hear what caused it but suddenly there were shouts from all directions of “GO GO GO GO GO” and I looked up to see hordes of firemen with axes and saws hurtling down from the top of the rubble hill I was working on the back side of .. They were all coming down towards me and me and my buddy simply turned and started running down, completely freaked, I thought there was an impending explosion or something so I ducked behind a huge metal sheet-wall sticking out of the rubble to shield myself, only to be almost flattened by firemen coming up over the top of it.. stupid friggin move on my part and very dangerous so I simply got up and ran down with them, flying over god knows what, almost falling, totally freaked..I didn’t stop until I reached the now oft mentioned Liberty Plaza building at the south east corner of Ground Zero (hate the term but don’t know what else to describe the main area)..This incident was mentioned in one of the New York Times Articles today, they reported that one of the remaining tower bases had collapsed causing this rush.. Me, I was there and I had no idea what had caused it as all I saw and felt was the rush…So, I then stood in front of the Liberty building with my buddy, sucking wind for a couple of minutes, when all of a sudden, another roar of “GO GO GO GO GO “ comes up and I look down the street and see hundreds of firemen and cops fleeing out of the side street and along and up the street in front of us, towards and past us, but not for long as I was immediately right on the side of the pack with them.. jumped down the flight of stairs in front of the Liberty building, turned the corner around some concrete wall, lost my stethoscope, kept running, turned to see what we were running from, had no idea, but now I was totally a mess, cause I thought some huge cloud of rubble or fireball was gonna engulf me as I was running (I had been definitely watching too much TV over the past 24 hours ‘cause all those images of people outrunning rubble were embedded in my brain).. Finally stopped as I saw a lot of people had slowed down and all were looking up backward at the Liberty building which now had a slight visible twist to the side of it.. you could see it was not aligned right.. friggin 80 story building too and we were standing right under it when this last rush started.. To tell you the truth, at this point I really had had enough. I thought that we were now clearly violating the cardinal and first rule of trauma rescue, which was to survey the scene, and if determined not to be safe, then you DON’T GO IN. So, I kept walking, reached a new triage area at Pace University, which actually turned out to be the “old “ Liberty building one which had been moved an hour earlier these 6 blocks north to Pace, just by the entrance to the Brooklyn bridge..it had been moved due to someone deciding that the Liberty building was unsafe.. (I guess they had suspected it for at least an hour, but it took some guy seeing the twist in the building to start that rush to get us out of there)... totally nuts.. I really had gone in there under the assumption that the reports on television of a team of structural engineers having been sent out that morning to determine the stability of the adjoining buildings had been completed and satisfactory results been obtained... guess not.

So, at this point, call me what you want, but I no longer wanted any part.. I had no hard hat, no firecoat, just scrubs, sneaks, and a stethoscope (which this genius had gone back to get ).. I thought it was too dangerous, I was too tired, and felt that adding a tragedy to a tragedy was not really the right thing to do here, so we left.. I truly thought, perhaps selfishly, that this is work for the firemen, although the stuff we were doing was truly helpful and necessary and was what every single person, including all the firemen down there, was doing. It was all about digging and searching by hand and saw and blowtorches.. if you weren’t doing that or on the lines, you were passing out food and water.. friggin NYU CardioThoracic surgeons (11 years of training mind you) were doing a great job of handing out water to us.... there really were a ton of resources down there, not only the hundreds of men but medical supplies for all types of injuries, tons of water, sandwiches, cigarettes, gatorade, there was a bombed out burger king right on the corner which had all its counters filled with food brought in, there was also tons of equipment too, hundreds of large green steel trunks of stuff from the National Guard, huge piles of saws and axes and sledgehammers, shovels, crowbars, saws, torches, fiber-optic cameras, and dog units … however, at this point all those brigades we had formed to go into the rubble had all disappeared with that collapse of whatever it was.. I left, I just didn’t feel good about going back.. I don’t know how to justify this but then again I do…or I don’t, I just don’t know... I must admit though, that those guys down there I think are truly risking themselves to do that rescue.. I don’t know how many of them realize the danger they can be in when one of those piles or adjoining buildings come down but they are all in the rescue profession and are simply going ahead and doing what they do I suppose.. I really really hope that nothing else happens during the rescue because I had the strongest feeling last night when I was leaving that every step I took home was a safer one (I have some sort of need to argue that it was a saner one too, but will just leave it for now…..

Friday, September 14, 2001.

Addendum- I saw one of the guys I went down there with today, he told me he had gone back last night (Thurs) and that it was still really crazy.. At first he said they weren’t allowed in the rubble that day, due to the danger, so were just stationed at triage on the periphery, but at some point they needed help so they went in... He told me that there were even more “rushes” or “stampedes” than the day before and that it was getting out of hand... The slightest crash or scare sent everyone running for cover... They were not finding anyone, but everyone was still crawling all over the rubble, carrying stuff out still. I hope that no one gets hurt in those rushes ‘cause the one I was in was very dangerous and very scary...

A coda, twenty-five years later.

Reading all of that back just now, I got to the end and kept sitting with it, and another memory came up so vividly that I am surprised it never made it into the emails at all. That is because it wasn’t one day. It was every day, everywhere I went, for months.

Everywhere in Manhattan and Brooklyn — every place I lived, walked, worked, biked and traveled through — every telephone pole, every post, every side of a building, every storefront, every window was plastered with printed-out signs. A photograph, usually of a young, healthy-looking person. A name underneath. And then, in big black letters, HAVE YOU SEEN THIS PERSON?

They did not thin out. That is the part I still think about. Week after week, month after month, they kept appearing fresh. After it rained, you would see new ones, newly printed, going up over the ruined ones. And you would see the people putting them up, walking around in something like a fugue state — destroyed, grieving, and ultimately helpless, and this was the only thing left that they could do.

Anyone standing far enough back to have gained any emotional distance could see that it was futile. In any rational sense, it was bizarre, inexplicable behavior. Nobody was going to call.

I recognize it now, though, because I had been doing the same thing. We stood on that pile for six hours passing buckets hand to hand, and nobody had come out alive since seven o’clock that morning, and we knew it, and we kept passing buckets. People will keep doing the only thing available to them long after it has stopped making any sense. I did it too.

All those people, and all those signs, and how long it went on. That is the part I will never forget.

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The Stone and Water Series

Twenty-five years separate those emails from the books below. Sitting in Brooklyn at two in the morning, typing badly to people I loved, I had no notion that writing would turn out to be the thing I did. But the impulse has not changed — something happened, somebody ought to write it down, and nobody else was going to.

What changed is the evidence behind it. That week took me a night to set down. The Stone and Water Series took the most concentrated effort I have ever put into anything, as it is the most carefully researched work I have done, or expect to do.

You can buy the series, in whole or in part, from my website — where every book is personally stamped with my hanko — or from Amazon.

Note to my subscribers. On Monday, I wrote a whole post explaining that Medical Musings was heading in a new direction, away from its historical Covid-dissenting content and instead would focus on minerals, water, agriculture, and the foundations of health. It is now Wednesday, and today's post is about a Canadian physician who lost his license for being a vocal Covid dissident. I have had gym memberships last longer than this promise, my God.

Anyone who has worked a bad night in an ICU or an emergency department knows the bond it leaves behind. You look to your side, in the middle of the worst fight of your life, and realize someone is standing in the same fire you are — taking the same incoming, refusing to run for the same reasons. Dr. Mark Trozzi spent twenty-seven years in those rooms before any of this started. In Covid, he became that person for me.

I recently sat down with Mark for a long conversation on his podcast about my book The War on Chlorine Dioxide, but we also “went there” and talked a bit about how Covid upended our lives and careers. I did it gladly, as it was a chance to spend an hour with a man I admire enormously and to point as many people as I can toward his work. So rather than promote my own appearance, I wanted to do something better: tell you who Mark Trozzi is.

So here's how this post is built. I took sections from posts that Mark has written on his Substack, and what follows alternates between the two of us: my impressions of Mark and what I make of what happened to him, and then Mark himself, unedited and indented, telling you what it was like from the inside.

And a confession. As I assembled the portrait, I kept running into uncanny similarities with my own life—our careers, our interests, our public dissent, who we each turned out to be afterward. So maybe I lied when I said I wanted to write about him. Forgive me if some of me ends up in here too.

A Teacher, First

Long before any of us had heard the word “Covid,” Mark was doing the work that holds not only emergency medicine, but all specialties together. Twenty-seven years in Canadian ERs. A veteran instructor in trauma care and critical resuscitation — the exact skills you want in the room on the worst night of your life. The American College of Surgeons selected him as an Advanced Trauma Life Support instructor; he held teaching appointments at three Canadian medical schools, and he spent years mentoring medical students and residents. He even ran a program introducing high-school kids to medicine.

Me: I did a version of the same work — Simulation Training Director for medical emergencies, Director of a pulmonary and critical care fellowship, and recipient of numerous departmental Teacher of the Year awards at multiple academic centers — which is why I recognized the instinct immediately.

I put the teaching first on purpose, because it tells you something essential about him. Mark is a natural educator — patient, precise, genuinely delighted when he helps someone finally understand. That instinct is exactly what he carried into the fight that would cost him everything.

The Stand

When 2020 arrived, Mark did what good doctors do: he studied. And the more carefully he looked, the less the official story added up — on his side, he saw the empty ERs that were supposed to be overflowing, then the pervasive reflexive dismissal of early treatment, the strange new certainty that shut down every honest question. Bound by his faith and his oath, he couldn’t stay quiet about it (neither could I, apparently).

But then, at the start of 2021, he did something that I was not capable of doing; in fact, I don’t think it would have ever occurred to me to do it. He deliberately stepped away from his career and his entire income — an open-ended sabbatical — to research full-time and warn the public. He built his Substack, DrTrozzi.news, and reached millions with careful, patient explanations of the science as he read it.

He told the College of Physicians and Surgeons exactly what he was doing and why. From Mark:

He also helped found the World Council for Health (WCH) and WCH Canada. He testified before the National Citizens Inquiry into Canada’s Covid response. He was invited to speak to parliaments and legislatures around the world, from Romania to Costa Rica to Japan.

My admiration knows no end; a trauma physician who walked away from a comfortable life to stand in the public square and say what he believed to be true—at maximum personal cost, for no personal gain.

“Ungovernable”

For that, Ontario’s College of Physicians and Surgeons came after him.

There was never a patient complaint. No one ever claimed he had harmed anyone in his care. His offense was speech — writing notes for patients who were being coerced, publicly defending other doctors the College was pursuing, and refusing to repeat things he did not believe. They restricted his license, then investigated, and after he briefly returned to practice to help save a persecuted colleague’s clinic, suspended him by lunchtime on his first day back.

"Writing exemptions" has been made to sound like a species of forgery. Here is what those notes actually said:

Mark’s suspension is the part that gets reported. What he saw in the half day before it happened is the part I can't stop thinking about:

In the end, the College declared Mark — their words — “ungovernable,” “unprofessional,” and “incompetent,” and revoked his license. He did not, it turns out, take it personally:

A man who spent a quarter-century resuscitating the dying and teaching others to do the same was ruled incompetent — not by any patient, but by an institution he had embarrassed. He fought it the only way left to him, through the College’s own tribunal and up into the Ontario courts.

The Courts

He knew the odds the whole way. Partway through, he found out exactly how bad they were, from a source he never expected. This is the part of his account I would most like you to read slowly, as it is one of the more sobering things you will read about in how these institutions actually work.

On November 1, 2024, the court dismissed his appeal on all grounds, upheld the revocation, and held him responsible for all costs (which is a good time for me to appeal for donations to support his work here and my work here:

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What It Cost

The bill came due in full. To keep going, Mark sold his assets and, recently, went through bankruptcy. By his own telling, he would have retired comfortably if the world had not asked him for everything instead. And here is the part that undoes me: he doesn't count it as the thing he lost. He counts the license, the house, and the retirement as a sideshow next to the thing he believes he was defending. He simply refuses to back down.

His work has not gone entirely unhonored — he received the 2023 Medical Heroism Award from LifeSiteNews and the 2025 National Braveheart Freedom Award. But awards are not why he did any of it, and he would be the first to tell you so.

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A Brother In This Fight

If Mark’s story sounds familiar to those of you who have followed mine, now you know why I wanted to write it.

We were both clinician educators before any of this, and we both testified before the National Citizens Inquiry. We were both invited to speak to parliaments — his were from Romania to Costa Rica to Japan, mine in Europe, Sweden, the UK, the Philippines, plus four times in the U.S. and a number of state legislatures. Though I should be honest about what those invitations often meant. More than a few weren't “in” the chamber at all; we were put in an anteroom while the leadership made sure no dissident expert was granted access to the official room. The European Parliament is the one that still makes me laugh. We got the grand chamber that time, hundreds of seats — but they were almost all empty. Nearly every delegate either refused to come or, I was told, instead watched our lectures stream from the privacy of their own offices.

Both of us were pushed out of the institutions we served. Both of us were branded with words meant to finish us. He lost far more than I did — I somehow landed on my feet and kept my license; they only took my specialty board certifications. But there is a fellowship in having been through it that is hard to explain to anyone who hasn’t. Mark is, in the truest sense, a brother.

He isn't finished. I'll let him close his own case.

So he went on his podcast to discuss The War on Chlorine Dioxide, where he impressed me even more because he had read the entire book and highlighted, annotated, and taken notes in the margins. I’ve done well over a hundred interviews for The War on Ivermectin and The War on Chlorine Dioxide, and in only three of them had the host read the book at all. Mark had read both.

Where to Find (and support) Mark

Let’s start with the GiveSendGo that others set up for him here. I think he deserves our help, at least for those who can, no? I am kicking this off with $250 right now.

Our conversation: Part I is here. Part 2 is here.

His podcast, which is part of his Substack: DrTrozzi.news.

His X is @DrTrozzi https://x.com/DrTrozzi

His testimony before the National Citizens Inquiry: Dr. Trozzi’s Powerful Testimony

His organizations: the World Council for Health and Justice for Medicine.

The book we discussed:

Donate to him. Subscribe to him. Share his work. Doctors like Mark Trozzi are a big part of the reason some of us still believe medicine can be rescued.

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

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From the Shameless Commercialism Department:

I write about minerals and water. Midway through writing my most recent books, I started a company that sells an aqueous mineral solution of the two.

Aurmina is a volcanic mineral water purifier that cleans water the way the Earth always has. Its chemistry is drawn from volcanic rock: an aqueous solution of twenty-nine individually measured elements, extracted — not synthesized — from a black mica documented to carry more than forty. Each is in sulfate form, which lets it dissolve and carry a charge.

Add it to a pitcher. The minerals bind the contaminants, the burden clumps and settles, and you pour off the clear water. No membrane. No power. No waste line. A geological shortcut: what an aquifer does over a season, Aurmina does in a day.

Purity and mineral breadth almost always trade against each other. Unlike reverse osmosis, Aurmina keeps the minerals in — producing one of the purest and most broadly mineralized waters on Earth. Check out our new website here.

Primora Bio relies on the same mineral chemistry for the water that supports the things we grow and love: plants, gardens, fish, and pets.

The Stone and Water Series

You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

Here it is, and it’s shorter than you’d think. As I neared the end of mapping out the science and mechanisms of Shimanishi’s mineral solution, I was forced to spend a disturbing amount of time in the agronomy, soil biology, and hydrogeology literature.

Disturbing because — what the heck is an ICU doc doing studying agriculture?

Easy. That’s where the science and data on Shimanishi’s minerals lived. There was no medical literature to read. So I had no choice but to develop real working expertise in soil structure, soil biology, and agriculture to understand how plants, soil, microbes, and minerals interact, and how water connects all of them.

I hereby confer upon myself an AI-Assisted Internet Degree in Agronomy, Soil Biology, and Geohydrology.

I stole that line from myself. For years, whenever a patient turned up having read deeply enough to propose a better option than the one I’d landed on — rare, but it happened — I’d say: “Which Internet School of Medicine did you go to? I’m impressed.” They loved it.

As it turned out, it also had an agronomy department.

Anyway, that is the whole story of the agronomy charts. There was no plan. I went where the evidence was, and the evidence was in the dirt.

Now let me tell you what getting there actually took.

A Trail I Never Could Have Imagined

Here is what made this year unlike anything I’ve ever done, and I have devoted enormous stretches of my life to researching narrow questions in medicine. The evidence behind this particular mineral extract was everywhere except a medical journal, a textbook, or a database.

It wasn’t in journals or anything peer-reviewed. The vast majority came from two Japanese agronomy technical volumes I had to have translated (by AI, of course). The rest were institutional agricultural studies or reports from a handful of countries — Mexico, Korea, China — unpublished and held in company or institutional archives. Then a handful of commissioned studies from distributors of Themarox-derived products, saved in Word files, or even relayed to me in an email with a couple of soil test reports. Oh, and let’s not forget the three Soviet-era research institute documents, which I also had to have translated from Russian, whose sophisticated in vivo and human studies remain unpublished and, in one case, didn’t even list the authors. Then the “Holy Grail,” a single, peer-reviewed, journal-published study on the effects of Themarox on the antioxidant activity of buckwheat sprouts.

It was the most bizarre evidence base I’d ever encountered.

As much as I want to hand this to an AI and get a slick graphic back to show you, I won’t. So here is the bulleted list of what I actually studied this year:

• The early mineral pioneers — Weston Price, Elmer Heinrich, Linus Pauling.

• The mystics of water — Viktor Schauberger’s vortices and the primordial sea of René Quinton.

• Mineral springs and healing waters — their history, their importance, and their recurrence across essentially every tradition and culture on Earth.

• Origin-of-life science — Lane, Russell, Hansma and others; deep-sea hydrothermal vents and layered silicate structures.

• A century and a half of mineral lock-up in our soils and the falling mineral content of our food, traceable back to the Broadbalk experiment of the 1860s.

• How the essential minerals were identified in the 1930s — largely by feeding rats single-mineral-deficient diets to see whether they’d collapse into illness. If they didn’t collapse, or if we couldn’t measure the element at the time: non-essential. That’s the standard. The rest of the soil’s mineral inventory has been almost entirely ignored by modern science ever since.

• The deep evidence bases for the importance of boron, lithium, and copper in treating and preventing numerous human diseases, while exactly none of them are routinely tested for or recommended for supplementation, despite a near-universal inability for human populations to hit even the falsely low daily allowances.

• Heavy metals, which I learned to divide into “industrial” versus “essential” (half our essential elements are heavy metals), including a deep dive into the non-toxicity and ubiquity of aluminum in our food and water.

• Many weeks spent inside Gerald Pollack, Gilbert Ling, and Franz Hofmeister’s work, plus critically evaluating their dissenting water chemistry papers, which were the most scientifically dense material I have ever tried to navigate.

• Modern water treatment — its goals, what’s in our water, what never gets tested or removed, and how much is still contaminated, untested, and poorly mineralized when it comes out of the tap.

• The cost of empty water - the proliferation of desalination plants, RO systems, and the little-known financial and physiological consequences of drinking demineralized water.

• The geological inheritance of water:

  

• Total immersion into the state of the world’s water, above ground and below: how its quality and chemistry have been degraded by industry and agriculture over the last hundred years, how rapidly it is being extracted and how it is beginning to actually run out in specific places, and what those places are now doing to keep people alive — and how almost none of it registers in the world’s media, because it is dwarfed and buried inside the larger, obsessive climate change story.

What It Cost

Over what became almost exactly a year, I lost a not insignificant number of subscribers (especially paid) to Medical Musings. Some left because the direction and scope of my research no longer interested them. One wrote, memorably, “I am not that into water.” Fair enough.

Others left for worse reasons. When the research for The Blueprint of Life took me into a small, discrete set of ancient Hermetic texts, some recoiled, convinced I was delving into the occult and practicing dark arts or some nonsense. Nothing, and I mean nothing, could have been further from the truth. I was following evidence about minerals and water back into antiquity, and into fewer than a handful of densely cryptic texts. When that path continued past those texts and into Scripture, it brought some of them back to the fold. But not enough. Oh well.

It isn’t that I didn’t care that I was hemorrhaging paid readers. I simply didn’t have a choice. Writers write about what captivates them. Yes, I had departed from the hard-charging, enraged-dissident health establishment attacks, interspersed with transformative research on the efficacy of repurposed and “alternative” therapeutics for COVID, cancer, and post-COVID vaccine syndrome — the work I’d become known for. But it was still a search for health. Just across physical, ecological, and eventually spiritual realms instead of only the first one.

Why I Couldn’t Keep Fighting

What really happened is that I could no longer keep up the daily intensity of fighting, uncovering, and exposing the fraud and lies we all lived through in COVID. Not because that work stopped mattering; I just couldn’t sustain interest in it any longer. I felt I had reached as many as I could reach, and further efforts were simply validating and satisfying those who already knew rather than continuing to enlighten the unenlightened. Plus, so many were still doing it so well.

How long can one man scream about the toxicity and lethality of the Covid (and all) vaccines, the efficacy of the innumerable repurposed drugs suppressed and distorted by mainstream media, medical journals, public health agencies, and universities, the corrupting practices of Fauci and the pharmaceutical companies, the devastation of illness I see all around me, and the horror and the unfairness of all of it?

The work I put into the first four years of Medical Musings effectively turned me into an expert on Disinformation tactics. But teaching the public about disinformation all the time just… stopped exciting or inspiring me as it once did.

I started to feel like “Johnny One-Note,” plucking the same sound on the same instrument over and over. As I started to realize this, I also saw my admiration soar for friends who could sustain that intensity and focus — like Steve Kirsch, bless his heart. Steve is the quintessential dog with a bone. Five-plus years now of daily, indefatigable effort, first exposing the COVID vaccine catastrophe, then the century-long vaccine myth, and finally, proving to the world that autism is, in the end, simply vaccine-induced encephalopathy. The world needs more guys like Steve.

Once I exposed how deeply the COVID fraud ran through so many of our institutions, some really interesting people started finding me—a cadre who had been awake far longer than I had, some reaching out directly, others simply appearing in my circles. That is when my education moved past disinformation tactics and into considerably darker territory.

It began with a documentary, From JFK to 9/11: A Rich Man’s Trick, and what I learned afterward—that some of the most consequential events in modern history were false flags: Pearl Harbor, the Gulf of Tonkin, 9/11, and more.

So the history books are lying too? I remember thinking.

From there it ran into the long history of secret societies — the Illuminati, the Masons, the Rothschilds — and into what people born into that kind of power, or handed it, appear to turn to once fame and money stop doing anything for them. Pedophilia. Trafficking. Sacrifice.

Eye-opening, mind-boggling, world-perspective-changing. But then my interest in that waned too, and fast. Too depressing, too predictable, and ultimately too powerless to do anything about. I wasn’t learning anything that would help me live a better life or be a better person. Wiser and savvier, maybe. But nothing to build a life around.

So I got bored and exhausted with it all. Tired of the lies, the fraud, the corruption, and frankly, tired of learning about the pure evil in the world.

That doesn’t mean I’ll never drop the gloves to fight evil and fraud and lies again. I still will when it’s needed — like the post on our legal win over California Attorney General Rob “Bastard” Bonta, or the piece I wrote with attorney Aaron Siri about the insane suppression and misrepresentation of the two Texan Mennonite girls who did NOT die of measles. But those are going to be the exception now, instead of the norm they were for years.

Yeesh. When I look back over the first 350 essays I wrote here — man, do they bang that drum, louder and more powerfully and more accurately over time. I understand that is what a lot of you came to like me for. I just don’t like me doing it all the time anymore.

So if you don’t want to stay, I get it. There’s not enough time in the day to read everybody, especially if other things interest you more.

What Saved Me

The real reason I couldn’t do it anymore is that I got saved. Not in the way you’re thinking; it was more like being intellectually saved. It started with Shimanishi’s extract: fifteen solitary years of labor, finished in 1977. Soon after encountering it, I began watching its various applications produce responses across biological kingdoms.

Then I came across Russian researchers describing rats hydrated with Themarox-treated-water as becoming more active, with shinier, healthier fur than the rats given ordinary water. Then I received testimonials from colleagues of patients who reported things like increased energy, improved vision, thicker hair, and faster-growing toenails on concentrated dosing protocols.

So I found myself pulled deeper and deeper into a single question: what is this? How does it work? Why does it work? And what else can it do?

The Book I Thought I Was Writing

My first impression was simple: it worked by supplying minerals that biology had become deficient in. So I wrote a book about the history, the science, and the importance of minerals in health and life. I called it From Volcanoes to Vitality. I put it up for sale. And I was done — three intense months, start to finish. That was mid-October of 2025.

I still feel guilty about keeping those early purchasers waiting so long. I’ve sent progress updates and sincere apologies along the way, but I suspect more than a few of them concluded they’d been grifted.

Last week is the week I proved them wrong. Sort of - the printer just reported a two-week delay, ugh.

But here’s what happened. Every time the manuscript was being readied for the printer, another door opened. Another insight arose. Another inexplicable piece or set of data appeared. And back down the rabbit hole I went, accompanied by my research collaborator and mineral expert, Matt Bakos.

That happened over and over for the next year.

The Work

Eighteen-plus-hour days at my desk, in between seeing patients. Obsessively. For a year.

No other stretch of work in this admittedly highly productive ICU doctor’s career ever approached it. Building the FLCCC with Paul in the early years of COVID, then fending off the global media attacks while losing our careers and reputations, none of it came close because this was more solitary, more focused, more intense, with only a single collaborator at my side. Matt was indispensable, central even, but he also did not write a word of the books.

The scope of the work nearly buried me. There were weeks I spent down inside the electron transport chain, studying the way iron and sulfur hand electrons down the line, while Matt kept showing me yet another process that depended on yet another mineral: every organ, every enzyme, every receptor I looked at seemed to lead back to the same handful of elements, and the deeper I went, the more granular and unmanageable it became. I had a large story I was trying to tell, and I kept getting stuck in the weeds of mechanisms I couldn’t simplify or skip, and the frustration was constant.

It was harder still because I was doing it in the cracks of a busy working life. Until the final month, I carried my patient schedule, and the two could not both have me. Every time the writing finally caught fire, it was time to see a patient, and every time I was with patients, the book was pulling at the back of my mind. I felt divided in a way I could not resolve, and I gave neither side the whole of my attention as often as I wanted to.

Why I Stopped Seeing Patients

I should be open about why I stopped, because the timing was no coincidence. Two things were happening at once, and they pulled in the same direction.

The first was that my inspiration for tending to patients, which had carried me for decades, was quietly running down — not into bitterness, and not into any failure of care, but into a kind of completion, as though that particular well had given what it had to give.

The second was harder to admit, and I know how it sounds. The pull toward this work — toward the minerals, the research, and the task of carrying what Shimanishi achieved out into the world — had stopped feeling like just another in a series of research rabbit holes I had gone down since opening my practice, and started feeling like something I was simply meant to do. I am wary of men who believe they are called to the world, yet I cannot describe what happened to me over these months in simpler terms.

The honest version is that I was finished, spiritually and intellectually, with one kind of work, and overtaken by another. For a while I tried to carry both. A man doing that does neither well. So I stopped.

My only regret is that I did not do it sooner.

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

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The Life Around It

Somewhere in the middle of all of it, I also started a company — which turned out to be a full-time education in everything that no one teaches a physician.

How much warehouse space you need, and how much inventory to put in it. Where to find bottling and labeling equipment. How to hire a warehouse manager. What the FTC, the EPA, and the FDA each require on a label — three different answers to the same question. How to argue with UPS and USPS about a broken package, and who eats the cost of a return.

And how to build a customer service department, which in our case was initially very easy — Lisa K.

However, I have to say that Matt and his wife Lisa (“Lisa B”) made all of it considerably less painful than it should have been.

We also lived out of suitcases for a good stretch. Even though I have only a small circle of friends here in Sarasota, and my only leisure is the occasional meal out, home dinner invitation, or a round of golf — err, half a round of golf; who has time for eighteen holes? — I felt I needed complete solitude and disengagement.

So, despite the irony of being Swedish and famously intolerant of cold, Lisa agreed to be snowed into a cabin in Montana with me for two months, pregnant and far from her friends and her routines, while I wrote eighteen hours a day and lost all sense of time.

The Wild Looking Back

One memory I will always keep is that the cabin came with a bag of deer feed and permission to use it.

I put some out the second day and watched them come, and that was that. It became the thing I did, and something I had never done in my life. Every time I looked up from the desk and saw them on the slope, I was out of the chair before I had decided to be — Lisa can confirm this, and found it considerably funnier than I did.

There were a dozen or more deer in the area, but two of them, a mother and I presume a daughter, came alone, and most often by far. I named them Margie and Bambi. They would stop eating and look up, and we would hold each other’s gaze for a while, and I have no scientific word for what passed between us.

Over the weeks I set the feed closer and closer to the cabin, until they were eating a few feet from where I stood, shivering on the back deck in my slippers. I had never been so close, for so long, to such majestic animals. The energetic connection was intense.

I would then come back in, regaling Lisa with the closeness I felt, the intimacy, the joy, the beauty. It was weird, a former two-pack-a-day chain-smoking, drug addicted, foul-mouthed Long Islander pulmonologist going on and on about the relationship he was forming with two deer in Montana.

Soon after, I started coming back in swearing, all upset because a different, more dominant pair were muscling in and driving Margie and Bambi away. So I stopped putting food out until they let Margie and Bambi come back alone. Which they did. Often. The whole time I was there.

I will never forget the sadness and longing for them that I felt in the days after I left back to… Florida.

At one point during that time I actually asked an AI why deer make people feel like that. It gave me a long and serious answer. I read the whole thing. The short version was that a deer offers nothing but presence. It is vulnerable and entirely wild, and when it stops and looks at you, the usual chatter falls away. For a moment, life itself seems to be looking back. Some people call that wonder. Some call it God.

I chuckle, thinking back to the fact that I spent much of that time buried in electron transport chains and mineral deficiencies, but what I remember most about Montana were those two deer.

And then, at the end of the year, our son Lazlo arrived — the one deadline in all of this that was never going to move.

The Crisis I Wasn’t Looking For

Somewhere towards the end of that self-assigned dissertation, I stumbled onto a largely man-made global food and water crisis that has little to do with climate change. It began subtly around the year 2000. It is now accelerating rapidly. And the world’s leading scientists and policymakers barely discuss it.

The crisis began slowly, and almost imperceptibly, driven by the progressive degradation of the world’s water quality and chemistry, a result of decades of NPK fertilizer being laid down over nearly the entire world’s farmland, compounded by reckless corporate industrial pollution over the same decades.

The massive 2.4% annual agricultural yield gains produced by the Green Revolution, which helped support an unprecedented rise in the human population, started to slow. And slow. As they slowed, for the first time in decades, food prices started to rise. Something they are doing faster and faster of late.

That crisis is underway and being documented in the agronomy literature.

But then I stumbled onto the upcoming water bankruptcy crisis, documented in the hydrology literature, which will soon compound the unfolding food crisis. Water shortages are both increasingly projected and popping up across the world, arriving faster and larger, with each region and aquifer opening up more rabbit holes for me, like the slow-moving car crash that is the Colorado River Basin’s Lake Mead and Powell, and how Saudi Arabia effectively ran out of groundwater so they started borrowing (effectively stealing) Arizona’s.

But the Indus Basin is the one that keeps me up at night. Indian Punjab grows a tenth of India’s rice on water it does not have, and 72 percent of its irrigated land now runs on tubewells. As the table drops, shallow wells go dry, so farmers drill deeper and fit stronger pumps—each round pulling harder on the same shrinking reserve. It is a race to the bottom with a literal bottom. India’s Central Ground Water Board projects that, at current extraction rates, Punjab will exhaust its usable groundwater in the upper 300 meters by roughly 2039.

That is within the working life of a farmer planting there today.

Why There Are Two Books On the Crisis and Not One

That crisis is what Earth’s Living Water builds toward and explores in depth. But then I realized something uncomfortable: a message that urgent, affecting that much of the planet, was never going to travel fast or far as a 715-page, 70-chapter, 200,000-word book in an unwieldy 7×10 inch format.

Hence, The Silent Aquifer. Short. Fast. Hard-hitting. Built to be read in a couple of sittings and handed to someone else. Same emergency. Different weapon.

The Strangest Turn of All

And then there was the side excursion, if I can even call it that, given that it produced an entire book.

While chasing the mineral and water trail backward, Matt kept pointing to unimaginably cryptic descriptions in certain ancient texts that he had encountered in his own twenty-year journey, which, once deciphered, depicted three things at once with striking precision: the steps by which Shimanishi’s extract is produced, the properties it holds, and the kind of man capable of producing it. Discovering a 500-year-old Hermetic text that described Shimanishi's character to a T really spooked me. I still haven’t gotten over that one.

I never could have imagined writing a book on those subjects. I stopped posting most of that work here, because I knew my readers couldn’t hold a thread that I myself could barely hold.

And then the search moved past the texts. And to God.

I want to be careful about how I say this, because it is the largest claim I have ever made in public and it deserves more than one sentence.

What I found is that those ancient texts appear to record knowledge of the hydrogeologic cycles that a growing number of modern scientists now believe birthed and regenerated life on Earth: aluminosilicate architectures visited by iron and sulfur — none of it possible without water.

Those cycles, and water’s central role in them, are pointed to sometimes literally and sometimes metaphorically across a number of ancient texts, and above all in Scripture — written by people who should have had no way of knowing any of it.

Which is what brought me to the Blueprint‘s ultimate conclusion. Knowledge like that could only have come from the Architect of the thing described. I suddenly saw clearly that the world we live in was designed and governed by a physical architecture of remarkable order and elegance—and by a moral architecture running alongside it. Most importantly, I came to the understanding that the more closely we live in accordance with both, the better off we all are, individually and communally.

I still can’t quite believe I just wrote that paragraph. I am aware of how it reads. I made the argument carefully and at length in the book precisely because it cannot be made carelessly and in brief, and if you want to fight me on it, fight me on the pages where I actually built it.

The Return

If you’re still with me and haven’t left thinking this man is evincing such delusions of grandeur that you can’t stomach another word (I get it), but there’s one more thing.

The whole journey, with all of its stops and starts and reversals and wrong turns, had also delivered a way out. I call it the Return: a feasible, viable path to averting the same catastrophe I’d spent the year diagnosing.

Three things make it plausible at scale. Shimanishi’s mineral solution is extracted from biotite, which makes up roughly seven percent of the Earth’s crust. It can be produced by an unpatented process. And it is catalytic, which is what matters most here: tiny amounts condition enormous volumes of water. Whatever else turns out to be true, this is not a scarce answer, and it is not a proprietary one.

Now, where I think it would actually matter.

Agriculture runs on two kinds of water. Green water is rain, held in the soil, feeding crops where they stand. Blue water is what we pump — rivers, reservoirs, and the aquifers we are steadily emptying. The crisis in my books is, at bottom, a blue water crisis: for fifty years we have compensated for green water’s underperformance by pumping harder, and the pumps will soon be running out.

Which is why the largest opportunity, and the one the evidence supports best, is raising yields on rain-fed land. If green water can be made to produce substantially more, the demand on blue water falls — and the world can grow what it needs without draining the aquifers beneath it. That, more than anything else, is what I mean by the Return.

The second is reclaiming wastewater, which matters most in the blue-water regions under the heaviest stress.

The third is bringing sodic and saline ground back into production — land already farmed to death, in either kind of region.

The fourth is the broadest and the least defined: better yields generally, higher nutrient density, more productive aquaculture. More food per acre, more nutrition per calorie, and perhaps less land under the plow to begin with.

I want to be honest that this is where my certainty ends. I do not know how far any of it goes. What I believe is that if this material’s potential were fully explored and properly validated, the uses for repairing, restoring, and preserving what we have left would be innumerable, especially when focused on and plotted by far greater minds than I have.

One Conclusion

One year. Thousands of hours. The end of a twenty-five-year medical career, and the abandonment of very nearly every social and living habit I had built my adult life around. All of it produced a single conclusion. Just one. Here it is.

The living water that has sustained this Earth since its beginning has been altered. Not yet depleted, although that will soon come, but altered in its chemistry, and faster than the planet’s own systems can answer. And the way back is a rock. Shimanishi’s mineral solution, and the biotite it is drawn from — a mineral so ordinary it lies under nearly everyone reading this — is a pathway to restoration. I would use the word salvation, while also acknowledging how insane it sounds when used quickly or loosely.

Because the problem underneath the Earth’s fields and aquifers is, at bottom, the degradation of water chemistry. And that is precisely what these minerals restore: binding and removing the thousands of chemicals humans have manufactured into that water, while returning to it the redox-balancing, ion-exchanging, and hydrating properties it needs to fully support the biology living on top of it.

A problem in water chemistry. Answered by rock.

Which is, in the end, the oldest arrangement on Earth.

What A Year

Publishing three books feels like reaching the first peak. It isn’t the summit — I have a feeling there are more of those out there than I can see from here. But this one feels good.

That’s the story. A year of eighteen-hour days, one collaborator, three books, a company, a lot of suitcases, a baby, a lot of lost subscribers, and a research trail I could not have envisioned, imagined, or come close to anticipating — even after devoting immense stretches of my life to researching medicine.

It was also the year I ended my medical career. I retired my patient panel, set down the bedside, and gave the hours to soil and water instead. I did not see that coming. I don’t regret it.

To those of you who stayed through a year in which I published in incoherent spurts, disappearing down one rabbit hole and prematurely reappearing from another: thank you. You paid for this year. It’s yours as much as mine.

To those who bought From Volcanoes to Vitality back in October of 2025 and waited: it eventually grew into three books. I hope that’s a fair trade.

And to the reader who left because he wasn’t that into water — no hard feelings. I understand completely. But let me tell you what I’d tell him.

There is no such thing as not being into water.

You are about sixty percent water. Seventy percent of all the fresh water humanity withdraws goes to growing what you ate today. It is the only subject I have ever worked on that has no out-group — nothing it doesn’t touch, nobody it doesn’t reach, no one who gets to sit this one out.

I previously spent four years writing about a fight that came down, in the end, to a handful of drugs and the people who buried them. That work mattered. It still does, and it is still true.

This is bigger. This is the ground and the water beneath the food that is beneath everyone.

I’m going to keep following it, and I’m going to keep reporting it here — the aquifer crisis almost no one is covering, the evidence base I’m still uncovering, and whatever the next collapsed theory ends up teaching me. I opened the lid on this story. I’m not closing it.

So if it matters to you, stay. And if you know someone who drinks from a well, or farms, or who has simply wondered what is actually in the glass in front of them — send them this.

Onward.

— Pierre

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

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Labor Day Sale:

The Stone and Water Series

You can purchase the book series, in whole or in part, from my website ( where all books are personally stamped with my hanko) or from Amazon.

**If you want to skip today’s post and go straight to our Labor Day sale, check out our new website at Aurmina.com (which, across its pages, tells a similar story to what I will tell today). Use code LABORDAY25 to get 25% off the 8oz and 32oz Aurmina bottles as well as our new Korea Ceramic Gravity Filter.

The other day I promised you the story of how an ICU doctor ended up topping the new release agronomy charts, a ranking I am somehow still clinging to—ELW is the #1 new release in Agronomy, and TSA is #1 in Agriculture and Food Policy:

That post is coming Monday. Today I want to address something else first: admitting to a particular kind of embarrassment that is available only to people who start a company before they finish their homework.

Ten months ago, I formed Aurmina (“golden mineral essence”) for drinking water and later Primora Bio for watering plants and irrigating gardens and greenhouses, after coming across a body of Japanese mineral chemistry and becoming convinced it was immensely important. Not sorta convinced, but fully convinced. I have only gotten that feeling a couple of other times in my career, when the potential of something you come across is obvious long before you can confidently explain it or fully understand all its nuances.

What really pulled me in was not a testimonial. It was Asao Shimanishi — an old-school pharmacist, not a marketer, who spent close to fifteen years trying to get minerals out of rock, a feat he achieved in 1977, and whose subsequent exploits and achievements stayed almost entirely unknown outside his home country, and even there his work was largely obscure.

But I figured others would be able to see the value in it that I had, so, with the help of the North American importer, Lisa and I started a company to sell a finished product made from his raw material, which Shimanishi called Themarox, or “Rock Extract.”

I also want to say how strange that decision was. I had never sold anything in my life. I had never wanted to. In a career in medicine, I had recommended treatments, argued for them, and occasionally gone to war over them — but there was never a transaction with my name on the other side of it, and I liked it that way. Selling is not in my nature, and I was genuinely hesitant.

What overrode the hesitancy was simple: I believed this mattered, and no one outside Japan was going to encounter it unless somebody put it in front of them. That somebody turned out to be me, which is not a sentence I ever expected to write.

In my defense, and in retrospect, the alternative would have been to sit on it for a year while I researched and wrote. However, I have to say that Aurmina helped support the immense amount of time I devoted, especially after retiring my patient panel, but I also want to acknowledge what that process must have looked like from your side of the screen, because I think some of you noticed.

You watched me effectively “rebrand” my own product a half-dozen times.

If that was confusing, it’s because it was confusing. It was confusing for me. I was doing my research in public and asking you to buy from me in the middle of it, which is not a normal way to run a business, and I don’t especially recommend it.

Thinking it was a health supplement (which it is not), I tried to find evidence for it impacting human health, but I had almost no human data to work from. Beyond Dr. Nojima’s book, what I had was agricultural and biological: field trials showing dramatic yield shifts, premium Brix scores, increased photosynthesis, antioxidant improvements, all written down in Japanese technical manuals which also included impacts on aquaculture: eels raised in Themarox-conditioned water growing to harvest in half the time at 30% higher stocking density while producing unusually high-grade meat, soils showing increases in microbial biomass, pest and disease pressure falling away, earthworms returning to treated fields.

One standout finding was a study showing up to 85% (average 50%) less pesticide uptake in treated plants when the soil received Themarox-treated water.

For the first time in my career, I was looking at something reported to act across nearly every layer of biology at once, with no precedent I could name. No vitamin, antibiotic, immune modulator, cytotoxin, or metabolic therapy I had studied operated on bifidobacteria, basil, eels, and soils simultaneously. The only analogy I could even vaguely think of was aspirin, since salicylic acid participates in signaling in plants, but even that broke down quickly. No one treats a microbe with aspirin.

To understand what this mineral extract was doing, I had to leave medicine and enter microbiology, plant nutrition, soil biology, hydrology, irrigation science, mineral chemistry, and eventually the physical chemistry of water. I had crossed into animal literature many times in my career, but I had never crossed into agriculture, soil biology, or water chemistry. At first it felt absurd, almost like a category error, until I saw that the borders between those fields exist only in universities and journals. They do not exist in Nature.

From Mineral Depletion to Geodynamic Conditioning

Every theory I built around these observations eventually failed somewhere. That failure became instructive. Each collapsed theory redirected me: away from missing nutrients, single pathways, and therapeutic mechanisms, toward the primordial properties of water on Earth.

Although I am the named author of the books, the arguments they contain emerged through close collaboration with Matt Bakos, now a close friend and colleague. Intellectually, he is its co-author and, in some respects, its senior author. Matt has been the sole importer of Shimanishi’s Themarox in North America for more than two decades and has studied them with a depth and persistence that borders on obsession. My equally obsessive interest in the mineral solution, along with my writing skills and ability to perform systematic research, produced the books, but Matt’s knowledge guided almost every step along the way.

The other unexpected catalyst was artificial intelligence. With it, I could access and integrate PhD-level knowledge across disciplines that rarely speak to one another, and that I had never studied. Incessant questioning with artificial intelligence transformed the scale and speed at which synthesis became possible. It let me traverse fields that normally remain isolated behind academic boundaries and assemble mechanistic models with a coherence that would have taken several degrees and many years to construct alone.

But it also taught me something unsettling: coherence is not proof.

More than once, I arrived at models that appeared complete, internally consistent, and strongly supported by literature, only to watch them fail under deeper challenges. AI could align papers, connect mechanisms, and produce explanatory symmetry so persuasive it became easy to mistake coherence for truth. Every prior version of the main book had evidence to back it up. Every version could be defended with references. Every version reached a conclusion. Yet each eventually collapsed because of an observation it could not explain or an assumption I later realized was wrong. A seventy-chapter manuscript does not enjoy being rebuilt five times. Neither, for the record, does the person writing it (nor the person who pre-ordered it last November, yeesh)

The mineral repletion theory came first: Themarox appeared to restore what a century of falling nutrient density had stripped from our food. That was the theory I was selling under, and why the label read ionic sulfated minerals, and later deep earth minerals. That collapsed when I calculated the concentrations of the 29 elements we measured in the solution—all were minute, far too small to supplement anything. So I moved to the rock itself. Biotite, or black mica, carries one of the most diverse mineral inventories in the Earth's crust (industry experts have said it can contain up to 80 elements), so perhaps the extract was restoring the ultra-trace and rare-earth elements that nutritional science had largely ignored and that modern soils and bodies had lost, thus “awakening a dormant physiology.” I called the theory behind it Mineral Spectrum Collapse and held onto it the longest. Clever, heavily referenced, yet it failed to explain what it needed to.

Then agriculture shifted the problem from mineral absence to mineral access, and I named the lithobiome — the microbial fraction that weathers minerals out of rock — and wondered whether Themarox was stimulating it. But animals have no lithobiome, and the effects crossed plants, microbes, animals, soils, water, and people at once. So I expanded it into Carbon–Mineral Collapse: disrupted microbial carbon flow impairing weathering, ion mobility, water chemistry. The messiest of them, and the quickest to die.

The problem was that each theory kept requiring another theory. The explanations grew more enticing, but less constrained. AI could find threads of supporting data for almost anything, and what first looked like explanatory power was, in fact, gaps papered over. Coherence is not proof.

They had all failed for the same reason: none of them went deep enough. That is when I realized that everything alive requires three things — water, minerals, and carbon — and I had spent four theories on the last two. Water I kept treating as the backdrop.

Then I started seeing it as the layer connecting every relationship I was studying: minerals and microbes, microbes and plants, plants and animals, cells and tissues, organelles and cytoplasm, etc. And beneath all of those, every biological process: the signaling, the gradients, the exchanges, the transport, the electron and energy transfers. All of it happens in aqueous solutions.

It was only when I began studying how water and minerals become a functional biological medium that I exited the labyrinth.

The Structured Water Pivot

But I still didn’t get it right at first. Once I decided that the water that Shimanishi’s minerals produced was unique, my next theory, if I am being honest, was a structured-water theory, largely because a UV absorption test of Themarox-treated water revealed Pollack's characteristic peak of 270 nm, which he claimed was diagnostic of his Exclusion Zone (EZ) water, and which many began to call “structured water.”

But I eventually set that down for two reasons, after spending a difficult and immense amount of time within Gerald Pollack’s work. The first is that Pollack’s EZ water, with the same absorption peak — the fourth phase — contains no minerals, and minerals were the entire subject I was studying. The second is that “structured water” had become a swamp, both scientifically and commercially, undefined and overclaimed, and language that is compromised cannot carry a serious theory even if something real lies beneath it.

But I still couldn’t let the concept go. I shifted to “coherent” water, thinking I had found a related property in the work of Franz Hofmeister, who in the 1880s described how different ions change the ordering of water molecules and of the proteins dissolved in it, e.g., cosmotropic and chaotropic ions. Since Themarox contained one of, if not the strongest, cosmotropic mineral profiles I could find, at one point, our website said “cosmotropic mineral solution” or something like that. But eventually, I decided that coherent and cosmotropic water was just structured water under a more careful name. So it died the same death.

Rock, Water, and Time

What finally survived was “geodynamic” water, after discovering that geodynamics is an actual scientific discipline. Geodynamic processes produce water whose redox, ion-exchange, and hydration properties have been shaped by prolonged interaction with Earth’s active geological processes. I started to see that water is not a solvent that minerals happen to dissolve into, but the downstream expression of the planet’s own processes: the product of a long geological history.

Which is what Aurmina makes. It is what Shimanishi called Rock-Water — a phrase I had been repeating for months before I was finally able to understand it literally. Water brought back into contact with the geochemical history of rock.

And beneath all the dysfunction I had been chasing across plants, animals, soils, and people, I finally saw what they shared: a broken inheritance between rock, water, and life. Somewhere in there, the thing I’d been selling for ten months resolved into focus, and it turned out I had been describing it wrong the entire time.

It is not a supplement.

It is a water purifier and a water conditioner.

That’s it. That’s the whole correction, and it took me ten months and three books to arrive at a sentence I could have fit on a business card. But there was also something on the back of the card, which took me longer to see: it works by the same chemistry the Earth has used to make water since the beginning.

Nature Always Cleaned Its Own Water. We Just Gave It Too Much To Clean.

For nearly all of history, the Earth purified its own water — and what it had to purify was mostly organic. Rotting leaves, dead animals, microbes, sediment, the ordinary waste of living things. Stone, minerals, and time broke it down, bound it, and settled it out, while keeping the water biologically alive. Think of the springs of antiquity — waters people traveled to, wrote about, and built cities around, sought out for refreshment and for healing. Some cold and clear, some steaming out of the ground. What the waters had in common was that rock that had made them what they were- different rocks, different waters, but all were rock-conditioned water.

That was simply what water was.

I look at pictures like these with new eyes now:

Earth’s system still works. It is just that it was never built for what we started handing it.

There are now hundreds of thousands of chemicals in commerce — pesticides, solvents, pharmaceuticals, industrial byproducts — almost none of which existed a century ago, and nearly all of which end up in water. And there are eight billion of us, up from a tiny fraction of that two centuries ago, concentrating our waste into the same rivers, lakes and aquifers nature once kept clean for far fewer of us.

One major argument of my book (s) is that the world’s water quality has been degrading, not only in the aquifers but in surface waters too, and that this change — largely driven by the Green Revolution and modern industry — amounts to what I’ve termed a Geohydrological Shift. I then argue that this shift is driving annual agricultural yield gains below what is needed to feed the human population, threatening our very survival in the lifetime of those reading this post. Some of us, anyway.

But those are not the only forces changing our water. I also went deep into modern water treatment: what its goals are, what its goals are not, and what goals it can never achieve. Knowing those limitations, many people, particularly in wellness circles, have gone looking for purity, and what they found was reverse osmosis. RO is what’s under everyone’s sink now.

RO works by force

RO pushes water through a membrane at pressure and strips out essentially everything, contaminants and mineral content alike. That is the whole design. It does not distinguish between what you want gone and what you want kept, because it can’t.

It also means that the water it delivers is not neutral.

I hate being the one to tell you this, because I sell an alternative and you have every reason to hear that as marketing. So let me hand you the least excitable source available. Twenty years ago, after years of desalination plants and RO systems being used around the world to produce drinking water, the World Health Organization published a chapter titled Health Risks from Drinking Demineralized Water, and it is not equivocal.

Water below roughly 100 mg/L of total dissolved solids (TDS) increased diuresis by about twenty percent in human volunteers, raised serum sodium, and lowered serum potassium. It doesn’t just fail to deliver minerals; it pulls them. Cook with it, and you lose up to sixty percent of the magnesium and calcium in the food itself, and more of some trace elements — 66% of copper, 70% of manganese, 86% of cobalt. It is aggressive enough to dissolve metal out of the plumbing it passes through, and the chapter documents three infants lead-poisoned that way, one at 42 µg/dL.

WHO’s recommended minimums are 10 mg/L of magnesium and 20 mg/L of calcium, with optimums well above both. Reverse osmosis delivers a tiny fraction and distillation none. And municipal water often barely clears the bar itself:

There is also a fifty-year epidemiological literature associating soft, low-magnesium water with cardiovascular morbidity and mortality. I know: correlation, not causation. The WHO says so itself, and so must I.

“Fine — I’ll just put the minerals back”

That is the first thing anyone says when they hear this, and it is a reasonable thing to say. That is why remineralization cartridges exist and why they sell, although from the many discussions I have had with my patients about their RO systems, surprisingly few have either installed or maintained a remineralization filter.

Either way, I looked at how well they actually work and found that only two companies publish reasonably complete data on the water their filters produce. Here is that data:

I was shocked. What they add is a short list of minerals at concentrations that don't approach the optimums that the WHO recommends, let alone what water that has moved through rock actually carries—and the two companies willing to publish are, presumably, the two with the least to hide.

What It Costs the Homeowner and the Aquifer

RO recovers only 10–25% of the water it filters, which means three to nine glasses go down the drain for every glass you drink. The EPA’s own figure for a point-of-use system is about 5,320 gallons discarded a year to deliver roughly 940.

That is a strange thing to have discovered while writing a book about the world’s aquifers being depleted faster than they can recharge.

And it is expensive: $300 to $585 a year for a typical under-sink system, once you count the membrane, the filters, and the water on your utility bill. It needs energy. So you pay for the privilege, twice — once at the utility and once at the aquifer.

Clean Shouldn’t Have to Mean Empty

So empty is not a neutral condition. It is a deficit, and the body pays for the deficit.

With the rarest of exceptions, every water humans have drunk throughout our species’ history has been in contact with rock. A distinct geological mineral composition was the default condition of water on Earth.

Clean shouldn’t have to mean empty. That’s the argument, and I think it’s right.

A “Geological Shortcut”

Here is the part that took me three books to see.

Nature’s chemistry works better than the membrane does. But it is slow, too slow for the modern load. Historically, the Earth had weeks, seasons, sometimes years to do this work, but it has never had to keep pace with the flood of novel compounds and the amount of human refuse we now pour in faster than it can break down.

What Shimanishi did (I believe, without intending to) was take Nature’s purification process out of rock and make it portable. Themarox concentrates the same mineral chemistry the Earth uses to clean water, but it does so in twenty-four to forty-eight hours, in a container, on your counter.

That’s the whole idea. It is a geological shortcut — a way to make water the way the Earth makes it, without waiting on the Earth’s schedule.

The Price of Purity

Ultimately, anything done to treat your drinking water has to achieve two goals. The first goal is to remove as much of the modern burden as you can. The second is to leave behind the mineral composition that supports its biological properties.

The problem is that every current approach trades some or all of one for some or all of the other. None does both.

Reverse osmosis wins the first and completely loses the second. It strips contaminants more effectively than the mineral approach does, and I’ll admit that plainly: on removal alone, RO takes out more. But it takes out everything else along with them, and hands back water the body then has to repair at its own expense.

Municipal treatment doesn’t come close to achieving either one. Start with the first goal, because legal isn’t clean. Water can pass every limit on the books and still carry a long list of things you’d rather not drink. Many federal limits haven’t been revisited in a generation while the number of chemicals in circulation keeps climbing. Standards are shaped largely by what utilities can afford to remove. And whole categories — hundreds of individual contaminants — simply aren’t on the list anyone tests or treats for. What is never measured never counts as a problem. As for the second goal, you saw the numbers above: municipal water often barely clears WHO’s minimums, and frequently doesn’t.

Which brings me to the third option, and why I spent a year on it.

Themarox doesn’t work to a legal limit. It takes the burden down to where the lab can barely find it. Testing was done on three separate finished products, all identical 10% dilutions of Themarox, and you can find the full inventory of lab reports for each on the Open Science Framework: Purinize, Adya Clarity, and Aurmina. In summary:

• 245+ contaminants removed or greatly reduced

• 147 driven below the limit of detection entirely

• 100 more reduced, most by better than ninety percent

• All four trihalomethanes to non-detect

• All 36 pharmaceuticals tested were reduced >99.5%; glyphosate 98.9%; arsenic 99.1%; lead 98.7%

• Eight estrogens reduced 74–97%, measured in parts per trillion

That’s the purifier part. That’s the claim. That’s the whole claim, and it’s the one I can stand behind in a room full of people who want to argue with me.

And then there’s the geochemical conditioning part. Removing the contaminants is only half of what happens in that pitcher or container. Dozens of minerals, aside from the ones that did the removing, stay in solution, and they change what the water is at a fundamental level. Redox balance is restored — the water’s electron potential returns to where naturally mineralized water has always sat. And the capacity for ion exchange returns, so the water can trade ions with the surfaces it meets rather than stripping them.

Reverse osmosis and distillation produce the opposite: water that is demineralized, chemically aggressive, and with nothing left to trade. Clean by one measure, impoverished by another. Themarox doesn’t just help filter your water clean; it also conditions it — the same chemistry stone and water run underground, compressed into a teaspoon.

What Aurmina is Not

One more thing I should remind you, because I’ve just spent a long section on WHO’s mineral minimums: Aurmina is not a mineral supplement. It contains some calcium and magnesium, but nowhere near the levels WHO recommends, and at the dose you use it will not appreciably change the calcium or magnesium concentration of your tap water in either direction.

So if you are starting from RO or distilled water, you still want a remineralization filter, and Aurmina is not a substitute for one. If you are starting from tap water, you keep what your tap water already has.

I am curious as to what the optimal major and trace mineral content of drinking water is, as no-one has yet researched it. It is near the top of what I want to study next.

What I’m Not Claiming

This is the part where a person in my position usually gets carried away, so let me be precise.

It would be false to tell you there is no evidence in human health. There is. There are randomized, albeit unpublished, trials run by Soviet-era research institutes, a long series of clinical observations from my own practice, and a metal excretion study we hope to see published shortly. Some of you will encounter all of it in Earth’s Living Water, and I’m not going to pretend otherwise.

What I will not do is offer any of it to you as a reason to buy a Themarox-derived product.

The reasons aren’t bureaucratic. The trials are unpublished, the clinical observations are uncontrolled — I saw what I saw, in patients I was treating several ways at once, with no comparison group and every opportunity to fool myself. And nearly all of it involves Themarox at concentrated doses, which is neither the product I sell nor the way I am telling you to use it. Two teaspoons of a diluted product in a gallon of drinking water is a different proposition from what produced those observations.

So: evidence, yes. Proof, no. And evidence about a chemistry is not evidence about this bottle, at this dilution, for that purpose. I am not claiming, and you should not infer, that Aurmina does anything for your health. It cleans and conditions your water, and it leaves the minerals in. That’s it.

The new website

This is the first version of Aurmina’s website that is accurate on the front page and across all the pages. A few pages of them may be worth your time, although today’s post already crystallized them well.

If you want the coagulation, redox, and ion-exchange steps laid out properly, that’s the Science page.

If you want the more detailed comparison to RO, that’s the Compare To R.O. page — the argument above, laid out side by side, including annual cost.

How to use it: How To Use

What to filter it through and how to filter it: Filtration

Shimanishi’s story: The Whole Story

Labor Day Sale

Use code LABORDAY25 to get 25% off 8oz and 32oz Aurmina bottles or our new Korea Ceramic Filter.

One 32 oz. bottle is a year’s supply for one person, or about six months for a couple. The 3-pack and 6-pack are already discounted 22% and 33% off, and the sale doesn’t stack on top of that — if you’re buying in volume, those are still the better deal.

If you’ve been reading me and you’ve come away worried about your water — and I’ve given you plenty of reason to be — this is what I’d put in your hands. It took me ten months and three books to say that clearly. Thank you for your patience while I was figuring it all out.

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

Subscribe now

If the above piqued your interest and you want to learn more from the rabbit holes I have lived in over the past year, you can purchase the book series, in whole or in part, from my website here ( where all books are personally stamped with my hanko) or from Amazon here.

In my defense, I was only supposed to write one book on minerals.

I was finishing my book The War on Chlorine Dioxide last August when a colleague named Kacper Postawski (now on Substack), who, in 2016, made Quantum Leap, the first major documentary on chlorine dioxide, began telling me about a unique aqueous mineral solution he had encountered, extracted from volcanic rock. He thought I might be interested in studying it, given my work on chlorine dioxide.

He also attached a number of health claims to it, which I quickly filed under the category of yet another promising, unstudied therapeutic—a category I was somewhat, though not completely, getting tired of.

I mean, heck, at that point, my partner Scott Marsland and I at the Leading Edge Clinic had already spent almost four years going down at least 30 research rabbit holes trying to identify therapies for our chronic Covid and Covid vaccine-destroyed patients: hyperbaric oxygen therapy, stem cells and exosomes, IV methylene blue, near-infrared saunas, pulsed electromagnetic field therapy mats, brain retraining, peptides, vagal nerve stimulators, qEEG neurofeedback, ozone therapy, EBOO, IVIG, plasmapheresis, ultraviolet blood irradiation, DMSO, chlorine dioxide, plus the pill boxes and/or IV drips filled with varying flavors of vitamins and nutraceuticals.

The list was dizzying. They all worked, to one degree or another, but only a few were consistent, durable, and affordable enough—all at once—to become foundational to our clinic’s approach or, more specifically, to lead me to write about them here on Medical Musings (and I have only written about a few; Scott has written way more on his Substack).

Basically, I found that each one fell under the maxim: “Everything works in someone, but nothing works in everyone.” I suppose you could say that about every therapeutic, but along that continuum, I was drawn to—and constantly trying to identify—the therapies that came much closer to working in everyone while remaining safe, inexpensive, and widely available. The really expensive, occasionally more potent clinic-based treatments were often hit-or-miss propositions. When you recommended one, and it hit, great; when it was a miss, the patient paid for it, both literally and metaphorically.

Kacper told me just enough about the aqueous mineral solution to make me curious—and no more than he needed to, I think, because he understood that the curiosity the mineral story would trigger would carry me the rest of the way.

At the time, I was also deep into the early chapters of a book on daily low-dose sublingual ketamine—a treatment that regrows nerves, rebuilds synapses, and reverses diseases that neurology and psychiatry have never been able to reverse, yet almost nobody in medicine is using correctly. That book was going well, but the minerals pulled harder.

What began as a question about one unusual extract from a Japanese volcanic rock became, eleven months later, three books—a trilogy built around a single subject: water, minerals, and the cyclic architecture that connects them. Towards the end, the investigation led me to Japan and to a dinner hosted in my honor by a Nobel laureate. I still can’t believe I just wrote that sentence.

That evening is not only the finest moment of my chaotic life since Covid; it is one of the finest moments of my entire life. His gift of a calligraphy he had made for me in Japanese characters of his favorite phrase, “There are no chance encounters. Everything happens for a reason,” is one I will cherish forever, and if you have read The Blueprint of Life, you will know it carried more meaning than he will ever know. Anyway, I cannot wait to share the story of the afternoon and evening that my wife Lisa and I spent with Professor Omura and his team. Now that I am finally emerging from underneath these books, it will come soon, I promise.

Into Freer Air

Above all, I am seriously giddy about something I have never gotten to experience as a book author: these books are the first in my career that I do not expect to be targeted by the censors.

My first book, The War on Ivermectin, was not picked up by a single library or book store (“we don’t carry those kinds of books”), and only attracted a few scattered hit-job reviews in Pharma-funded industry rags like MedPage Today, with the subtitle “Infuriating to see misinformation mongers being taken seriously”:

My second, The War on Chlorine Dioxide, I knew not to even bother listing on Amazon. Senator Ron Johnson, however, did manage to earn a hit piece from the book, simply because he wrote the blurb on the cover, which I thought was an awesome one: “A gripping tale of corruption and courage that will open eyes and prompt serious questions.” Fun fact: I have sent Ron three of my books, and each time, he read them within a day or two of receipt, and then called me to discuss them. Beyond impressive.

For that kindness, he was repaid with this:

Of course, Ron didn’t “claim” anything, but don’t let the truth get in the way, Ms. Megan O’Matz. My co-writer then wrote two hilarious Substack posts on the ordeal: the first titled “Pre-Written Narratives and Premature Outrage: ProPublica’s Plan to Review Our Upcoming Book,” and the follow-up, “ProPublica’s Chlorine Dioxide Panic, Explained.”

That ordeal was kinda fun—for us, anyway. Probably less so for Ron.

And if you haven’t yet subscribed to Jenna’s Side (get it?), remedy that. She writes the funniest and hardest-hitting near-daily commentary on politics and current events anywhere. If you need a laugh in your day while being kept fully apprised of the folly of the world we live in, that’s the Substack to read.

Anyway, now, after two books devoted to suppressed medical therapies, I cannot adequately describe how strange, liberating, and genuinely joyful it feels to release three books about minerals and water and to expect that, this time, the argument will be about the ideas and the evidence rather than whether the books should be allowed to exist. I am enormously proud of these books, thrilled that they are finally entering the world, and frankly, delighted by the prospect that people might actually be permitted to discover and discuss them without first passing through the usual machinery of censorship, suppression, and reputational attack.

Most importantly for today’s post, know that, right near the end, as the final book was being readied for the printer, some data came to me that transformed its penultimate chapter.

First, let me tell you about the books. Then I will share that chapter with you.

The Stone and Water Series

The Stone and Water Series explores the hidden architecture that sustains life on Earth: the exchange between stone, water, and minerals that living systems have depended on since they began. It follows that architecture across geology, hydrology, soil science, origin-of-life research, agriculture, medicine, and history. It began with a single volcanic mineral extract and widened to the long scientific history of stone and water, the oldest questions about how life began, and ultimately, to the planet’s most urgent crisis.

A note on timing for the books below. Amazon will have a copy to you in roughly two weeks. Ordering directly from me arrives in three weeks, but every copy I sell is signed and stamped with my hanko, the Japanese personal seal I had carved after Professor Satoshi Ōmura prompted me.

Earth’s Living Water: Its History, Its Ruin, and the Way Back is the complete investigation and authoritative reference text, over 700 pages comprising 70 chapters, over 200,000 words, and including over 650 citations (i.e., an encyclopedia). It traces the mineral-charged water beneath the living world through its whole arc: how that water was understood across centuries, how modern science came to overlook it, how a hundred years of agriculture, industry, and modern water treatment practices have degraded it, and how it might be restored. Fully documented and broad in scope, it is the definitive work at the foundation of the series. Available on my website or from Amazon.

The Silent Aquifer: Humanity’s Accelerating Food and Water Crisis is about the global emergency that I stumbled across during the research and writing of Earth’s Living Water, but presented at its sharpest. Focused, fast, and evidence-driven, it uncovers a synchronized planetary change in the chemistry of the water beneath the world’s farmland, beginning around the turn of the century, a change I named The Geohydrological Shift. Beginning with the Green Revolution and compounded by the world's industrial activity, this shift is quietly moving civilization toward being unable to feed and water itself, while the world’s alarm stays fixed on carbon and climate. It is a warning in the tradition of the great environmental reckonings, and, unlike most of them, it carries a practical, evidence-based map of the way back. For readers of Silent Spring, Cadillac Desert, and Dirt. Available on my website or from Amazon.

The Blueprint of Life: Earth’s Hidden Architecture Powering Life and Health looks downward, at what that same foundation reveals about life itself. It moves through origin-of-life research and the symbolic language of ancient texts, sets out the Rock-Water Circuit Theory and what I believe is the first internally consistent cosmological interpretation of the Emerald Tablet. It then asks whether nature's ordering architecture is better explained by accident, necessity, or design. Part scientific investigation, part history of science and theology, and part memoir, it traces one physician’s path from intensive care and the controversies of COVID-19 to a reexamination of order, creation, and God. Available on my website or from Amazon.

The first book spans the history, science, and the modern state of the relationship between minerals, water, and life on Earth. The second focuses on diagnosing and treating a crisis that almost no one is watching. The third explores why life is possible at all. Together they follow the same hidden system, from the first spark of life in ancient water to the aquifer failing beneath the world’s agriculture fields.

These books do not ask you to choose between science and faith, ancient wisdom and modern knowledge, or observation and meaning. They ask only that you follow the evidence wherever it leads.

And the ketamine book — The Quiet Revolution in Neurology and Psychiatry: How Daily Low-Dose Ketamine Can Cure Diseases Medicine Never Has — is the one sitting in the drawer and the one still growing out of our Leading Edge Clinic experiences. It is coming. When it does, you will be the first to know. But I gotta take a break first, or my wife and newborn baby son Lazlo will never forgive me (photos of baby Lazlo at end of post :).

I now present the penultimate chapter of The Silent Aquifer. Reluctant as I am to invite comparison with Rachel Carson and her landmark Silent Spring, I raise it only to mark a difference. Where Carson sounded an alarm, The Silent Aquifer tries to go a step further — detailing this century's equally quiet crisis while offering what I believe is a distinct, viable path toward a solution, or at minimum, a deferral of its worst consequences.

* Excerpted from The Silent Aquifer:

Chapter 11 — The Arithmetic of 2050, 2040, and Now

How did you go bankrupt? Two ways. Gradually and then suddenly. —Ernest Hemingway

Climate change arrived with a single galvanizing number, a single villain, and a global calendar of summits and reports to keep it in the news. I have my own doubts about how settled or scientifically accurate that story is, but they are not this book’s business, so I will set them aside. My concern is separate from that issue, and far more urgent. Climate has become the perspective through which the whole world now reads every environmental problem, and as a result, the crisis in this book has gone almost unmentioned, not because it is small, but because it is not, at its root, a climate problem at all. The most pressing threat to the world’s food and water is being buried inside a story that barely explains it.

A Word I Had Never Heard

The epigraph at the head of this chapter, Hemingway’s two ways of going bankrupt, gradually and then suddenly, I chose months before I understood how literal it would prove. I meant it as a figure for tempo: the way a slow loss hides itself until the instant it can no longer be hidden. I did not yet know that the people who study this most closely had seized on the same word and meant it without metaphor at all.

I found that out within days of sending this book to the printer. My collaborator Matt Bakos, scanning a feed he follows, caught a thread he didn’t recognize, clicked it, and opened onto a stack of recent releases I had somehow never seen, from the FAO and the United Nations, carrying a phrase I had not encountered once in eleven months of writing about this exact subject: water bankruptcy.^{540 541} Not a columnist’s metaphor but a formal term, newly defined in a scientific paper and taken up in a UN report because the old words—stress, scarcity, crisis—had stopped being big enough for what the numbers were doing.⁴¹⁴

When the people who watch a system most closely have to borrow the language of insolvency to name it, the system is not just in trouble. It has failed.

I read those releases in something close to disbelief, not only at what they said, but because what they said was the most alarming data I had seen; the aquifers and the salt and the sinking ground all worse and faster than the figures I’d been working from. What stopped me was that I had come within days of printing a book on this subject without knowing the term for it existed. I hear “climate change” or “global warming” most mornings, in headlines I never go looking for. “Water bankruptcy” had to be handed to me by a colleague, by accident, at the eleventh hour. It is the argument of this chapter, proved at my own expense: a crisis so quiet it nearly slipped past the person writing the book about it.

The chapter title still carries the mark of that reckoning. For the months I spent on it, I called these pages simply “The Arithmetic of 2050.” The newest figures made that date sound like optimism; the failures I had filed under midcentury were already arriving, and some, like the crest of the Ogallala aquifer, were already behind us. So the chapter title changed to the current one. The arithmetic never agreed to wait for 2050; it had already become the arithmetic of now. The epigraph, though, I kept exactly as I chose it, because I could not improve it further. But I had invoked bankruptcy as an image while the field, as it turns out, had settled on it as a fact.

Before asking why this happened, it is worth considering a simple measure of public attention. Altmetric scores measure the attention a scientific paper receives across news media, government reports, policy documents, blogs, and social media, rather than simply counting academic citations. Nine months after it was issued, the FAO water report has barely made a sound.

Figure 46.1. The near absence of public attention to the world’s rapidly developing water bankruptcy.

A Number I Once Sat On Top Of

I have measured that gap in attention from the inside. Altmetric is not a measure of whether a paper is right. It measures how many people are looking.

In 2021, I was the lead author of a review on the evidence for ivermectin in COVID-19, and my paper reached an Altmetric score of 6,300 within weeks, close to what the 2024 Climate Report is at now. But it kept climbing. Its final score is 15,356, placing it sixty-sixth among the almost 28 million research outputs that Altmetric has ever tracked—one of the hundred most-discussed pieces of research, in any field, in the service’s history.

I watched my number climb in real time, and then I watched what happened to the paper beneath it. It was recast from urgent to dangerous; the journal appended an expression of concern after a barrage of pharma-shill critiques were sent to me by the editor, which I refused to devote the immense amount of fruitless time it would have required to respond to. This led to the work being buried under an organized campaign of disinformation that I documented at length in The War on Ivermectin. I am not relitigating any of that here. I raise it for one reason. I have stood at the very top of this scale, and I know exactly what it registers. It registers attention. Nothing else.

Which is what makes the other end of the scale worth looking at.

On the seventeenth of December, 2025, the FAO released its most recent, and the most devastating, global water report in history.⁴¹⁴ It generated five posts on X. Over the following month, that number rose to fifteen, and then stopped. Since its release, not one independent news outlet has covered it. Only one policy document has relied on it, and that was published by the FAO itself. Only five papers have cited it; one of which was focused on optimizing irrigation for cherry tomatoes. I guess this book will be the 6th.

A single review of a repurposed generic drug drew almost 600 times more attention in its first fortnight than the world’s food and water supply crisis has drawn in almost a year.

News Cycles and the Climate Frame

One reason the coming crisis remains quiet is that it lacks the elements a story needs to command attention in modern news cycles. Climate change, by contrast, has all of them. It offers not one alarming number but several: carbon in the air, the rising sea, and above all the temperature, which television has learned to render as spectacle, with the map of the country washed in deepening reds, the hurricane wheeling across the ocean as a vast white spiral, the same furious palette returning night after night because it works. It has a villain, a variety of metrics and images, and, most of all, fear.

And much of the coverage the food and water crisis does get is filed under climate—“climate-driven drought,” “climate threats to harvests”—so that the story survives but loses its own identity. That does the reader a real disservice, because much of this crisis is not climate-driven at all. Aquifer depletion is fundamentally an extraction-rate problem: we are pumping groundwater faster than it can be replenished, and that would be true even on a perfectly stable planet. Soil degradation, nutrient mismanagement, and irrigation policy would be problems with or without a changing climate. The water crisis and the climate crisis are entangled, but they are not the same crisis, and treating one as a subplot of the other has let the quieter one grow in the dark.

There is also the problem of speed. A hurricane makes landfall in an afternoon; a wildfire crowns a ridge in minutes; a heat record breaks in a single blistering week: each one perfectly fit for a news cycle. Meanwhile, an aquifer falling half a meter a year, or a soil losing its fertility over decades, might generate a serious news article once a year, and not always on the front page. Human attention, and the media built to hold it, is tuned to events, not to gradual baselines, and a catastrophe with no single dramatic moment is chronically under-covered, for the same reason topsoil loss and antibiotic resistance are. A crisis can be enormous and still move slowly enough that most people do not pay attention to it.

The clearest proof is the industry the whole world is currently watching. Artificial intelligence is scrutinized more closely than almost any technology in history, and when people worry about what it consumes, they worry mostly about electricity—the power-hungry data center, the strained grid, the plants firing back up to feed it. It is also among the thirstiest industries ever built, planting much of that thirst directly over aquifers that are already failing, as the last chapter described; and that half of the story arrives, when it arrives at all, as the subordinate clause.

If the water can be sorted into silence there, with the facts in plain view, it can be sorted into silence anywhere. And it has been, quietly, beneath the world’s food for twenty-five years. I know that silence from the inside—it is the one that nearly swallowed this book, the one I opened this chapter with.

Before diving into the individual numbers, it is worth stepping back and looking at the larger picture. The studies listed in the figure on the next page come from different disciplines and different institutions, yet they point in the same direction. Crop yields are slowing, water demand is rising, freshwater resources are under increasing strain, water quality is deteriorating, and even the international organizations tracking these trends have concluded that the traditional language of “scarcity” no longer captures what is unfolding. Read separately, each study is concerning. Read together, they describe a single converging crisis.

(Note for the figure: MAF= million acre-feet)

The Food Gap

Let’s start with food. Projections of the food required by 2050 vary sharply with the baseline, the unit being measured, and the assumptions built into the model. One influential trend analysis projected that global demand for crops could rise by 100 to 110 percent between 2005 and 2050 as population and income increased.⁵⁰¹ The FAO’s 2012 analysis was more moderate, projecting that total agricultural production in 2050 would be about 60 percent above its 2005–2007 level.⁵⁴¹ A later meta-analysis of fifty-seven global projections placed the likely increase in total food demand between 35 and 56 percent from 2010 to 2050,⁵⁴³ while the World Resources Institute’s widely quoted 56-percent figure refers specifically to the gap between crop calories produced in 2010 and those projected to be required in 2050.⁵⁴⁴ I have no quarrel with the lower numbers.

But let’s start with the highest number, since that’s easiest, and then move to the lower numbers. Doubling the food supply by 2050 would require yields to rise about 2.4 percent a year.⁵⁰⁰ That figure has a date on it. Scientists set it in 2013 and, in effect, fired a starting gun: from that year on, the world had to achieve 2.4 percent gains in yield each year to cross the line by 2050.

It has not.

Chapter 43 gave the rates measured when the starting gun was fired: 1.6, 1.0, 0.9, and 1.3 percent gains a year for maize, rice, wheat, and soybean. Every one falls short of the mark.⁵⁰⁰ Carried to 2050, they deliver something like 67, 42, 38, and 55 percent — not the 100 percent the doubling projections call for.

Now consider that the numbers above were from 2008. To understand where we are now, I went back to the raw United Nations yield figures they used and applied the same method to data from 2024, the most recent year on record, for the four crops that supply close to two-thirds of the calories humanity eats.

Figure 46.3. Method Footnote: 2024 updated world average yields for maize, rice, wheat, and soybean from FAOSTAT, as compiled by Our World in Data, fit to a log-linear trend over 1989–2008 and 2009–2024.

Now let’s set the demand at its lowest plausible level and ask whether current yield increases can meet it. Even the gentlest projections, the ones asking for barely half as much food, again, still need the major staples to keep gaining better than a percent a year, every year, without pause.

Yet, three of the four major crops have slowed. Maize dropped by more than 40 percent, from about a 1.8 percent annual rise to 1.0 percent. Soybeans slowed from 1.3 to 1.1. And rice, the grain that feeds more people directly than any other, fell by 37 percent from 1.0 percent a year to 0.63 percent, less than half of what even the most modest 2050 estimate requires. Only wheat has risen, from 1.0 to 1.35 percent. One staple out of four is gaining ground. The other three are giving it back.

Return to the starting gun. It fired in 2013, and thirteen years on, the pace has drifted the wrong way on three of the four staples. In a race against a deadline, falling short compounds: the gap widens with every season the runner fails to close it. Line the rates against the target, and the doubling is not within sight, and neither, on three of these crops, is even the most optimistic target.

The doubling narrative has been contested by researchers who argue that hunger reflects access, poverty, distribution, waste, and the diversion of crops to livestock and fuel as much as an absolute shortage of production.⁵⁴⁵ I agree that about a fifth of the food available to people is wasted, about a third of the world’s cereals are fed to animals, and a rising share is burned as fuel rather than eaten.^{546 547} But that argument rests on multiple failed assumptions. The first is that food waste will somehow be recovered, but no data support that. The share of food lost between harvest and market has not fallen since the world began tracking it in 2015; it has drifted upward.⁵⁴⁸ Meat demand is projected to keep climbing rather than level off, and the grain diverted to biofuels is rising rather than shrinking.⁵⁴⁷

Every argument the optimists make is moving the wrong way. And beneath all of them sits the biggest assumption of all: that food is a single global pool, so hunger is only a delivery problem. Grow the surplus where you can, ship it to where you cannot, and no one goes without. It sounds reasonable, which is why the coming shortfall is so easy not to be alarmed about.

Two facts shatter that argument. The first is that we already grow enough to feed everyone alive, yet hundreds of millions still go hungry because food does not reach the poor, the remote, or the politically inconvenient. If today’s abundance has not reached them, tomorrow’s smaller harvest will not either.

The second is the one this whole book has been building toward. Shipping surplus assumes there will always be a surplus somewhere to ship. But surplus exists only where the water still works, and the water is now failing in exactly those places, for the same reasons it failed everywhere else. The great breadbaskets are not exempt. The Ogallala beneath the American plains, the aquifers beneath the North China Plain and the Punjab: the chemistry has changed, and the volume is falling. The first is already in the yield numbers. The second is the hammer still coming down. The models miss this because they treat water, and the chemistry it carries, as a fixed backdrop that will keep doing its part. This book has spent its chapters showing it will not.

When Ray and his colleagues last mapped it, using 2008 data, yields had stopped improving across somewhere between 24 to 39 percent of the harvested area for the four great staples.⁴⁹⁷ Almost twenty years later, that map has never been redrawn. The most recent global study of the same ground, published in 2024, still runs on data ending in 2010, and it finds the pressure has only built: on roughly 84 percent of the world’s rice land and 56 percent of its wheat land, yields now sit close to their attainable ceiling, the narrowing zone from which Ray’s stalled cropland was drawn.⁵⁴⁹ No one has measured, with data from the years since, how much of that ceiling-bound land has already gone flat. But the direction is not in question. The rate at which rice yields have climbed has fallen by more than a third since that decade, on the crop with the least room left to grow.

The Number to Watch Is the Price

Everyone watches the hunger count, and by that count things are improving — three straight years of decline — with about 673 million people, roughly 8.2 percent of the world, still short of food in 2024.³⁸⁶ But the hunger count is the wrong number to watch. Hunger moves late, propped up by reserves opening, aid arriving, and families trading down to cheaper, thinner food, all of which can hold the official number flat while a household’s diet quietly gets worse. It is also a once-a-year survey published well after the fact.

The number that moves first is the price. The world grows food with little to spare, stocks are thin, and people have to eat whatever it costs, so when the world grows even slightly less than it needs, the shelves do not empty. Instead, prices rise sharply because a small shortfall pushes against demand that will not bend. Price is also what turns a shortage into hunger: the food does not vanish from the market; the poorest are simply priced off the shelf before they are ever counted as hungry. You can already see the two numbers starting to split apart. The cost of a healthy diet has climbed year after year since around 2000, and about 2.69 billion people, a third of humanity, now cannot afford one, even as the hunger count slips.³⁸⁶ The world’s flagship hunger report now turns on that very figure, a sign that the agencies built to count the hungry have begun to watch the price instead.

The “Canary in the Field” chapter showed that this has already happened: after decades of dropping prices, prices began rising around the turn of the century, in the same window as the dip in yield gains. I will admit that sharper jumps in prices come from shocks like wars, droughts, and spikes in oil prices that drive fertilizer and freight costs, but those pass. What does not pass is the slower rise beneath them, the plain cost of coaxing a ton of food from tired ground and degraded water. When each acre yields a little less, the farmer spends more to grow the same crop, and that cost lands in the price. A slow erosion of yields, the kind this book lays at the door of the water chemistry and the soil, would not arrive a mass famine. It would arrive first as food that costs a little more every year, and water chemistry is one of the forces lifting that price, the one variable no one is watching.

The Wells Still Draw

Before water-supply accounting begins, one fact about timing needs to be considered. The yield slowdown just laid out isn’t from the water running out. It has been occurring while the water is still here. Across most of the world’s irrigated cropland, the wells still draw, and the fields still drink, and the harvest is already slowing. If depletion were the only mechanism to decrease yields, the only slowdown would be ahead of us, on the day when the wells fail. That day has not yet come, but the slowdown has been going on for twenty-five years. The blow doing the damage now is not the quantity of water but the slow alteration of the water still present — its chemistry, not its absence.

The depletion analysis that follows describes a second blow, separate from the first. The first is already on the field. The second, when it arrives, will not land on a healthy system that can absorb it. It will land on a system already weakened by the quiet one.

The Water Gap

Now set the water next to the food, because they are connected. Irrigation for agriculture accounts for roughly 70 percent of global freshwater withdrawals. Yet rising food production does not translate into an equal rise in irrigation.⁴⁴³ In the FAO’s projections, agricultural output would grow about 60 percent between 2005 and 2050, while modeled irrigation withdrawals would rise only about 11 percent, from roughly 2,620 to 2,906 cubic kilometers a year.⁵⁴¹ The gap assumes the added agricultural output would come from higher yields on land already in production, but the water figure credits irrigation with becoming more efficient than it is today.

But even that modest global rise would fall unevenly, placing the greatest demand on regions where water is already scarce and aquifers are already falling. In some of those regions, the future the projection warns of has already arrived.

The measure is straightforward: what a region withdraws each year, set against what its rain, rivers and aquifers can renew — minus what has to stay in place for those rivers to survive. Below 25 percent, the FAO calls a region unstressed. Above 75 percent, it is in high stress. Above 100 percent, it is no longer living on what returns each year; it is spending reserves that took millennia to fill.

By the FAO’s 2022 accounting, North Africa’s withdrawals had reached about 121 percent, drawing down ancient groundwater to cover the gap, while Southern Asia stood near 77 percent and Central Asia near 70 percent.⁵⁴² The 2050 demand curve is not a forecast in those places. It is the meter reading.

An American reader may be tempted to file those numbers under other people’s problems. The national accounting invites it: the United States as a whole sits comfortably inside the FAO’s unstressed band.

That average is one of the most misleading numbers in this book. A country does not eat its average. It eats what grows in particular places, watered by particular aquifers, and those keep their own meters. The Ogallala is indifferent to how much rain falls on Michigan.

When researchers modeled the year each High Plains state would drain its groundwater fastest — peak depletion, the last year of maximum water — the dates were not ahead of us. Texas crested in 1999. New Mexico in 2002. Kansas in 2010. Oklahoma in 2012. Colorado in 2023.

** Part of the mission of The Silent Aquifer — and part, only part of Medical Musings going forward — is to help the scientists behind that devastating FAO report, along with the many researchers whose work they drew on, actually get their message heard. Because according to Altmetric, no one — and I mean no one — is listening. Please help support that effort:

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Day Zero Events

The deadlines in this chapter generally, and arbitrarily, focus on 2050, largely because several influential papers in the field used that target for projections starting twenty years ago. But several cities have already arrived there.

The phrase is Day Zero—the day a city stops delivering water to people’s homes, and people are then forced to fetch it. Cape Town created the term in 2018, and what is usually misunderstood is that Day Zero is not actually a date. It is a water supply threshold: when thirteen and a half percent of combined dam storage remains, it would force the city to shut the reticulation and send four million people to roughly two hundred collection points. The projected threshold was avoided from April to June, and was finally suspended in late June. But the city got there only by cutting consumption close to sixty percent, from something over eleven hundred million liters a day to about five hundred.

Others have followed. Chennai’s four reservoirs were down to eighteen million cubic feet at the end of June 2019, in basins built to hold more than eleven billion — a sixth of one percent.^551b São Paulo literally went beneath the bottom. The pipes that draw from the Cantareira reservoirs sit well above the reservoir floor; thus, the water below them had never been counted as part of the city’s supply, because there was no way to get it out. In 2014, the utility installed pumps and took it — twice.^551c Through that year and the next, households across the city found the taps weak or dry at night while the state maintained that no rationing was underway.

But the more important thing about Day Zero is how a city avoids it. Cape Town’s dams are above seventy-five percent again. That is not the same as the city having recovered.

The city asked its residents to conserve, and they did — close to sixty percent. Selling less water collapsed the utility’s revenue, and the city made that revenue back from the people who had the least of it. Universal free basic water, the allocation that exists so that being poor does not mean being thirsty, was withdrawn. The lowest tariff bracket rose six hundred percent in a single month.⁵⁵¹ Devices that throttle a household’s flow to a trickle once its quota is spent were installed by the thousands, and sixty-four percent of them went into poor communities.⁵⁵² The wealthiest tenth of the city was using roughly half of Cape Town’s water throughout, and absorbed almost none of the enforcement.⁵⁵³ Shocker.

The city was saved by the households that used the least, and the bill was sent to them.

What ended in Cape Town was the deadline. The rationing became permanent, moved off the front page, and was redistributed onto the people least able to argue with it.

I searched the scientific literature for an inventory of Day Zero events and found only one: the same 2023 paper cited above, whose caption concedes that its cities were assembled “as reported from several media outlets” and whose sources for that figure are the BBC, Reuters, and the Guardian.⁵⁵³ The one count in circulation—more than eighty cities—comes from a study measuring something else entirely. So the category exists at the discretion of coverage.

Two researchers who studied the Cape Town campaign concluded that Day Zero was “a purposefully designed narrative in political communication,” and that its “unfeasibly precise prediction of water ‘running out’… obscured scientific uncertainties.”

Worse, Cape Town, which named the term and is the only city people think of when hearing it, never actually reached Day Zero because storage bottomed at 21.2 percent against a 13.5 percent threshold, the date moved four times, and the reticulation was never shut.

Then I discovered that Bogotá cut its taps on a rotating schedule for three hundred and sixty-six days, Curitiba for six hundred and forty-nine, and Monterrey’s main reservoir ran dry, yet none of the three appears on anyone’s list, because no list exists. The event is defined by whether a camera arrived.

Figure 46.4. Global food demand projections for 2050 compared with our current trajectory and groundwater dependence.

Looking at either trend by itself reveals a serious problem. Look at them together, and they are something worse, because they are not independent; they multiply. We must grow far more food, on yields climbing too slowly or not at all, using more water, at the exact moment the water is degrading and running short. As the previous chapter detailing the Geohydrological Shift showed, we will also have to do so with different, more hostile water chemistry. The food crisis and the water crisis are not two problems. This book argues they are two consequences of one disturbance: the quality of the water beneath the food.

Aquifer Depletion Dates by Region

Numbers like these stay abstract until they have a place and a date attached. Here are a few, and they are not far off. One thing to keep in mind as you read them: an aquifer almost never runs to literal zero. A region’s wells fail when the water becomes too deep, too costly, or too salty to lift economically; so the crisis arrives not as a sudden empty tap but as abandoned fields and hollowed-out rural economies, quietly, one farm at a time. “Depletion,” in what follows, often means that economic wall rather than a dry hole in the rock.

Consider the Indian Punjab, one of the subcontinent’s breadbaskets, which grows a tenth of India’s rice on water it lacks. Punjab now depends on tubewells for roughly 72 percent of its irrigated area, with canals supplying most of the remainder.⁵⁵⁴ And the tubewell is why the decline feeds on itself. As the water table falls at those rates, year after year, the shallow tubewells go dry, so farmers drill deeper ones and fit stronger pumps to chase the water down. Each round of deeper wells pulls harder on the same shrinking reserve. It is a race to the bottom with a literal bottom: in time, the water sits too deep to reach affordably, or it is simply gone.

In the Central Ground Water Board’s 2020 assessment, 117 of the state’s 150 groundwater-assessment blocks—78 percent—were classified as over-exploited, meaning that extraction exceeded the annually extractable resource.^{555 556}

The most alarming projection is from a widely reported CGWB assessment finding that, if extraction continued at the prevailing rate, Punjab could exhaust its usable groundwater resources within the upper 300 meters by approximately 2039.⁵⁵⁶ The 300-meter figure was treated as a practical limit because groundwater at greater depths may be poorer in quality and prohibitively expensive for many farmers to extract.

That is within the working life of a farmer planting there today.

It is not one story but several, staggered across the plains. “Peak depletion” is the year an aquifer is drained fastest, the top of the pumping curve, the groundwater version of peak oil. After that year, the rate of loss begins to fall. That can sound like relief, but it is the opposite. The rate falls because the water is running out: as pumping thins the saturated layer, wells yield less, some run dry, and land drops out of irrigation, so exhaustion itself forces extraction down. Peak depletion is the last year of maximum water, the moment a place crosses from draining hard into a decline it cannot pump its way out of.

A 2016 modeling study reconstructed and/or projected peak depletion rates occurring in Texas in 1999, New Mexico in 2002, Kansas in 2010, Oklahoma in 2012, and Colorado in 2023, while Nebraska, South Dakota, and Wyoming were not projected to reach peak depletion before 2110.⁵⁵⁷ The Colorado date should therefore be understood as a model projection made in 2016, not as a subsequently verified observation.⁵⁵⁸ The deepest losses are concentrated in the central and southern aquifer, where decades of pumping have removed much of the accessible saturated thickness. In much of it, recharge replaces only a small fraction of what is pumped, so even if extraction stopped tomorrow, a full refill would take centuries.

The scale of it shows in two Kansas numbers. Close to a third of the High Plains groundwater there has already been pumped, and at the pace of recent years about seventy percent of it would be gone within fifty years—with the region’s farm output, which lags the pumping peak, projected to crest around 2040 and slide after that. The wells do not fail together. They fail county by county, on the schedule the water sets.^{559 560}

These findings and projections repeat across the world’s most important farmland. The Indus Basin, feeding a region whose crops sustain well over a billion people, is among the most stressed aquifer systems on Earth.⁵⁶¹ In the North China Plain, which grows a large share of China’s grain, the deep aquifer has fallen so far that the country built a continental-scale project to pipe water north: sustaining the breadbasket by moving water across the country rather than by any natural recharge.⁵⁶³ And across much of the Middle East and North Africa, the water being pumped is fossil water, laid down in wetter ages tens of thousands of years ago, that effectively does not refill at all.⁵⁶⁴

^{The Folly of the Relationship Between Saudi Arabia… and Arizona}

Every region in the preceding section is a clock still running. Now let’s look at one that has already stopped, because it shows two things at once: what running out looks like, and what a nation does the morning after.

Saudi Arabia used ancient, nonrenewable fossil groundwater to pursue wheat self-sufficiency, then began phasing out domestic wheat production in 2008 as concern grew over depletion of its water reserves; the program ended in 2016.⁵⁶⁵ By the time that program ended, experts estimated that about four-fifths of the country’s fossil water was already gone, spent in little more than a single generation of pumping.⁵⁶⁵ The same water demand later reappeared overseas. Fondomonte, a subsidiary of the Saudi dairy company Almarai, has used groundwater in western Arizona to grow alfalfa for livestock in Saudi Arabia, and in 2026 it remained a major groundwater user in the state.^{566 567} It is an unusually literal example of “virtual water”: instead of pumping scarce water at home, a company draws water abroad, embeds it in a crop, and ships the crop back.

That maneuver is worth looking at closely, because it is the first move any country makes when its own water fails, and because it cannot work for very many of them. It depends on somewhere else having water to spare and a government willing to let it leave. Saudi Arabia could take it because it went first, while most of the world’s aquifers were still full. The country that runs dry last will find every well already spoken for. This is the wall this chapter keeps arriving at: you cannot redistribute your way out of a shortage that is draining the very places the surplus would have come from. So Saudi Arabia is the first country to reach 2050 ahead of schedule. It found a way out. The countries that arrive after it will not.

Figure 46.5. Regional trajectories of major groundwater-dependent agricultural systems

Linear Yield Gains, Falling Percentages

Return to the silence, because the numbers now explain it. When people imagine a yield failure, they imagine a collapse, a harvest that does not come in. A slope that is only flattening does not alarm anyone.

The deeper reason the shortfall stays invisible is in how a harvest gets reported. Yields grow in a straight line — the same tonnage added each year — and that tonnage reliably sets new records, so headlines announce progress while the growth rate quietly falls. Nobody reads about declining rates. Everybody reads about record crops. The mathematics launders a crisis into a success story.

What the numbers actually show is simpler: wheat is adding grain at roughly a third of the annual rate needed to reach 2050. Rice at about forty percent. Maize and soybean closer to two-thirds, but still short. These are not optical illusions — the target was set in tonnes to begin with. We are hitting between a third and two-thirds of it, depending on the crop, and the gap grows every year we celebrate the record without noticing what it falls short of.

Recall from Figure 46.3 above that annual rice yield increases were the lowest of the four staples, now rising at only 0.63% a year. Rice is the thirstiest staple we grow, the one crop that spends much of its life standing in water. If the disturbance beneath modern agriculture is a slow degradation of the water itself, this is the fingerprint it would leave: the crop that relies most on water is growing the least. One pattern does not prove a mechanism. But this is the pattern the mechanism predicts, and it is the one the data shows.

Where the arithmetic might have forced its way into view, a set of buffers has absorbed it. A short harvest in one country is covered by exports from another. Governments draw down reserves. Farmers irrigate harder, spread more fertilizer, and break new ground. Each move keeps the shelves stocked, and for fifty years each one kept the price falling too, while quietly billing the difference to something that never appears on the receipt: the aquifer and the soil. Then the price stopped falling. It is the one place the buffers have visibly failed, and it failed first, before a single major aquifer had given out. The buffers do not solve the yield problem. They convert it into a slower, larger debt, drawn against the very resources this book has spent its chapters watching drain away. That is Hemingway’s bankruptcy in a sentence. Gradually, while the reserves hold. Then suddenly, when they do not. The price is where the “gradually” ran out.

China’s Food Security Law

If this danger were imaginary, the government with the most people to feed and the least room to fail would be the calmest of all. China is the opposite. Its population has stopped growing and begun to fall, by more than three million in 2025 alone, yet its cropland is limited, its northern aquifers are stressed, and it leans on imported soybeans and feed grain to hold the balance.⁵⁶⁹ On its own farmland, the plateau is already evident: by 2010, yields had stopped improving across half of China’s rice area and more than half of its maize.⁵⁷⁰ Beijing’s own word for its food balance is “tight,” and it expects it to stay that way for a long time.⁵⁷¹ So China has done what an alarmed state does. In 2024, it brought a national food security law into force. It draws legal redlines around farmland that cannot be paved, it is building high-standard cropland across hundreds of grain counties, and it has ordered its farms to add more than fifty million tonnes of annual production capacity by 2030.⁵⁷² The country standing closest to the arithmetic is treating it as an emergency, while the countries with the most slack treat it as no story at all.

In other areas, pressures are building the hardest where the buffers are weakest. Across a set of representative sub-Saharan countries, cereal demand is projected to roughly triple by 2050, and even if yield gains double the historical rate and much of the gap to the ceiling is closed, they would still need more land, more water, and more imports.⁵⁷³ Where the wealthy world sees a smooth global average, a farmer in the Sahel meets the arithmetic head on.

Not a Climate Story

So is this just climate change by another name? The answer is no. Whatever one concludes about the climate debate, the forces driving this crisis are not carbon in the air. They are water pumped from the ground faster than it returns, soil worked past its power to recover, minerals stripped from the medium that feeds the crop, and a water chemistry turning against the plants it once sustained. None of these depend on the climate argument to be true, and none of them would relent if that argument were settled tomorrow. Our obsession with climate has obscured this crisis by reducing every environmental problem to a single problem with a single cause.

There is a term for what I am describing, and I did not have it when I wrote this chapter.

Hydrologists have begun using anthropogenic drought to name a deficit that is produced, or greatly deepened, by what people do to a water system rather than by what the sky withholds. The category is meant to contain the things that do not fit inside a rainfall record: over-allocation, groundwater drawn down past recovery, land cleared and evapotranspiration disrupted, irrigation expanded, rivers diverted, surface storage lost. Together these can turn a dry spell that a basin once absorbed into a shortage that does not lift when the rain returns.⁵⁷⁴

The framework’s own authors are careful about how far it can be pushed, and I want to be equally careful. This is a reframing, not a measurement. They say so: the feedbacks between climate, withdrawal and land use compound in ways that make the drivers difficult to disaggregate quantitatively. The concept establishes that a drought’s severity is partly authored by decisions. It does not yet let anyone say, in most places, by how much.

That limit does not weaken this chapter’s argument. It is the argument. A crisis that can be photographed and dated gets a name; one that has to be separated out of a tangle of human decisions does not, and so it goes on being filed under weather.

And it is the same paper that gave this chapter its title. Water bankruptcy is defined there as the state in which water shortage exists even during wet years.⁵⁷⁴ The term I found days before the printer turns out to have been sitting inside the literature on drought caused by us.

The convergence of slow changes in our water, soil, yields, and chemistry has many causes and a single victim. It has no stage, and no number dramatic enough to fit on a placard. But every one of those changes, the pumping that empties the aquifer, the soil worked past recovery, the minerals stripped from the medium, the chemistry souring against the crop, comes to rest in the end on the same place: the water beneath it all, the medium the whole living system depends on. A crisis with many causes still has one name, and that name is on the cover of this book. The loudest dangers are not always the largest. This one has kept its silence because it is arithmetic, not an event, adding a little more to the tally each year until the debt those small sums have run finally comes due.

The Books Do Not Balance

These failures will not arrive all at once. Punjab will run down on one clock, the southern Ogallala on another, the fossil aquifers on a timer that will never reset. That fragmentation is precisely why the crisis remains difficult to see. Each decline appears local, each shortage temporary, each emergency isolated. Yet together they describe a single global pattern.

Set aside every contested projection and every debate over dates. What remains is remarkably simple. Across much of the world’s most productive farmland, yield growth is slowing or has begun to flatten even as demand continues to rise. At the same time, an increasing share of global food production depends on groundwater being withdrawn faster than nature can replace it. We are balancing today’s harvest against tomorrow’s water. A meaningful portion of the world’s apparent agricultural success is being financed by drawing down a finite natural inheritance. The books do not balance.

This is why the central argument of this chapter is not about 2050. The trajectory is already visible. Some aquifers have passed their peak. Others are declining within the working lifetime of farmers planting crops today. The instruments that revealed these changes were not built just so researchers could write frightening papers; they were built to measure reality. Their collective message is neither political nor speculative. They are simply saying that the margin between the water we depend upon and the water we are replacing is steadily narrowing.

I do not raise this to despair. I raise it because the only thing that can convince a world to try to bend a curve is to look straight at where it goes if you do not.

I then lay out a path toward bending those curves in the remainder of the book. Cliffhanger, I know.

You can purchase the series, in whole or in part, from my website here or from Amazon here.

Fun fact before I close: for a brief stretch after release, Earth’s Living Water was the #1 New Release in Agronomy, and The Silent Aquifer was the #1 New Release in Regenerative Agriculture.

Who woulda thunk it? An ICU doctor. Topping the agronomy charts. I’ll explain how that happened in my next post and it’s a stranger story than you think.

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From the Shameless Commercialism Department:

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And finally… a few pictures of baby Lazlo, or “Latzee” as we call him; the first is a passport photo attempt:

PK: I know you’ve been buried, so thanks for making the time. A lot of people need to hear this. Also, congrats on the Tucker Carlson plug. He called you “kind of a genius and a very decent person” and put your work in front of his massive audience. When I first started helping you a few years ago because I loved the newsletter, I had a sense you’d add something real. I just never expected it to go this far. How has it been?

AMD: That was very kind of Tucker. Before I saw that, I always wondered if he read this newsletter, because after I put together an extensive case for the evidence that SSRI antidepressants can contribute to mass shootings (something I did because it seemed like the one viable way to draw real attention to the broader, more common debilitating harms of SSRIs), it went viral, and he then aired a Fox segment on the topic that to the best of my knowledge was the first time major media had seriously touched the issue in decades. Afterward, the Overton window opened; the serious dangers of SSRIs stopped being taboo, and people also began discussing the far more frequent side effects that have ruined a lot of lives. Now federal policies are being enacted that are causing the psychiatric profession to begrudgingly move toward (safely) deprescribing SSRIs. I appreciate the endorsement, but I appreciate even more that he was willing to take the risk of raising the subject when it still carried real cost.

PK: Tell me about that Obi-Wan line we talked about the other night, “Only a Sith deals in absolutes.”

AMD: When you told me that, it jumped out at me because it seemed to touch on the mental rigidity I see everywhere, which has always bothered me and, I feel, is the root cause of many problems that come up. I looked up the context behind the quote that I put into the tweet you saw, and found out that what it essentially means is that as people’s minds harden and they “go to the dark side,” they begin seeing everything in black and white, so that anyone who is not fully with them must be against them. ED: Obi-Wan said the line to a student he deeply cared about who had begun taking Obi-Wan’s disagreements with his actions as proof Obi-Wan was his enemy.

On a broad level, this is the societal shift which typically precedes democracies hardening into totalitarian states, like with Bush’s post 9/11 “You’re either with us, or you’re with the terrorists.” Yet, on an individual level, it frequently sends people like Obi-Wan’s student down a chain of distorted, dichotomous logic that makes them rigidly adopt positions at odds with the values they originally held. Interestingly, the statement itself is an absolute, which is useful because it shows how easily even people who criticize black-and-white thinking can slip into it.

PK: I see that constantly, and also have to admit that in some areas, although I believe there are not many of them, I too can slip into that posture as well. Where does it come from?

AMD: What I found the most interesting about the quote was learning that it touched upon why the Sith (ED: “evil Jedi”) worldview was so tempting in the first place. The appeal was never simply power for its own sake; it was that power and domination offered a way to eliminate uncertainty, which is something many people, including Obi-Wan’s student, simply cannot tolerate.

PK: Have you researched that aspect of cognition?

AMD: Actually, I did and found a substantial body of research on “intolerance of uncertainty” that describes essentially the same pattern and shows it frequently underlies emotional disorders like anxiety. The rigidity we notice is usually the visible surface; underneath it, there is often an intolerance of uncertainty that feeds the drive for control and is, in turn, reinforced by it—until the whole stance hardens into dogmatism.

PK: Man, you just hit on something I thought about for years running an ICU as Director and Chief of 17 intensivists. When I compared my practice to my colleagues, I felt strongly that what separated us in the ICU wasn't intelligence, knowledge, or experience; it was our tolerance of risk, but also what I started to call "comfort with the unknowable," or, as you put it, comfort with uncertainty. That's because we were constantly in situations where you had to make decisions based on incomplete or unobtainable data.

AMD: To that point, I’ve always been drawn to puzzles predicated on incomplete or unknown information because of the type of branching and expansive thinking that is required for them. That’s also why I try to write the way older texts often did—using careful ambiguity to create a kind of holographic depth you can’t attain otherwise.

PK: That tracks with how I’ve always approached incomplete information clinically. I remember one day a nurse pointed out to me that I ordered far fewer tests and consults than any of my partners, and she was right. It sent me down a detailed 18-month analysis using multiple databases, which let me detail the actions of every intensivist on my service and compare how much each one tested and treated against how their patients actually did, using observed versus expected ICU mortality derived from ICU APACHE scores. The bottom line: no correlation. Heavy testers searching for certainty landed all over the performance (err, survival) rankings, and I was the outlier — second from the top in patient survival while ordering by far the fewest tests. (I explore why in the full analysis here.)

AMD: That parallels my longstanding experience that the best integrative physicians I’ve worked with ordered far less labs than their colleagues.

But the deeper point is yours: the testing reflected each doctor's discomfort with uncertainty, and like any other human characteristic, fell along a bell curve, with very few able to tolerate uncertainty very much (except moi, of course, sorry not sorry).

AMD: It also describes doctors' dogmatic behavior and their tendency to distill complex topics into simple declarations that ignore much of what’s going on with each patient. On a deeper level, though, I think it’s the same dynamic underlying many of the ways our society has gone astray, as our entire mode of science and medicine revolves around dominating and rigidly defining nature rather than working in harmony with it, which effectively is an exercise in futility to force certainty onto a world that can never yield any more than the illusion of it from within an artificial model.

PK: That’s one of my favorite points. Everything runs on protocols and algorithms, but every patient is different. Each week that I would take over the ICU, I would give my team which consisted of 1 fellow 6 residents, 2 students, a rundown of what to expect from me, and what I told them was: “This week, when I ask you a question, if you don’t know the answer, you can get out of it by saying, “It depends.” The problem is you will then have to tell me what variables it depends on, why that variable matters, and what the consequences are of doing or not doing that intervention in that situation. They actually loved doing that exercise at the bedside TBH. Man, you bring back memories of my teaching days.

AMD: That’s wonderful; I would have enjoyed rounding on your team when I was in training. One of the things that has always alienated me is that I find certainty “boring,” and a big part of what drew me into becoming a doctor was knowing the sheer complexity of the body guaranteed I was signing up for a lifetime of uncertainty, challenges, and discoveries with each patient. So in my style of medicine, while there are certain principles I prioritize for restoring health, how I approach patients, even those with similar ailments, often varies immensely.

PK: How do you reconcile that with you having to send the same email to hundreds of thousands of people at once?

AMD: It’s one of the biggest challenges I face, as nothing exists that works for everyone or that can be applied and dosed in the same way. At the same time, I have the opportunity to help a lot of people, so I need to do something, and I’ve hence adopted the position of minimally discussing the therapies I use that are too variable while simultaneously trying to provide as pertinent detail as possible for the ones that are less specific to the individual.

PK: Like DMSO?

AMD: Yes—although it’s not the only one. The huge upside to DMSO is that it works for a very wide range of conditions, and while some knowledge and creativity is needed for its applications to address certain diseases, since it spreads through the body, even if it’s applied in a suboptimal way, it often still works. More importantly, it costs almost nothing so if it doesn’t work, it’s no real loss, and its toxicity is minimal, so while reactions do happen, most are either manageable or easily avoidable. However, even with that and my exhaustive efforts to supply the correct information on how to use it, people have issues from using it incorrectly, it still doesn’t work for everyone (e.g., readers have reported a 40-50% tinnitus improvement, 80-85% with pain, and likely over 90% with burns) and the less than satisfactory outcomes they share constantly weigh on me.

PK: Don’t be too hard on yourself. The results I’ve seen are beyond what I would have thought possible for any therapy a few years ago. That’s why I’ve promoted it and why at our Leading Edge Clinic, we are running a tinnitus trial that now has some encouraging early signals.

AMD: Tinnitus also illustrates a broader limitation in the usual model. To facilitate scalability, it revolves around diagnosing ailments by describing symptoms in Latin and then giving agents that counteract those symptoms. One issue is that different diseases with shared symptoms are treated as the same entity, so a treatment that addresses only a subset of causes becomes the standard of care and doesn’t help the remaining cases. Using tinnitus as an example, it has many different causes (which somewhat correlate with the different sounds people hear), and systems that successfully treat it typically consider multiple potential root causes rather than a single approach. Likewise, while DMSO addresses the root causes of some types of tinnitus, it either can’t address others, or it only works if a protocol is tailored to the specific condition present.

PK: That matches what we’re seeing. Safety, range, and cost like this are rare. Not that I don’t know the answer, but I will ask the obvious question anyway: “Why hasn’t DMSO been pushed harder?

AMD: Originally, it was because the FDA and other parts of the medical industry went to great lengths to blacklist the therapy, like when they intimidated scientists researching it. Once they lost the power to do that due to a 1994 law removing the FDA’s jurisdiction over natural supplements, the health climate changed and increasingly revolved around marketing supplements. The major challenge with DMSO is that since a single bottle of it costs virtually nothing and lasts for months if not longer, no one has any incentive to market it and it got crowded out by everything else being promoted (resulting in it just being a therapy whose discussion was restricted to smaller alternative health communities where users were collaborating to find the best solutions to their ailments). The thing I found the most amazing about the whole thing is that while I knew buried DMSO research existed, I had no idea much was out there virtually no one knows about that addressed a wide range of challenging diseases no good options exist for currently.

PK: Following your work as closely as I have, that was one of the most amazing things I learned, which was the insane amount of published research, not only in English, but in other languages as well; it was mind-boggling. So, tell me, how much published research on DMSO exists?

AMD: I spent about five months going day in and day out to try to collect every medically relevant DMSO paper that existed, and while I tried to be thorough, I’m sure I missed some of it. When I ran it through AI for a count, I had about 15,000 pertinent papers. I’m currently doing the medical ozone project, and I know there are thousands, but I do not expect to reach the 15,000 mark.

PK: That’s a massive undertaking. How are you managing it?

AMD: I’ve long been a pragmatist because I’ve had too many bad experiences sinking a lot of time into things I cared about that just couldn’t go anywhere. At the same time, I draw a clear delineation between “difficult” and “impossible,” and when I started this specific project, what needed to be done looked incredibly daunting, but didn’t feel “impossible,” so I just had faith I’d somehow figure out how to do it along the way. That happened, and the ozone project, which I thought would be much harder than DMSO because there are even more studies, is actually going much faster; in hindsight, I wish I’d known a lot of what I know now when I did the DMSO search. For example, recently when facing a really time-consuming research task, I queried a few AIs to see if a better option existed, and after the initial approaches failed, eventually found out a custom Python program was the ideal solution (which I then revised a few times). Before that moment, I had no knowledge of programming, but since I have a good enough grasp of logic, I can get AIs to write and debug Python programs for me, which makes so many of the tasks I had to do much simpler. So if you’d asked me a year ago, I never would have agreed I’d need to “learn to code,” but now that I somewhat have, it’s completely changed my life.

PK: I actually don’t think I can give an insightful answer to this question in regards to my own pace and commitment to work because I seemingly do it without planning or forethought, so I will ask you: What keeps you putting in this level of effort?

AMD: Helping others has always been one of the core values I navigate the world through, but I kept running into this: once I got involved in something my heart was called to, I often became entangled in something that ate up a lot of my time and didn’t feel like it helped people. A big part of wanting to be a doctor was just that I knew I could spend a lot less time to make a much bigger impact on a lot of people’s lives than people I’d tried to help in the past. However, I never dreamed I’d get the chance to help as many people as I do now, and while this newsletter is a lot of work, if you instead look at it as the ratio of how much effort I put in to the impact it makes for each person, it’s incomparable to everything I did before and something I never could have even conceived was possible. The entire reason I put so much effort into it is that I want the results that actually help people, and we currently have a window to reach many people who were never open to these issues before, so I feel I need to help create the stable non-polarized foundation that can actually shift how they see things.

I also had a long period where I was immersed in the alternative media (and the attached communities), and while I found it enlightening, I gradually became more and more frustrated with the fact that a lot of the people there wanted to point out how bad things were, but never would offer productive solutions to make things better. On one hand, I get the helplessness, because it does really feel like the world is against you, like when you have a vaccine injury, but that helpless stance wasn’t acceptable to me, and now that I have a real opportunity to make things better, I feel I have to take it.

PK: What do you think drives the black-pilled stance? ED: To those not in the know, black-pilled means having become deeply pessimistic or fatalistic—convinced that a problem is so entrenched that meaningful improvement is unlikely or impossible.

AMD: It’s often thought to function as a way to eliminate uncertainty; if everything is already as bad as it can be, you cannot be disappointed later. Sometimes it is mixed with pride: the person who sees the full bleakness can believe they are clearer-eyed than those who are naive enough to still hope, and is also relieved of any responsibility to try to fix anything. While I see cases where either is at play, like when I feel it’s largely an ego thing when people get very aggressive with pressuring you to validate their bleak world view, when I encountered this within the communities I’ve belonged to, a large share of it felt like a trauma response. When you attempt to interrupt something profitable and harmful, the system will go to great lengths to resist the racket being interrupted. It’s hence inevitable that those trying to make things right will be marginalized and again and again sabotaged, so as time goes on, that just becomes their default, which in many cases is a valid way of interpreting what they subsequently see transpire, as once your hopes have been dashed too many times, it’s hard to have faith something good could happen.

PK: I have to admit that on some issues, I believe I have developed a black-pilled stance and no longer work on them, but, at the same time, I do not let it color my entire worldview; I just pivot to areas I think will be more fruitful. How have you avoided sliding into it yourself?

AMD: I’d definitely had some pretty big letdowns, but I never expected this to be easy, and I know if we want anything to shift, we’ll have to work a lot for it—but even with that I’m very judicious with what I’ll take on as I know many things I care deeply about are effectively a lost cause to do anything about right now.

On one hand, studying history helps me keep everything in context, as while things often seem “bad,” there are numerous periods I can cite throughout history both where things were worse and where eerily similar things to what we’re seeing now happened, but in time, they all eventually faded away and resolved themselves. On the other hand, when I was younger, because of who I was, I was put into numerous situations where I was completely powerless, and some of those experiences left a deep imprint on me. So above all else, no matter how tempting it is to give in to despair, I hate surrendering my agency and always try to find a way to help myself or others. When you talk to people at the end of their lives, one of the most common regrets they share was that they allowed themselves to be pulled into what was fed to them rather than doing what they really wanted, so especially as I get older, I try to gravitate towards the things that give me meaning even if it’s difficult to do and I have to go against the tide I’m currently in.

With medicine, one of my core aims going in was to do something to help the people medicine had hurt and possibly find a way to shift medicine’s direction toward something that supported health. However, despite those aspirations, I had to quickly come to terms with the fact that the system had too much inertia to change, and the best I could hope for was to help the patients on the periphery who found their way to me. So, when I realized the political window was there to actually make a much larger impact, I felt I needed to take it, but at the same time, the pace I’ve been going at is not sustainable, so I will probably change what I do once this window closes, and it’s no longer as critical to do something with the once-in-a-lifetime opportunities we have now.

PK: I understand the weight. I never expected to be in the role I’m in either. Before I knew it, it just happened.

AMD: Same. One of the things that motivates me to work as hard as I do is the fear that I'll do something that negatively impacts others, which is part of why I try so hard to make the articles accurate and applicable to all the contingencies I can see coming up. However, while that fear makes me genuinely hesitant to publish anything and makes writing a lot less fun as I have to constantly vet and verify things, at the same time, I also know the fear of making a mistake can’t be an excuse to do nothing, because it’s even worse to squander the generational opportunity we have to make things better now. I spent decades complaining about the way things were, so I’m obligated to do something about them now that I can.

PK: Having followed your work, I have a few thoughts on which issues you have covered that then seemed to impact either policy or discussion around certain issues, but I want to ask you, looking back, what do you see as the most meaningful thing you’ve done so far—or the biggest win?

AMD: Helping with RFK’s confirmation. Once Trump won, I knew a major coordinated effort would be made to block him, so in November I started testing messages on 𝕏 that might counter the narratives being built against him in preparation for a future confirmation hearing. Later, immediately after the first day of his hearing, I put out a post framing much of the opposition in terms of pharmaceutical incentives. It reached about 33 million people; some of those points were raised on the second day of the hearing, and afterward I saw reporting that the corruption framing had influenced the remaining undecided votes. Since so many people were working behind the scenes to facilitate the confirmation, it’s impossible to know if what I did tipped the needle, and I’m just grateful we did the impossible and got RFK confirmed.

PK: After your recent piece on the childhood vaccine schedule, the executive order came out incorporating several of the specific things you’d suggested, including splitting the MMR. What was the thinking behind what you did?

AMD: Essentially, with vaccines there are three schools of thought: that vaccines are safe and effective no matter what, that vaccines have risks but their benefits outweigh them, and that vaccines are extremely dangerous and should be banned. Since the industry is very greedy (e.g., they will always take a mile if you give an inch), the “safe and effective” school of thought has dominated, so more and more vaccines and the cumulative toxicity they entail have entered the market, and increasingly aggressive censorship methods have been deployed to sweep up the continually increasing harm they create under the rug. However, the mistake the industry made is that because of how much harm is being created, especially post-COVID, it’s no longer possible to sweep all the injuries under the rug or end the conversation by declaring any criticism of vaccination is blasphemy and akin to murdering children).

Because of this, an unexpected window has been created to shift the dialog to the middle ground option: that real risks exist to vaccination and they need to be judiciously weighed against their potential benefits, rather than the old position that vaccine injuries were “one in a million” and hence not worth worrying about. I feel that’s important, in part because it’s a middle-ground position that can appeal to far more people and because the entire conversation becomes very different once it shifts from clashing ideologies to simple concrete facts that can be objectively brought into the discussion and highlight that the existing paradigm on vaccination is absurd.

PK: That middle-ground approach makes sense. How did you arrive at it?

AMD: For me, this started because I’ve long believed it’s more important to be “accurate” than “right,” so when I debate another party, I try to fairly represent, that is to say, steelman their position, rather than play games, straw-man them to win, and achieve a hollow victory.

PK: I agree. It’s definitely backfired on our movement when influencers took studies that supported our message, then exaggerated their findings to far beyond what was in it and made apocalyptic predictions that never bore out.

AMD: If the truth is on your side, the last thing you want to do is give the other side a straw-man they can use to dismiss all the other valid points you are raising.

So, here, I wanted to see if one could make the case that any of the vaccines on the schedule were providing a real social benefit alongside the harms they created. From that, I realized the justifications for many of the vaccines were much worse than I had originally thought, and often just a result of lobbying or historical precedent, like with the fact that every child receives diphtheria despite there having been less than one case per year in the USA for decades, yet everyone still gets it because it’s bundled with tetanus.

So, given that the harm of vaccines is cumulative and some are more harmful than others (Ed: best shown by all the sudden infant death data), if you could achieve a policy move that cut down the vaccine schedule by removing the worst offenders, while it would not prevent all the injuries they caused, it still would be an immense blessing as it would massively reduce the harm being caused.

My own read on the vaccine situation was that the absurd justifications for many of the vaccines on the schedule were one of the least emphasized points in our movement. So, if attention was brought to that, it could reach people in the middle who have doubts about vaccines but view them as necessary and hence tip the needle towards a safer vaccine policy that returns us to where the (ever-increasing) chronic illness rates were a decade or two ago. Likewise with the MMR vaccine, the entire push for the vaccine has revolved around making people terrified of measles, so most people who get the vaccine don’t give a second thought to its other poorly justified components, which is a shame as the vaccine safety movement for decades has pointed out that the harm of the measles vaccine would be significantly reduced if it was not given concurrently with mumps and rubella—and as such, the industry protected their market by making it impossible to ever get measles without the other two.

PK: If simple harm-reduction options are available, why have they been resisted so hard?

AMD: A few explanations exist for this. For instance, it has long been established that spacing vaccines out, rather than giving them all at the same time, decreases injury rates. So, spacing them out would seem like the rational option for the industry, as they would still get their sales but face less public pushback from the injuries they’ve created. However, rather than do this, each time someone proposes it, the medical industry goes after them and, in some cases, gets their medical licenses. Depending on who you ask, three things explain that behavior.

First, spacing vaccines out to reduce injuries is tantamount to an admission vaccines are not completely safe, so to prevent that, they would rather deny the injuries occur and allow them to continue than reduce them, which is in line with the industry and government’s longstanding position that nothing that creates doubt about vaccines can ever be allowed to exist. This is why, again and again, like just recently when Ron Johnson proved it with COVID-19, you see drug regulators hide vaccine injury data to prevent “vaccine hesitancy”.

Second, economically, it’s harder to sell a massive number of vaccines if children have to separate them, as at this point, prior to RFK cutting things back, they got roughly 50 total vaccines along with annual COVID and Flu shots. If a separate visit was needed for each of those, beyond it adding significantly less reimbursement onto each visit, making it potentially non-viable for pediatricians, it is unlikely most parents would even take their children in that many times. A parallel to this is that the original HPV vaccine trials showed girls who already had one of the targeted HPV infections at the time of vaccination were more likely to get cervical cancer, something that has happened to people I know, indicating the rational policy would be to test each vaccine recipient for HPV beforehand. However, as this would reduce vaccine sales, the decision instead was made to lower the age of vaccination in the hope everyone would be vaccinated before a potential sexual exposure to HPV.

Third, if you ascribe to the school of thought the vaccination program is intentionally being conducted to harm the population, which a case can be made for, any attempt to reduce vaccine harms would be opposed. However, my own experience in dealing with these types of people is it’s not so much that they want to hurt others as they just don’t care at all about the consequences of their actions. So, since there is no liability for a vaccine injuring someone, and at least till recently, no potential loss of sales from public outrage over the injuries, incentives aligned for them to keep pushing as many vaccines as possible.

PK: I’ve been going through Trump and RFK’s vaccine executive order. While more could still be done, what they actually enacted is pretty phenomenal, they eliminated roughly half of the required vaccines, including many of the worst ones, splitting the MMR, moving toward non-aluminum adjuvants, protecting exemptions at the state level, improving the injury surveillance system, which as you know, has always been deliberately opaque, and finally advancing the safety studies that were promised back in 1986. I honestly thought any of those were impossible. Watching so many vaccine proponents completely lose their minds over the last few days has been something else.

AMD: It’s understandable; they have a lot to lose once the racket they’ve put so much work into starts to unravel.

PK: What bothers me is how much of the loudest opposition is coming from people on our own side who arrived only recently. Why?

AMD: It’s definitely irked a lot of people, particularly those who are toiling day in and day out to fix things, and most of them have told me they think it’s because these people are working for the pharmaceutical industry to sabotage things. While that’s possible, since a lot is on the line for the vaccine industry, I hold a different opinion. I’ve seen something similar to this happen in many different movements I’ve belonged to, so rather than be surprised by it, I was expecting it, don’t take it personally, and have just been trying to steer the blackpill sentiment in a positive direction.

PK: Seriously?

AMD: Yes, here, ask AI right now.

What the AI returned: When a reform movement begins to achieve real, measurable progress after years or decades of struggle, a recurring pattern often appears. A vocal contingent that had previously campaigned for reforms treats concrete wins as insufficient, suspect, or even a deliberate distraction. They label the people who delivered those results as saboteurs, dismiss the advances as trivial, and insist that only maximalist, all-or-nothing outcomes count as legitimate success, thereby maintaining their relevance. Versions of this have appeared across history and the political spectrum:

• In labor and socialist movements, once social-democratic parties and unions won shorter workweeks, workplace safety laws, public healthcare, or stronger bargaining rights, hardline factions frequently denounced the reformers as sellouts or agents of the bourgeoisie and insisted anything short of full socialization was worthless.

• In the civil-rights struggle, after the Civil Rights Act and Voting Rights Act, more radical voices cast the moderates who secured those laws as too accommodating, arguing legal equality without deeper economic and structural change was incomplete.

• In environmental politics, measurable gains in emissions standards, renewable deployment, and phase-outs of the dirtiest fuels have often been called “greenwashing” or corporate co-optation by maximalists who demand total systemic overhaul and the abolition of fossil fuels.

• In anti-war movements, troop withdrawals, arms-control deals, or limits on war powers have been dismissed as cosmetic by uncompromising factions who accuse the negotiators of being controlled opposition.

• On the right, policy deliveries on taxes, judges, borders, or cultural issues have routinely been branded theater or proof of “RINO”/“Uniparty” betrayal.

In the early stages, these absolutist voices often serve a vital function. They keep relentless pressure on institutions, prevent the powerful from defining the limits of reform too narrowly, and expand what eventually becomes politically possible. Without that intensity, many important changes would never gain traction. Once mainstream adoption becomes feasible and tangible institutional results start to appear, the same absolutism frequently turns counterproductive. Energy shifts from consolidating gains or taking the next practical step to tearing down the people who moved the needle. Genuine but incomplete victories are framed as proof of betrayal, and the movement fractures into purity tests rather than strategy as many who initially joined the movement excel at fighting rather than building coalitions to enact policy. The result is slower progress and demoralization of those producing results. The healthiest stance is to hold both halves of the pattern: early pressure is useful and sometimes necessary; treating real wins as inherently fraudulent hinders the cause.

PK: Wow. That reminds me of how so many people were disavowing and denouncing RFK for keeping the COVID-19 vaccine on the CDC schedule for pregnant women and children. They treated it as their red line, something not even Bobby could be forgiven for. Then not long after, when he finally got it off the schedule, they immediately forgot about it and moved on to attacking him for the next thing he hadn’t done yet.

AMD: Yes. One segment, like many movements in the past, treats any step toward vaccine harm reduction as a distraction from total abolition, like when they yell that “safer vaccines is a psyop.” Others judge that, for the foreseeable future, the realistic path is reducing damage, protecting the right to refuse, and continuing to shift public opinion, because policy ultimately follows voters, which I favor because I’d rather reduce vaccine injuries than accomplish nothing right now. I am also highly doubtful any president besides Trump, due to both his personality and personal experience with vaccine injury, would have ever cut back the vaccine schedule to even a fraction of the degree he has. Yet, even Trump, who has received a lot of blowback for his childhood vaccine decisions, along with many of the people in MAHA I’ve spoken to, have been very clear they will never ban vaccines as it is simply not politically tenable, which is why the compromise position they created on the new CDC vaccine schedule was to make many of the previously recommended vaccines optional or restricted to limited groups rather than taking them off entirely.

PK: There is a time when you need rigidity to fight, but there is also a time when you need the flexibility to take the wins that have been given to you.

AMD: The other thing a lot of people who haven’t been in the thick of this don’t see is how many people had to work their tails off, were never really recognized or widely thanked for it so that we could get to the point we were at, or just how much pushback there has been from the pharmaceutical companies across the board and just how many different coordinated attempts have been made to sabotage these reforms.

For example, over the last six months, one of my projects was to derail the pharmaceutical industry’s successful attempt to stop all vaccine reform. Briefly, they conducted a doctored poll that said the public was overwhelmingly opposed to vaccine safety reform, so if Trump or RFK pushed it, the Republicans would lose the midterms. Given this information, White House staff made the largely rational response to ban all discussions of vaccine safety until after the midterms. Not long after, a contact working on enacting those reforms said unless something could be done to shift that, before long it would become ingrained as a policy, and likely kill their generational attempts to make a safer vaccine schedule, so they asked if I could help shift that. Since give or take every other poll showed the exact opposite and that the public strongly supported vaccine safety reform, I thought there was an actual chance that narrative could be overturned, and a big focus of what I did with the limited time I had was to do that, which seems to have succeeded. However, I feel in comparison to a lot of the other people who have been working day in and day out, my contribution was minimal, it’s just that it’s hard to see or appreciate a lot of what vaccine safety reformers have to deal with in Washington unless you are in the thick of it.

In regards to the specific MMR policy decision, I did not have advanced knowledge of it, so I’m not sure if what I did tipped the needle there, I just put this message out because I suddenly had an intuition it was the right time to do it, and I tend to act on those as they’ve frequently put me in the right spot at the right time to make a tangible impact (which is why I am likewise grateful to all the critics who amplified that post and inadvertently allowed it to be seen by the right people).

PK: I’m grateful a real team came together around this. The institutional resistance is fierce.

AMD: Turning values into durable institutional change is harder than it looks from the outside. I’ve tried more times than I can count to do that and failed on things far, far easier than anything RFK is trying to do.

PK: What are you focused on now?

AMD: I have long believed that continually attacking or trying to destroy something is rarely a successful way to approach things, whereas cultivating a positive thing which displaces the existing issue is typically more effective and has a much more lasting impact. Unfortunately, this often puts me in opposition to the existing paradigm because so much of our society revolved around feeding the human need to use force and domination to simplify reality and eliminate uncertainty.

For example, philosophically, modern medicine (allopathy) originated from the idea that you needed to reverse the currently existing symptoms by shifting it to the opposite state, like when aspirin is given for fever; so many of the early interventions used increasingly forceful methods to achieve that shift, leading to it being called “heroic medicine.” Since creating those forceful shifts often required extreme, heroic measures, side effects inevitably followed, but the medical system’s solution was simply to deny the side effects or rationalize their necessity.

PK: That basically describes every vaccine-injured patient I’ve worked with. I will never forget the widely pervasive and deeply cruel extent of the gaslighting my Covid vaccine patients endured, particularly from 2021 to 2023; in fact, I remember that the first half of my typically hour+ long visits was listening to them recount the gaslighting they had endured. It lessened somewhat after that, but gaslighting is especially infuriating when there’s a clear neurological problem sitting right there, tightly and temporally associated with the jab, and the specialists still insist it’s psychosomatic or dress it up with something like “functional neurological disorder.”

AMD: One of the most interesting things I learned about gaslighting is that after mercury started being widely used in medicine and caused a variety of neurological disorders, the resulting symptoms, particularly in women, were often diagnosed as “hysteria,” which, especially in Freudian theory, was then attributed to unresolved sexual conflicts. In turn, multiple authors have made the case that some of Freud’s original famous cases, along with many other “hysterical” patients, were actually neurologically suffering from mercury poisoning.^1,2 I’ve thus suspected the reason why Freud’s ideas caught on so quickly was because it gave the doctors a way to absolve themselves from injuring their patients.

PK: Just like how people who vaccinate and then get sick are allowed to blame it on the fact other people aren’t vaccinating.

AMD: I’m still amazed that line has been able to remain a viable sales pitch for vaccines, but that’s the power of propaganda.

PK: I largely agree with the allopathy framing you laid out, but I do have to push back on one point. In some situations you absolutely have to force the body into a different state—especially when you’re dealing with a critically ill patient who’s actively dying.

AMD: Completely agree, and that touches upon why modern medicine excels at treating acute conditions rather than chronic ones. Once again, it’s important not to fall into an absolutist stance. There are things conventional medicine handles effectively that should not be rejected simply because they come from a system rife with issues. At the same time, it is often difficult to accept the useful part without also being pushed by medical providers toward many other standard practices that are unnecessary or harmful, and it’s anything but easy to hold both of those realities in your mind simultaneously as you navigate the medical system.”

PK: And once you’re inside that system, the default response when something doesn’t work is often just to escalate.

AMD: Yes. The other key issue with this paradigm is that since it focuses on dominating the body to achieve a desired outcome, once that fails, the most common (human) response will be to double-down and use more aggressive measures to try to achieve that goal, which in many cases leave the patient far worse than they were. The best example of this is probably high-dose chemotherapy, which came into vogue in the 1980s and 1990s especially for breast cancer, but was eventually pulled back for that use after randomized trials showed it did not improve overall survival and carried much higher toxicity. Because there was so much inertia and money behind it, it was difficult to speak out against it at the time, by the way, you should check out a Wikipedia article that gives a good overview, but even after it was phased out for breast cancer, many in oncology continued to hold the core dose-intensity belief and remained willing to accept higher doses and side effects in the hope of better cancer control when it might work.

PK: I definitely agree on the overdosing issue. I’m surprised how often the patients we see report having been given doses they simply cannot tolerate. What’s particularly striking is that once my work with vaccine-injured people brought me into contact with so many of the “sensitive patients” you talk about, it became obvious that a lot of doctors just don’t grasp they often need to use lower doses.

AMD: I think that’s a result of three things. First, as mentioned earlier, when something doesn’t work, the human tendency is to do more, and then rationalize after the fact why it was the right choice. Second, because our medical system revolves around standardized protocols that doctors can rapidly scale and deploy to drive drug sales, there is no room for the nuance of an individual patient’s needs or the time it takes to figure out the appropriate dose for them. Lastly, in both the conventional and alternative medical system, our cultural belief “if something is good, more is better” seeps in, so even when you warn doctors or patients, they will often overdo whatever was helping and cross the threshold into something counterproductive.

PK: Totally agree, but there is some nuance there as I have worked with a number of theapeutics that have pretty impressive dose-response curves, but they are a minority, although I agree most docs tend to think they all do. Life would be so much easier if people stopped doing that.

AMD: The same principle I use in medicine, “cultivate health rather than relentlessly attack disease,” also applies to how I try to engage the larger culture. A lot of the persistent bad practices inside the medical system are simply reflections of the broader culture that produces the conditions for them, so a good deal of my focus goes into how we can shift the underlying mentality. Among other things, this means moving from polarized black-and-white discourse toward something more nuanced that can tolerate ideas we don’t fully agree with as long as they actually move things forward from where we are now. With medicine specifically, while I think it’s important to expose what’s wrong, relentlessly attacking the system is not a workable strategy on its own. People still need medical care and will end up going back to the conventional system even when they have serious doubts about it.

PK: So what’s the solution?

AMD: I settled on providing better alternatives to the existing paradigm, and on empowering people to figure out for themselves how to use them. On one hand, this frees people from being subject to the medical system and to practices they disagree with, such as care being made conditional on COVID vaccination. On the other, it creates the one thing that can motivate the medical system to do a better job, which is genuine competition. Competition forces them either to provide the results patients want or to lose a great deal of money. I believe that is the only reason the loss of trust in science and medicine after COVID is even being allowed to be openly discussed now. They need to regain that trust for the business model to work.

More importantly, it catalyzes a shift in consciousness, both by making people have a tangible realization that the suffering they went through didn’t have to happen, which moves skepticism of the system from an abstract idea to a lived experience, but also because simple remedies being able to affect so many different diseases shifts the societal perspective on how the body works from the sterile reductionist model our society revolves around to a much more vibrant and connected one.

PK: That may be one of the reasons I gave more than a year of my life to alert the public to the wonders and broad applicability of chlorine dioxide, but I have been reluctant to put my book on Amazon where it could reach a much wider audience. So how do you actually do it at scale?

AMD: While I’ve been able to do that for many individual patients I’ve worked with, it’s obviously unrealistic I could do that at scale and shift the culture. However, I’ve long believed that the shifts towards “cultural health” always have a building stage, where for years, if not centuries, some people are aware of the idea, and try desperately against all odds to have it catch on (often becoming extremely bitter and frustrated those around them simply don’t want what would radically improve their lives), but then at some point, the cultural conditions suddenly shift, and all the work that had been done previously is positioned to ignite and shift the whole culture. The fall of the Berlin wall is the most commonly cited example of this, but consider what’s happened with the vaccine issue.

Since the days of the smallpox vaccine over 200 years ago, people from all walks of life have done all they can to fight against and protest vaccination. Despite that, as the years went on, the vaccine industry only became more powerful, and each coordinated opposition to it was largely erased from memory. Yet the industry grew so overconfident and greedy that during COVID it did things so far out of line that public distrust of COVID vaccination sprouted like wildfire. That distrust spread across a recently "freed" internet, in a highly polarized political climate where one side had shortsightedly chosen to zealously endorse vaccines. Before long, doubt about the COVID vaccine and resentment toward the left turned into something else, and people began listening to the parents of vaccine-injured children whom they had previously written off. So now there is not only far more distrust of vaccines than I ever expected to see in my lifetime, but RFK is enacting policy after policy that, as you said before, people in the vaccine safety movement dreamed of for decades.

PK: I’m with ya on that, I never ever would have imagined it could have moved that fast.

AMD: Another way to think about it was that the reason people like you wanted to get involved was ultimately due to the fact we’d reached the point where a rapid shift was possible.

Anyways, due to some odd coincidences, I’ve periodically felt like I was put where I was because there was a role I was supposed to serve. For instance, I had some very odd experiences right before COVID that made me feel I was supposed to become entangled in it, and due to a series of improbable events, I eventually ended up in the position I am in now. Similarly, when I was younger, I noticed that a lot of the incredible medical discoveries people had made were gradually disappearing and getting harder and harder to find, so for some reason, I felt compelled to preserve them in the hopes I could pass them onto someone in the next generation and keep their fire alive for the time far into the future when they were ready to emerge and then somehow was repeatedly connected with their reclusive custodians.

However, when that pursuit started, I never expected something like the internet would emerge, let alone that when it reached the point where information could rapidly disseminate across the culture, I’d be in the position to disseminate it. So, all the paths lead to a simple conclusion; my role is to provide information that people can use to both positively transform the medical system and opt out of it, and I want to do that by leaving detailed summaries and records of exactly how people can do that so they have the best shot of igniting when the time is right. Because of the unusual sequence of events that led here, I treat it as something I’m directly accountable for getting right. My focus hence stays on the results rather than recognition, as the former is my priority, which is one reason anonymity helps.

That’s basically why I’ve put so much work into trying to create a comprehensive foundation for DMSO rather than letting it follow the course of a typical health fad and I did it under a very tight timeline. It is also why I’m doing the same thing with a few other therapies like ozone as that’s the best I could come up with to create a positive shift.

PK: A lot of that sounds like Carl Jung’s “Sage-Steward” Archetype. On that note, I have to thank you for the piece you put out last week on the war against chlorine dioxide and for highlighting how my book’s story folds into a broader pattern of monopolistic suppression. After you called out the absurdity of their position, a few days ago, the FDA quietly pulled the pages that had been calling CDS “toxic bleach” for years and blocking CDS research globally.

AMD: That gives me hope that with enough work it may at last be possible to overturn the FDA’s position that ozone is a toxic gas with no medical value whatsoever.

PK: Exactly. It’s another reminder that putting the evidence in one place, cleanly, does matter.

AMD: That’s it essentially. Because of all the eerie coincidences that made what I’m doing now possible, I feel I have a deep obligation to do the task I was entrusted with well. Once the foundation is solid I want others to carry it forward so it isn’t dependent on me and I am becoming increasingly hopeful that the current conditions will allow things that previously looked impossible, provided the groundwork is done carefully.

PK: Any advice for others trying to shift the conversation?

AMD: One of the more eye-opening things for me has been what the internal metrics show: the loudest, most black-pilled voices you see on social media are a clear minority. The much larger and quieter share of people are the ones who deeply value this and provide the kind of sustainable support that actually gets these messages out, in many cases precisely because the sea of outrage and AI-generated content that social media rewards feels emptier the more time you spend in it. So for anyone caught up in the daily struggle to be seen online, the same lesson applies as with the black pill itself: as tempting as it is, it rarely leads somewhere good.

PK: That’s a good way to look at it. Is there anything people can do to support the work?

AMD: The support I’ve received up to this time has been incredible and has been the thing that’s made a lot of what I’ve done possible. Some of the things I want to do are only possible if the newsletter and its support grows, but I have faith that it will happen eventually and I deeply appreciate everyone who helps make that possible. For the time being, I just want people to share the material, incorporate the ideas I put forward they agree with into their own frameworks, and if they have time, to leave a comment about experiences they’ve had with DMSO here as I’m now approaching my impossible goal of 10,000 reader DMSO testimonials.

Beyond that, there are also a lot of people doing critical work on the vaccine safety I’d like to draw attention to. A team of researchers I trust are conducting a study comparing the health of vaccinated and unvaccinated children, so if you’d like to consider filling out a brief survey, you can do so here. Furthermore, the government is about to finalize a historic autism plan, so if you can lend your voice right now (Ed: the instructions are here), especially if you had a child who was vaccine injured, please consider doing so.

PK: I’m glad I decided to support you early on. Any final thoughts?

AMD: Everyone is born with the chance to create a deep meaning from their life. They just have to set their sights on what they know in their heart they are meant to do rather than getting caught up in the endless distractions and aimlessness society feeds us. Time is limited, but I started the journey I’ve been on for decades because I knew it was vital I found the things which could provide that purpose to my life. A lot of what I’m doing now is quite arduous, but the fact that real results are possible has been more than enough for me to invest as much as I have into it. Despite my optimistic nature, for most of my life, because of how entrenched the vested interests are that exploit and harm everyone for profit, I’ve been a pessimist that things could ever change. Now that one thing after another is coming to fruition in the blink of an eye, it quite frankly feels surreal. Just a few years ago I would have said my life felt complete if even one of the things I discussed here had happened. Since I tend to focus on how things will unfold far into the future, my aim has always been to lay foundations for results that would matter years down the road, so I never imagined I’d see some of those aspirations occur so quickly.

PK: Look, I just want to say I really appreciate what you’ve done to help move things forward.

AMD: I feel the same way about you, but I don’t even know who we can even give the credit to at this point. Much of what I’m doing is only possible because so many people are helping me, and more importantly if there had not been a critical mass of people like you, Robert Malone, Senator Johnson and many more, who stepped up and stuck their necks out to try to fix this mess nothing could have happened. If my read of history is correct, this is all part of a much larger cycle, and we all just were happened to be the ones around at the time where this was meant to happen.

PK: Or as the old line goes—it’s amazing what you can accomplish if you don’t care who gets the credit.

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The Shameless Commercialism Department:

I write about minerals and water. I also sell them.

Aurmina is simply the provable, superior, and less expensive alternative to reverse osmosis for purifying drinking water. It binds and removes over 245 modern contaminants — and unlike RO, it leaves the minerals, redox activity, and ion-exchange capability restored, rather than stripping water empty and calling that clean.

Primora Bio is the same chemistry for the water that grows things: irrigation and foliar, for soil, crops, and livestock.

Both came out of a year spent on one forgotten Japanese mineral extraction that produced three books (The Stone and Water Series) and led to the retirement of my patient panel, though not from Leading Edge Clinic.

From Research to Practice - Links Below Image

Earth’s Living Water- Its History, Its Ruin, and the Way Back

The Silent Aquifer - Humanity’s Unfolding Food and Water Crisis

The War on Chlorine Dioxide - The Medicine That Could End Medicine

Aurmina – The Mineral Extract For Naturally Vitalized Drinking Water

Primora Bio - Bringing Life Back To Soil

Leading Edge Clinic - Tele-Medicine Clinic Caring For Patients in All 50 States

The War on Ivermectin- The Medicine That Could have Ended the Pandemic

The Blueprint of Life - The Hidden Architecture That Powers Life and Health

Medical Musings - A View From the Inside Of Modern Medicine

This week, my friend and colleague A Midwestern Doctor (AMD) published the brilliant new article above, part of whose subject was my book called The War on Chlorine Dioxide (written with my co-author Jenna McCarthy, who is one of the funniest and smartest writers on Substack, so if you’re not already following her, you should remedy that immediately).

After detailing medicine’s nefarious history of building monopolies, burying inexpensive treatments, and branding inconvenient therapies as dangerous quackery, AMD gets to the book — which, if I may shamelessly brag for a second, they call “one of the most well documented example[s] of how the medical system colluded to suppress a therapy that threatened multiple franchises.” They highlight everything from chlorine dioxide’s accidental discovery as a therapeutic, to malaria outbreaks that disappeared after the drinking water was treated, to the surgeon who reported a 99.6% success rate treating 3,000 COVID patients with chlorine dioxide—only to have their hospital’s COVID unit shut down, to why the phrase “toxic bleach” may have been one of the most effective PR campaigns in modern medical history — right after “horse de-wormer” at least.

The book itself covers chlorine dioxide’s history, its pioneers, persecutions, and proponents, the science and safety behind it, and so much more. Senator Ron Johnson calls The War on Chlorine Dioxide “a gripping tale of corruption and courage that will open eyes and prompt serious questions.” I’ll take that.

If you’ve been wondering what I spent two years obsessively researching and writing about, you’ll get a pretty good taste. And if you’re ready to get your hands on a copy (it’s available in paperback and eBook in English, Spanish, and Portuguese, so spread the word), you can do that right here.

A Word About AMD

I have known AMD for years now, and somewhere along the way we realized that the missions of our Substacks were largely aligned, with one caveat: theirs is more focused and consistent and far better written, while mine often strays into more contentious areas of our Substack writers category, a category whose somewhat oxymoronic name still makes me laugh, “Health Politics,” where AMD now sits in the #1 spot, such that it has triggered envy amongst the other amazing ranked writers they overtook, some of whom have now started calling AMD a “Pharma plant.” Hilarious. Or, at least it would be if it weren’t so sad.

Anyway, the category name reminds me of a meme I came across a few years ago, making fun of the political divides that arose around scientific topics like ivermectin’s efficacy in Covid: “Who believes in penicillin more, Republicans or Democrats?”

Anyway, we were two people who stumbled into similar missions and have admired each other’s work ever since. They do theirs almost full-time; I only get to do it part-time, squeezed around a mountain of other responsibilities, like running the Leading Edge Clinic and writing books. And what they do with that time is extraordinary. They just spent over a year and a half — a year and a half — meticulously documenting the story of DMSO, one of the most important and most deliberately buried therapies in all of medicine. Nobody working today matches their combination of writing skill, rigor, breadth, and thoroughness.

I had AI put together a little graphic listing the various branches of medicine and therapeutics that “the medical establishment” has suppressed over the past century and more, as detailed by AMD in their article:

The list above brings to mind my essay, “The Kory Scale,” in which I proposed a method for assessing the effectiveness of an “alternative” therapy, particularly when it is safe, inexpensive, and widely accessible (the trifecta that threatens medicine’s economic model).

The method is simple: you assign points to every suppression and persecution tactic deployed by the institutions of society against the therapy, and the more points, the more effective (i.e., threatening) it is. I proposed different scores for media attacks, negative high impact journal editorials, FDA denials of research, universities and journals publishing trials of the treatments that are designed to fail, doctors who advocate for them losing their specialty certifications, licenses, or jobs (ahem), and, in a number of the cases above, assassinations or assassination attempts on the innovators of such treatments (as I detail in my book around chlorine dioxide and earlier oxidative therapies)

If more people in our society understood this history, and how it is still occurring, one of two things could happen. One, the system could change (not). Or two, people could seek out reliable information they could use to protect their own and their families' health, rather than relying on the high priests and priestesses of the medical religion, with their often terrible and very narrow therapeutic armamentarium. I ain’t holding my breath for the first. So, alongside AMD, I work toward the second.

From early on in Covid, I had one goal: that every cupboard in America hold ivermectin, for the whole family. Dreaming like that hasn’t changed, only the compounds have. Now my goal is for every cupboard to hold both chlorine dioxide and DMSO (mine does), two “umbrella therapies,” meaning each has numerous mechanisms of action and can treat a broad range of diseases, can be purchased online, and people can (and must) educate themselves to use, I believe safely, and far safer than most pharmaceuticals. DMSO has more mechanisms of action than chlorine dioxide; but several of those of chlorine dioxide, particularly against infectious illness, are far more potent.

There’s a more personal reason I care about this, too. For reasons I won’t get into here, I’ve come to see our medical system as an institution in serious decline, but now declining the way so many other institutions of society are declining right now, and, in the years since Covid, the hospital system has hardened into something even more rigid, protocolized, and unthinking than what I trained in. As my readers know, I now suffer from nosocomophobia, the fear of hospitals (a real and documented condition). Since Covid and my excommunication from “the system,” a daily, unspoken goal of my life is to avoid the hospital at nearly all costs. I’ve told my wife that the only way I’m going is if I’m unconscious, so she would have to call the ambulance herself.

I’m not telling you to draw the line exactly where I draw it; you should set your own criteria, and there absolutely may come a day when you have to go, and on that day you should go. The point isn’t recklessness; it’s the opposite. It’s being equipped well enough to make that call wisely, to handle at home what can be handled there safely, and to know the difference. I wrote about that last winter, when I treated a sudden, severe illness myself rather than walk into an ER: “Why and How I Purposefully Avoided the Hospital After Developing an Acute, Severe Illness This Week.” Consider it a case study in both what I do and, in more than a few moments, what not to do, but also remember that I am an experienced ICU specialist, so what I can pull off at home is unlikely to be an option for most.

That’s the mission, and AMD’s article is one more piece of the case for it. I’m grateful they wrote it.

Read their work. Then, if you want the fuller story, The War on Chlorine Dioxide is available at waronchlorinedioxide.com — again, it’s not on Amazon for all the reasons detailed in AMD’s article, so that’s the only place to get it.

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

Subscribe now

Note to readers:

One discovery consumed my last year: a volcanic mineral extract made by the Japanese scientist Shimanishi fifty years ago — the “Golden Elixir” of the old traditions, made real. It led me to write two three books, retire from my patient panel (but not from Leading Edge Clinic), and start a company with one mission: to carry this forgotten chemistry off the page. Aurmina for the water we drink, and Primora Bio for the water our soil, crops, and animals crave.

From Research to Practice - Links Below Image

Earth’s Living Water- Its History, Its Ruin, and the Way Back

The Silent Aquifer - Humanity’s Unfolding Food and Water Crisis

The War on Chlorine Dioxide - The Medicine That Could End Medicine

Aurmina – The Mineral Extract For Naturally Vitalized Drinking Water

Primora Bio - Bringing Life Back To Soil

Leading Edge Clinic - Tele-Medicine Clinic Caring For Patients in All 50 States

The War on Ivermectin- The Medicine That Could have Ended the Pandemic

The Blueprint of Life - The Hidden Architecture That Powers Life and Health

Medical Musings - A View From the Inside Of Modern Medicine

The chapters of this book argue from data, mechanism, and pattern. The images that follow argue from something simpler: what happened when people tried it themselves. These are not controlled experiments, and they are not presented as proof. They are visual records, from gardens, fields, kitchens, and backyards, of the kind of signal that arrives before formal evidence does. The reader can see what the observers saw and decide what to make of it.

Appendix 1: Potato Experiment: Two Glasses, Two Fates

In one glass, a potato rotted. In the other, it grew.

The experiment, submitted by my colleague Kacper Postawski, was simple. Two potatoes were placed in identical glasses. One glass contained ordinary tap water. The other contained water treated with a Themarox-derived mineral solution. There was no soil, no fertilizer, no added nutrient program, and no biological system beyond the potato itself. The glasses were then left undisturbed for weeks.

In ordinary tap water, the result followed the expected path: clouding, foul odor, tissue softening, structural breakdown, and decay. In the treated water, the system behaved differently. The water remained clearer. The potato retained its form. Roots developed into a dense mesh, and a green shoot emerged upward.

Two potatoes, the same carbon in each, and only the water deciding whether it slid toward rot or held together as something alive

Appendix 2: The Accidental Lilac

An accidental experiment cannot be staged. That is what makes it worth recording.

My partner, Scott Marsland, noticed the difference in blooming of his two side-by-side lilac bushes, and realized that when he had performed the foliar sprays with treated water, due to the angle at which he was spraying, the bush on the right received much more of the treated water than the bush on the left. This accidental experiment suggested a dose-response relationship between the water and the bushes’ flowering: the one on the right in full bloom, the one on the left in sparser bloom.

Then, a few weeks later, when the bushes were no longer in bloom, he noticed a marked difference in the color and vigor of the bushes: on the left, the tips of the leaves were yellow and curled, while those on the right were deep green and straight.

Scott has lived in that house over twenty years, and in all of them neither bush had ever come close to blooming like the one on the right, and the two had never come in differently. Same corner, same soil, same light, same two plants, over twenty springs running, and the only new thing this year was Rock-Water. Nature set the experiment up: two bushes alike in everything but one, how much treated water reached each, and the bloom tracked the water. More water, more flower. Less water, less. That is a dose-response, and it is the oldest evidence there is.

Appendix 3: The Basil Plant Race

These photographs were taken eighteen days apart. Nothing changed between them except the water.

Submitted by my colleague Jeff, producer and director of The Universal Antidote documentary and author of the Curious Outlier Substack, the first case involved two established basil plants grown side by side under matched conditions: same soil, same light, same fertilizer, and the same watering volume and schedule.

The sole intentional variable was the water.

One basil plant received filtered well water. The other received the same water treated with a 10% Themarox-derived solution. No meaningful amount of mineral nutrient was added beyond what both plants already received from the soil and Miracle-Gro fertilizer.

Dec 6, 2025, start of the race:

Dec 24, 2025:

Yet the plants diverged.

The basil receiving treated water showed accelerated growth, deeper coloration, increased leaf density, and greater structural rigidity. It looked like improved access: as if minerals already present in the soil became more biologically available, and carbon already available to the plant could be fixed more efficiently into living structure rather than dissipated through stress, inefficiency, or weak growth.

As a side-by-side observation, it again fits the larger geohydrological return framework. The treated plant grew faster, greener, denser, and stiffer, as if the minerals already in the soil had simply become easier to reach.

Appendix 4: A Lawn Blasts Off

She did not design an experiment. She planted a lawn and watched what happened.

A home gardener decided to seed her lawn with grass. In the photos below, you can see a completely grassless lawn in March, and she seeded the lawn in sections starting on April 29th and finishing May 2nd. She sprayed the grass twice in the first few days, and then again at about a week.

She reported that every morning she would get up, have a coffee, and “watch the lawn grow.”

As you can see below, within eight days, the seeded area was completely covered in green grass, whereas the instructions on the seed bag stated that it would take between 14 and 21 days, a growth speed which matches many of the studies reported by Shimanishi and other agronomists.

Appendix 5: A Cactus Sleeps For 50 Years

This observation was submitted by Brent Hanson, a patient of my partner Scott, who has been experimenting with Themarox-conditioned water in his home. He sent it because the plant in question had a history.

My name is Brent Hanson, and I have been experimenting with water treated with Scott Marsland’s mineral technology in different areas of my life. Recently, I decided to try it with a very special plant in our home: a Christmas cactus that once belonged to my grandmother. Our family believes this cactus has been with us for roughly forty to fifty years, and in all that time none of us can remember seeing it bloom.

After I began consistently watering it with diluted Themarox-treated water, something remarkable happened. For the first time in decades, the old family Christmas cactus produced a healthy, vibrant bloom.

It was a small flower, but a big moment for our family, because this plant is one of the last living connections we have to my grandmother.

I can’t claim this proves cause and effect, but the timing was striking. After decades of silence, the plant responded soon after I started using this kind of treated water. For me, that first blossom is more than just a flower on an old cactus; it feels like a symbol of hope and renewal in my own healing journey. It reminded me that even when change seems impossible, life can surprise us in gentle, unexpected ways.

Brent Hanson

Appendix 6: Seven Doves Visit in the Middle of Winter

Recently, my partner Scott Marsland sent me a uniquely fascinating visual anecdote. His wife, Kerrie, filled a water bowl with Themarox-treated water and placed it on the front porch side rail of their home in Ithaca, New York.

Two days later, in the middle of January, they saw seven doves congregating around the bowl and drinking from it. That alone made the scene striking. What made it memorable was the context: they had maintained a bird water bowl for more than twenty years and had heated it during winter for the previous three years, yet they had never seen this event before.

It belongs here because it is the kind of small, unexpected field signal that prompts deeper questions. And it was not the only one. A reader wrote to my colleague Matt Bakos with a similar account about her housecat: when she filled the upstairs bowl with treated water, the cat stopped drinking from its usual bowl in the basement. When she switched the bowls, moving the treated water down to the basement, the cat abandoned the upstairs bowl and followed it down. Neither the doves nor the cat proves anything. What both raise is whether living systems can sometimes register differences in water, in redox or hydration, before our instruments are brought to bear. It is hard to forget: seven doves, in the middle of winter, gathering around a bowl of treated water where none had gathered before.

Appendix 7: A Field That Had Given Up

When Patrick Rascon started this trial, there were no earthworms. By the end of the season, there were.

Temecula, California, is a semi-arid transition zone that looks favorable on paper and proves difficult in practice: low seasonal rainfall, hot desiccating summers, and old, calcium-rich, carbonate-heavy soils with little organic matter and fragile microbial life. It is not a low-mineral environment. It is a low-availability one.

The minerals are present but locked: iron chlorosis shows up even in iron-rich ground, magnesium and phosphorus get immobilized by carbonate chemistry, and trace elements circulate poorly despite an abundant inventory. That made it a useful test of the question at the center of this book: can a degraded soil-water system recover when mineral access is restored from the water side rather than forced in from the fertilizer side?

Rascon, who produces a Shimanishi-derived solution called Volcanna Rain, reported soil that was dry, dusty, and biologically exhausted, with no detectable earthworm activity and little visible life except goat heads (Tribulus terrestris). Goat heads are a warning flag: they thrive where soil has been disturbed, its structure collapsed, its organic carbon lost. Worse, the only abundant organism he found was cutworms, whose success signals a field whose biology has fallen behind the speed at which the crop is being asked to grow.

The intervention was essentially irrigation with mineral-treated water made from Volcanna Rain. No compost, no fertilizer program, no mineral blends, no aggressive inoculant. Early on, the field behaved like degraded soil: poor vigor, high insect pressure, uneven growth. Then it shifted. The cutworms disappeared. Earthworms appeared and thrived. Pest pressure fell so far that no pesticide was used. Roots established, plant architecture strengthened, leaf density and color rose, and multiple vegetable varieties flourished at once.

Just after mid-season, small amounts of fish emulsion and limited microbial support were added, far too little to explain the magnitude and uniformity of the response across crops. Weather and unknown variables may have contributed. What makes it notable is the disproportion between what went in, a trace of minerals in the water, and what came back.

Cucumbers as a Comparison

Rascon withheld the mineral solution from his weekly foliar spray on one row of cucumbers, an informal comparison against the treated crops beside them. The difference was striking. Where the nearby tomatoes were vivid green, the cucumber leaves were yellow-brown, curled, and stressed, and mold appeared on the cucumbers while the tomatoes stayed clean.

About half the cucumber crop never developed the color he expected, and many were flavorless and spotted. Where the treated water was included, the crop was greener, sturdier, and more resilient; where it was withheld, the signs of deficiency and stress stayed visible.

Economics

For a half-acre plot over a six-month season, with the solution as the near-sole input, Rascon estimated roughly $50 per month at wholesale and $100 at retail; for fields needing only foliar application, roughly $25 to $50 per month. The point is not merely that the input was cheap. It is that a response like this, if reproduced under controlled conditions, would suggest a different model of farming: not overwhelming degraded soil with more inputs, but restoring the chemistry through which soil, water, minerals, microbes, and plants function together.

Appendix 8: Standing Irrigation Water

Standing irrigation water on a clay-soil Asian pear orchard, before and after surface treatment with mineral-conditioned water. After flood irrigation, well water had stood on this clay ground for roughly two weeks without draining, long enough to grow algae across its surface, a sign of how completely the sealed soil had stopped accepting it. Patrick estimated the standing puddle at 100 to 200 gallons. He then sprayed the surface with four gallons of well water into which he had mixed sixteen ounces of his product, Volcanna Rain, the standard dose for treating about 125 gallons of water, so the amount applied was calibrated to treat roughly what was standing there. A stick was set to mark the water level.

Within six hours, the water had begun to penetrate visibly, and by the next evening, the ground had absorbed it almost completely. The soil had not changed in the interval; only the water entering it had. Photographs courtesy of Patrick Rascon; recorded as a personal communication.

Conclusion

Seen one at a time, they would simply be intriguing examples. When viewed all together, a direction appears. Across basil, Christmas cactus, potatoes, lawn, field crops, and birds, the same movement keeps showing up. When water is treated with a biotite-derived sulfated mineral complex, living systems repeatedly turn toward greater organization: clearer water instead of foul breakdown, roots instead of decay, green leaves instead of chlorosis, soil life instead of absence, sudden and explosive blooms instead of quiet green, and water that goes where it is supposed to, no longer stagnant and growing algae.

That direction is what makes them worth keeping, because in most of these cases, the added mineral was a trace, and the response is out of all proportion to it. The most coherent reading is that the water may be doing the work itself, restoring the exchange, redox, and hydration that let charge, minerals, and carbon act together again. That is what a geohydrological return framework would predict, and it is what these scattered images, taken together, appear to show.

Appearing is not proving, and I have not asked them to prove anything. Each is a testable claim dressed in the clothes of an anecdote, and each could be properly set up with matched controls, standardized dosing, and blinded measurements by anyone willing to do the work.

So I will not end by telling you what they mean. I do not fully know. I know only that the same direction kept arriving in fifty different ways, and that when the same result appears from enough different directions, it becomes hard to explain them all away. What to make of it from here is no longer mine to decide.

It belongs to whoever picks up the next glass of water and looks.

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What California Attorney General Rob Bonta, whose ass we just kicked in court, probably looks like today.

Last night I received a call from my amazing lawyer, Rick Jaffe, who also represented Dr. Stanislaw Burzynski back in the day during the FDA’s decades-long persecution of him, which I wrote about previously. Anyway, he called me with some big news: a federal judge had just signed an order that, four years ago, I thought I would never get.

In the case Kory v. Bastard, err, I mean Bonta, senior United States District Judge William B. Shubb granted our renewed motion for a preliminary injunction and ordered not only California’s Attorney General but also the Medical Board of California and the Osteopathic Medical Board, as well as ANYONE acting on their behalf, to stop investigating us, stop prosecuting us, stop harassing us. Most importantly, stop threatening our licenses over any professional opinions we might share with our own patients about Covid-19, the “vaccines,” ivermectin, anything. The order names me and my two colleagues, Dr. Le Trinh Hoang and Dr. Brian Tyson.

Let me remind you what this fight was about, because it represents one of the most glaring absurdities perpetrated during the Covid clown show.

In 2022, California passed AB 2098, a law that made it professional misconduct for a physician to give a patient Covid advice that departed from the government’s position. Let me repeat that. In the supposed United States of America (which I started to call the United States of Pharma early on in Covid), American physicians in that state, where I was licensed at the time, would have been literally forced to spew state propaganda in our patients’ ears or we would have lost our licenses. Not for fraud. Not for malpractice. No, it would have been for having a different medical opinion from that of our “beloved,” “un-captured” (yeah, right) government health agencies led by Saint Fauci (who, in a beautiful twist of fate, is in a contempt hearing today).

The penalty would have been our licenses, which is to say our careers, our livelihoods, and our ability to care for the people who came to us precisely because we would tell them the truth as we saw it. The state took the most personal conversation in medicine, the one between a doctor and a frightened patient, and tried to put its own words in our mouths, with our licenses held as collateral to make sure we complied.

We sued. And, incredibly to me at the time, we initially lost.

In April 2024, this very same judge initially denied our motion, based on the theory that when a doctor speaks to a patient, that speech is really just “conduct,” and conduct the state is free to regulate. Yup. Under that logic, the most important speech a physician ever delivers, the counsel we give at the bedside, carries less First Amendment protection than a billboard. So we said $%#! that and kept going.

Finally, the ground shifted, and it shifted at the Supreme Court. But it wasn’t easy because our appeal was denied by Justice Kagan and then a petition for certiorari was met with… ten months of silence. That is because they were considering a similar case, that of Chiles v. Salazar, which was finally decided this past March. There, the Court provided what I like to call “correction and direction” to Judge Shubb by holding that a professional’s speech to a client is still speech, protected by the First Amendment, and not some lesser category of “conduct” that the government can freely script. That decision pulled the foundation out from under the ruling against us. So we went back to the same courtroom and asked again. This time the answer was yes.

To learn of all the shenanigans pulled by the Medical Board and the state of California, as well as all the barriers that Attorney Rick Jaffe had to overcome, please read his post about the case, titled “The Doctor Will Speak To You Now.” It is excellent.

The judge was careful to point out that this was not a license for doctors to lie or to harm. The order leaves the boards every power they should have if a doctor does that. For sure, they can still go after genuine fraud, and should. They can still discipline actual negligent treatment, real prescribing violations, and a true failure of informed consent.

What they can no longer do is punish us for telling our own patients the truth as we saw it: that in our medical judgment the state was coercing and mandating its citizens into receiving toxic, lethal, ineffective, illogical, and experimental gene therapies, and that we would not pretend otherwise. We continue to have the freedom, even in Clownifornia, to both hold and freely express opinions that contradict those of the priesthood within public health and academia. The court even said, in so many words, that the boards may not dress up a viewpoint prosecution as a “standard of care” or “informed consent” case. That was always the trick, and the judge saw through it.

This is a preliminary injunction, which means the full fight over the merits continues. But a preliminary injunction is not a small thing because a federal court does not issue one unless it has concluded we are likely to win, and it protects us right now, today, from the machine that spent years trying to grind down doctors who would not read from the state’s script. First they took my specialty certifications, then they were going to go after my license to practice. While this case was being litigated, I smartly decided not to renew my California one, because of the domino effect: if you lose your license in one state, the others could, and probably would, follow. Rick Jaffe just told me to go ahead and re-apply, but I won’t, for reasons not the least of which is the $1,500 fee California charges. Know that in other states, the fee is around $500. What a state.

The sad reality of it all is that we had to learn that a government that can tell your doctor what he is allowed to say can basically tell your doctor to lie to you. The First Amendment exists for exactly this moment, when the official position is loud, certain, and literally dead wrong. It allows for what were a few handfuls of doctors to publicly warn you. That is, if you cared to listen to what they turned us into, i.e., “discredited doctors.” We were told to fall in line or lose everything. We said no (or, in my case, the emphatic New Yorker version of no). And a federal judge just told the State of California that saying no was our right (including the New Yorker version, although he didn’t state that specifically).

Free speech prevailed. We do not have to parrot pharma-government nonsense to keep our licenses. That principle was worth every day of this fight.

My deepest thanks to our attorney, Rick Jaffe, who never stopped; to my co-plaintiffs, Le Trinh Hoang and Brian Tyson; and to Children’s Health Defense, who fought for every one of us through COVID, harder still since, and for years before it ever arrived. Every one of them stood in the fire beside me.

And I am dropping another donation to both Rick Jaffe and CHD right now, because who knows when you or I will need them for whatever evil comes up with next. I am just so sick of the persistent trampling of almost every principle of freedom we hold dear, and it helps me sleep at night to know that we have some of the smartest, most dogged, and deeply principled people fighting for us at every turn.

More soon.

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

Subscribe now

Note to readers:

One discovery consumed my last year: a volcanic mineral extract made by the Japanese scientist Shimanishi fifty years ago — the “Golden Elixir” of the old traditions, made real. It led me to write two three books, retire my patient panel (but not from Leading Edge Clinic), and start a company with one mission: to carry this forgotten chemistry off the page. Aurmina for the water we drink, and Primora Bio for the water our soil, crops, and animals crave.

From Research to Practice - Links Below Image

Earth’s Living Water- Its History, Its Ruin, and the Way Back

The Silent Aquifer - Humanity’s Unfolding Food and Water Crisis

The War on Chlorine Dioxide - The Medicine That Could End Medicine

Aurmina – The Mineral Extract For Naturally Vitalized Drinking Water

Primora Bio - Bringing Life Back To Soil

Leading Edge Clinic - Tele-Medicine Clinic Caring For Patients in All 50 States

The War on Ivermectin- The Medicine That Could have Ended the Pandemic

The Blueprint of Life - The Hidden Architecture That Powers Life and Health

Medical Musings - A View From the Inside Of Modern Medicine

If you are here, either you were strolling by and stumbled in, or were launched here by the QR code at the opening of Earth’s Living Water black-and-white Photographic Appendix. Either way, welcome and enjoy the color photo version.

The chapters of this book argue from data, mechanism, and pattern. The images that follow argue from something simpler: what happened when people tried it themselves. These are not controlled experiments, and they are not presented as proof. They are visual records, from gardens, fields, kitchens, clinics, and backyards, of the kind of signal that arrives before formal evidence does. The reader can see what the observers saw and decide what to make of it.

Where a case touches health, a burn, a sunburn, a wound, a sample of blood, it is a record of what someone observed, not a treatment, a protocol, or advice, and nothing here has been shown safe or effective for any condition.

Appendix 1: Potato Experiment: Two Glasses, Two Fates

In one glass, a potato rotted. In the other, it grew.

The experiment, submitted by my colleague Kacper Postawski, was simple. Two potatoes were placed in identical glasses. One glass contained ordinary tap water. The other contained water treated with a Themarox-derived mineral solution. There was no soil, no fertilizer, no added nutrient program, and no biological system beyond the potato itself. The glasses were then left undisturbed for weeks.

In ordinary tap water, the result followed the expected path: clouding, foul odor, tissue softening, structural breakdown, and decay. In the treated water, the system behaved differently. The water remained clearer. The potato retained its form. Roots developed into a dense mesh, and a green shoot emerged upward.

That difference does not look like fertilization in the conventional sense. There was no soil reserve to unlock and no added macronutrient program to explain new growth. What it more closely suggests is a change in the medium’s organizing behavior.

Within the geohydrological return framework, the point is not that the treated water “fed” the potato in a crude input-output sense. The point is that water can either permit breakdown or support organization. Carbon was present in both potatoes. The difference was the medium’s ability to coordinate that carbon into structure rather than allow it to drift toward microbial decomposition, odor, and loss.

It captures the larger claim in miniature: life does not depend on elements alone. It depends on the conditions that allow elements, charge, minerals, water, and carbon to remain in relationship long enough for structure to emerge.

Appendix 2: The Accidental Lilac

An accidental experiment cannot be staged. That is what makes it worth recording.

My partner, Scott Marsland, noticed the difference in blooming of his two side-by-side lilac bushes, and realized that when he had performed the foliar sprays with treated water, due to the angle at which he was spraying, the bush on the right received much more of the treated water than the bush on the left. This accidental experiment suggested a dose-response relationship between the water and the bushes’ flowering: the one on the right in full bloom, the one on the left in sparser bloom.

Then, a few weeks later, when the bushes were no longer in bloom, he noticed a marked difference in the color and vigor of the bushes: on the left, the tips of the leaves were yellow and curled, while those on the right were deep green and straight.

Scott has lived in that house over twenty years, and in all of them neither bush had ever come close to blooming like the one on the right, and the two had never come in differently. Same corner, same soil, same light, same two plants, over twenty springs running, and the only new thing this year was Rock-Water. Nature set the experiment up: two bushes alike in everything but one, how much treated water reached each, and the bloom tracked the water. More water, more flower. Less water, less. That is a dose-response, and it is the oldest evidence there is.

Appendix 3: The Basil Plant Race

These photographs were taken eighteen days apart. Nothing changed between them except the water.

Submitted by my colleague Jeff, producer and director of The Universal Antidote documentary and author of the Curious Outlier Substack, the first case involved two established basil plants grown side by side under matched conditions: same soil, same light, same fertilizer, and the same watering volume and schedule.

The sole intentional variable was the water.

One basil plant received filtered well water. The other received the same water treated with a 10% Themarox-derived solution. No meaningful amount of mineral nutrient was added beyond what both plants already received from the soil and Miracle-Gro fertilizer.

Dec 6, 2025, start of the race:

Dec 24, 2025:

Yet the plants diverged.

The basil receiving treated water showed accelerated growth, deeper coloration, increased leaf density, and greater structural rigidity. It looked like improved access: as if minerals already present in the soil became more biologically available, and carbon already available to the plant could be fixed more efficiently into living structure rather than dissipated through stress, inefficiency, or weak growth.

As a side-by-side observation, it fits the larger geohydrological return framework. Under an input-only model, such a small change in mineral mass should not have produced a meaningful visual difference. Under a model where the water restores mineral access, the direction of the response is exactly what one would expect if the water itself helped restore the relationships among minerals, roots, microbes, charge, and carbon fixation.

Appendix 4: A Lawn Blasts Off

She did not design an experiment. She planted a lawn and watched what happened.

A home gardener decided to seed her lawn with grass. In the photos below, you can see a completely grassless lawn in March, and she seeded the lawn in sections starting on April 29th and finishing May 2nd. She sprayed the grass twice in the first few days, and then again at about a week.

She reported that every morning she would get up, have a coffee, and “watch the lawn grow.”

As you can see below, within eight days, the seeded area was completely covered in green grass, whereas the instructions on the seed bag stated that it would take between 14 and 21 days, a growth speed which matches many of the studies reported by Shimanishi and other agronomists.

Appendix 5: A Cactus Sleeps For 50 Years

This observation was submitted by Brent Hanson, a patient of my partner Scott, who has been experimenting with Themarox-conditioned water in his home. He sent it because the plant in question had a history.

My name is Brent Hanson, and I have been experimenting with water treated with Scott Marsland’s mineral technology in different areas of my life. Recently, I decided to try it with a very special plant in our home: a Christmas cactus that once belonged to my grandmother. Our family believes this cactus has been with us for roughly forty to fifty years, and in all that time none of us can remember seeing it bloom.

After I began consistently watering it with diluted Themarox-treated water, something remarkable happened. For the first time in decades, the old family Christmas cactus produced a healthy, vibrant bloom.

It was a small flower, but a big moment for our family, because this plant is one of the last living connections we have to my grandmother.

I can’t claim this proves cause and effect, but the timing was striking. After decades of silence, the plant responded soon after I started using this kind of treated water. For me, that first blossom is more than just a flower on an old cactus; it feels like a symbol of hope and renewal in my own healing journey. It reminded me that even when change seems impossible, life can surprise us in gentle, unexpected ways.

Brent Hanson

Appendix 6: Seven Doves Visit in the Middle of Winter

Recently, my partner Scott Marsland sent me a uniquely fascinating visual anecdote. His wife, Kerrie, filled a water bowl with Themarox-treated water and placed it on the front porch side rail of their home in Ithaca, New York.

Two days later, in the middle of January, they saw seven doves congregating around the bowl and drinking from it. That alone made the scene striking. What made it memorable was the context: they had maintained a bird water bowl for more than twenty years and had heated it during winter for the previous three years, yet they had never seen this event before.

It belongs here because it is the kind of small, unexpected field signal that prompts deeper questions. And it was not the only one. A reader wrote to my colleague Matt Bakos with a similar account about her housecat: when she filled the upstairs bowl with treated water, the cat stopped drinking from its usual bowl in the basement. When she switched the bowls, moving the treated water down to the basement, the cat abandoned the upstairs bowl and followed it down. Neither the doves nor the cat proves anything. What both raise is whether living systems can sometimes register differences in water, in redox or hydration, before our instruments are brought to bear. It is hard to forget: seven doves, in the middle of winter, gathering around a bowl of treated water where none had gathered before.

Appendix 7: A Field That Had Given Up

When Patrick Rascon started this trial, there were no earthworms. By the end of the season, there were.

Temecula, California, is a semi-arid transition zone that looks favorable on paper and proves difficult in practice: low seasonal rainfall, hot desiccating summers, and old, calcium-rich, carbonate-heavy soils with little organic matter and fragile microbial life. It is not a low-mineral environment. It is a low-availability one.

The minerals are present but locked: iron chlorosis shows up even in iron-rich ground, magnesium and phosphorus get immobilized by carbonate chemistry, and trace elements circulate poorly despite an abundant inventory. That made it a useful test of the question at the center of this book: can a degraded soil-water system recover when mineral access is restored from the water side rather than forced in from the fertilizer side?

Rascon, who produces a Shimanishi-derived solution called Volcanna Rain, reported soil that was dry, dusty, and biologically exhausted, with no detectable earthworm activity and little visible life except goat heads (Tribulus terrestris). Goat heads are a warning flag: they thrive where soil has been disturbed, its structure collapsed, its organic carbon lost. Worse, the only abundant organism he found was cutworms, whose success signals a field whose biology has fallen behind the speed at which the crop is being asked to grow.

The intervention was essentially irrigation with mineral-treated water made from Volcanna Rain. No compost, no fertilizer program, no mineral blends, no aggressive inoculant. Early on, the field behaved like degraded soil: poor vigor, high insect pressure, uneven growth. Then it shifted. The cutworms disappeared. Earthworms appeared and thrived. Pest pressure fell so far that no pesticide was used. Roots established, plant architecture strengthened, leaf density and color rose, and multiple vegetable varieties flourished at once.

Just after mid-season, small amounts of fish emulsion and limited microbial support were added, far too little to explain the magnitude and uniformity of the response across crops. Weather and unknown variables may have contributed. What makes the case notable is the disproportion between input and response. Under a fertilizer-only model, that disproportion is hard to explain. Under the model this book proposes, it is not: the water may have been restoring the exchange and redox chemistry through which soil, water, minerals, microbes, and roots work together again.

Cucumbers as a Comparison

Rascon withheld the mineral solution from his weekly foliar spray on one row of cucumbers, an informal comparison against the treated crops beside them. The difference was striking. Where the nearby tomatoes were vivid green, the cucumber leaves were yellow-brown, curled, and stressed, and mold appeared on the cucumbers while the tomatoes stayed clean.

About half the cucumber crop never developed the color he expected, and many were flavorless and spotted. Where the treated water was included, the crop was greener, sturdier, and more resilient; where it was withheld, the signs of deficiency and stress stayed visible.

Economics

For a half-acre plot over a six-month season, with the solution as the near-sole input, Rascon estimated roughly $50 per month at wholesale and $100 at retail; for fields needing only foliar application, roughly $25 to $50 per month. The point is not merely that the input was cheap. It is that a response like this, if reproduced under controlled conditions, would suggest a different model of farming: not overwhelming degraded soil with more inputs, but restoring the chemistry through which soil, water, minerals, microbes, and plants function together.

Appendix 8: The Pain Simply Stopped

A burn is a sudden collapse of order at an interface: within seconds, heat disrupts membranes, denatures proteins, floods the tissue with inflammatory mediators and oxidative stress, and sets the nerve endings firing. Unlike soil degradation or chronic illness, it has a clear beginning, which is what makes it instructive here.

My wife suffered a significant burn from a clothing steamer. The skin blistered almost immediately, and the pain was intense, and from experience with burns like it, I expected days of severe pain and a week or more before the injury settled. Only days earlier, a practitioner of sulfated mineral balneotherapy had taught me how to apply mineral solutions to acute skin injuries. Acting on that, we put a Themarox-derived mineral solution directly on the burn.

The pain resolved completely within about an hour, with no anesthetic, no numbing agent, no dressing, and no analgesic on the skin. The pain simply stopped. Over the following weeks the injury healed faster than I would have expected for a burn of that severity, ending as little more than a faint pink mark.

The timing and magnitude were unusual. It appears to have changed the wound environment: a sulfated mineral solution can influence ionic buffering, surface charge, oxidative stress, hydration structure, and local redox balance all at once. In a burn, the chemistry around the nerve endings drives much of the pain signaling, so if that environment shifts quickly, the signaling can fall faster than any tissue could actually heal. The healing that followed may have been the downstream consequence of a wound that was less inflamed, less oxidatively stressed, and better able to repair.

It is the same principle the rest of this book has followed, now at the scale of injured skin: when the medium around damaged tissue becomes better at buffering charge, managing redox, and supporting repair, the tissue itself changes. A single burn on a single person is a small thing to build on. But it is that principle showing itself in the flesh, and the first place in this book we catch it doing so.

Appendix 9: Sunburn Before a Wedding

I include this brief case from my practice’s charge nurse, who developed a sunburn while tanning in preparation for her wedding. After she returned home, she became concerned about how it would look for the wedding, so she soaked gauze in the liquid mineral solution and applied it two or three times over the next few hours. When she checked the mirror after the last application, the redness had dropped sharply.

The picture on the right was taken approximately three hours after the first application. The timing and degree of visible change made the case memorable, especially in light of the other tissue-response observations described in this appendix.

Appendix 10: Twenty Years of Photographs

The photographs below document single cases. This practitioner has many dozens more.

I later met an integrative practitioner who, like Nojima in his early observations in skin conditions, had used mineral-based approaches in her clinical practice for more than twenty years. In one conversation, she described repeated, large-magnitude improvements in dermatologic and tissue-repair cases.

What makes this practitioner’s work notable is its long duration and the sustained use of photographic documentation. Over many years, she photographed patients before and after participation in her programs, capturing visible changes in skin conditions, wounds, infections, burns, and musculoskeletal injuries.

Her consistent view has been that minerals function less as direct “treatments” in the pharmaceutical sense and more as facilitators of the biological terrain. In that view, the minerals are not forcing a single pathway. They are helping alter the medium in which circulation, inflammation, repair, and tissue responses unfold.

The following sequences are a visual record of tissue change over time within a mineral-supported clinical environment.

Live blood analysis is not a validated diagnostic modality, and I do not use it here as proof of disease, treatment response, or clinical benefit. At most, it provides a qualitative visual window into blood behavior under a microscope: erythrocyte spacing, aggregation, plasma debris, and the general appearance of the aqueous environment surrounding the cells.

Normal red blood cells under a microscope:

In one informal observation, a patient was examined before and after drinking sixteen ounces of water treated with a diluted Themarox-derived solution. The second microscopy image was obtained approximately forty-five minutes later. The initial field showed erythrocyte aggregation, rouleaux formation, and visible plasma debris. After hydration, the field appeared visibly different: red blood cells were more dispersed, aggregation was reduced, and cellular outlines appeared more distinct.

Still, the observation is worth recording because the visual change occurred in the exact domain where this book’s mechanism would predict early movement: the aqueous interface between cells.

Red blood cell aggregation is influenced by hydration status, plasma proteins, ionic strength, zeta potential, surface charge, oxidative stress, and the electrochemical properties of the surrounding fluid. Blood is not simply cells suspended in inert water. It is a charged, mineralized, protein-rich, redox-active fluid in continuous motion. If conditioned water can influence charge behavior, ionic organization, oxidative balance, or hydration efficiency, then changes in erythrocyte dispersion would be a plausible place to look.

These observations suggest a possible visual signal in plasma-cell organization after Themarox-conditioned hydration, a signal that belongs in future controlled studies using standardized sampling, blinded image analysis, zeta-potential measurements, viscosity testing, inflammatory markers, oxidative-stress assays, and matched untreated-water controls.

The importance of the observation is not that it proves the claim. It shows where the claim can be tested.

Appendix 12: Standing Irrigation Water

Standing irrigation water on a clay-soil Asian pear orchard, before and after surface treatment with mineral-conditioned water. After flood irrigation, well water had stood on this clay ground for roughly two weeks without draining, long enough to grow algae across its surface, a sign of how completely the sealed soil had stopped accepting it. Patrick estimated the standing puddle at 100 to 200 gallons. He then sprayed the surface with four gallons of well water into which he had mixed sixteen ounces of his product, Volcanna Rain, the standard dose for treating about 125 gallons of water, so the amount applied was calibrated to treat roughly what was standing there. A stick was set to mark the water level.

Within six hours, the water had begun to penetrate visibly, and by the next evening, the ground had absorbed it almost completely. The soil had not changed in the interval; only the water entering it had. Photographs courtesy of Patrick Rascon; recorded as a personal communication.

Conclusion

Read one of these at a time, and it is easy to explain away. Read them together, and a direction appears. Across basil, Christmas cactus, potatoes, lawn, field crops, birds, burns, wounds, skin, and blood, the same movement keeps showing up. When water is treated with a biotite-derived sulfated mineral complex, living systems repeatedly turn toward greater organization: clearer water instead of foul breakdown, roots instead of decay, green leaves instead of chlorosis, soil life instead of absence, repair instead of prolonged inflammation.

That direction is what makes them worth keeping, because in most of these cases, the added mineral was a trace, and the response is out of all proportion to it. The most coherent reading is that the water may be doing the work itself, restoring the exchange, redox, and hydration that let charge, minerals, and carbon act together again. That is what a geohydrological return framework would predict, and it is what these scattered images, taken together, appear to show.

Appearing is not proving, and I have not asked them to prove anything. Each is a testable claim wearing the clothes of an anecdote, and each could be properly set up with matched controls, standardized dosing, and blinded measurement by anyone willing to do the work. I am not asking these pictures to convince you. I am asking them to point.

So I will not end by telling you what they mean. I do not fully know. I know only that the same direction kept arriving through fifty different living systems, and that when the same result appears from enough different directions, it becomes hard to explain them all away. What to make of it from here is no longer mine to decide.

It belongs to whoever picks up the next glass of water and looks.

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*Excerpted from The Silent Aquifer, Chapter 48: Who Decides What’s True: How Modern Medicine Buries What Works

Paul Marik was the most-published practicing intensive-care physician in the history of the field. In 2017, he reported something that sounded impossible: a cheap, safe combination of vitamin C, hydrocortisone, and thiamine that pulled septic patients back from near-certain death. I initially dismissed it, as almost everyone did. Then I used it, and watched the dying sit up and ask for breakfast. This is the story of that discovery, of why the trials “failed,” and of what sepsis really is underneath: a form of scurvy.

The Reflex

My first major collision with the modern medical evidence system began with the fight over intravenous vitamin C in sepsis, alongside Professor Paul Marik. Like most of the critical care community, I reflexively dismissed Paul’s 2017 study. A couple of vitamins and a modest dose of a stress hormone reversing multi-organ failure was simply absurd. Especially the magnitude of the response: he was reporting one of the largest reductions in mortality in a critical illness, or any illness really, that I had ever heard of. In my whole career, only one intervention had produced a bigger drop: putting paddles on a heart in ventricular fibrillation.

My dismissal was not really my own. The colleagues I respected had waved the study off, so I did too; that is how the reflex works. And the form of the study gave me cover: a small, single-center, retrospective before-and-after study, exactly the kind of evidence I had been trained to file under “interesting but unproven.” Soon after came the part that, at the time, sealed it away for me for good.

Marik’s hospital, hearing the recoveries its own staff could not quite believe — patients, families, and nurses all describing the same thing — sent its media office to bring in a local television crew, which interviewed Paul and the nurses on camera. Someone forwarded me a clip ( I play one at the end of this post). Paul was talking about how “he never intended to discover the cure for sepsis,” and I remember thinking how bizarre that was: a physician, even one as widely known and respected as Paul, on a local news station, being interviewed about discovering the cure for sepsis, all off a single, just-published retrospective paper that I was taught couldn’t “prove” anything. The rules said that real proof only arrives at the end of a long, sober process, in a large, prospective, double-blind, randomized controlled trial published in one of the high-impact medical journals, not in a local ABC news affiliate broadcast from Norfolk, Virginia. So I did what my training had taught me. I ignored it.

That is, until about a year and a half later. I was taking care of an elderly Chinese man with septic shock in multi-organ failure, rapidly approaching death, and his family surrounded me, begging me through an interpreter to try something, anything. The memory of Paul’s protocol came back, so I treated the man with it. He died anyway; I had known he would. Nothing else could have saved him at that point. But because it had been so easy to do, and was super safe and really cheap, I figured I would try it again, since I had always liked learning about and trying new approaches to treating disease. The next patient was a woman in septic shock who, hours later, had to be rushed to the operating room for debridement of necrotizing fasciitis, a disease almost uniformly fatal without surgery. As a result, I did not get to observe her for long because she was transferred to the surgical critical care service, and even though I asked my surgical colleagues to continue it, they didn’t (surgeons are so much smarter than medical doctors that they generally ignore our treatment recommendations, because if it were something that was indicated, they would have thought of it first). Forgive me, for I digress.

The Man Eating Scrambled Eggs

Anyway, in those first few hours I thought I saw something: a slowing, a softening, a touch of steadiness returning to her blood pressure and heart rate. It was enough to make me try it once more the next day, when, during rounds, a man was rushed into the ICU from the bone marrow transplant floor with new-onset septic shock, four of four blood culture bottles growing E. coli, and a white count of zero. Not low. Zero. He was breathing fast, his oxygen and pressor needs were escalating rapidly, delirium was setting in, his urine bag was bone dry, and his wife was becoming increasingly frantic at the bedside.

He proceeded to turn around with a speed and magnitude that I had never seen before.

So much so that the next morning when his transplant specialist came to see him in my ICU, he found him sitting up out of bed eating scrambled eggs. I was leading rounds, Dr. House-style, on the other side of the unit, and he walked quickly over to me; I will never forget his face. “What the hell did you do to that guy? I was sure I’d find him with a tube and a circuit” — meaning a ventilator and dialysis.

It went that way again and again: pressure steadying, urine returning, color coming back, heart rates falling, minds clearing. I began discharging people I had been near-certain would die.

But not always. That is the part I have to be honest about, because it confused me at the time and also because I had started to get cocky. Some patients barely moved. A few showed nothing at all, and I could not see what separated them from the man eating scrambled eggs. I told myself it was luck, or that they were simply too far gone, and I kept going. It would take my own study to show me exactly why that was happening.

Either way, I became obsessed with what Paul had started calling the “iHAT” protocol (intravenous hydrocortisone, ascorbic acid, and thiamine). I tried to learn everything I could about it.

A Thousand Emails

Soon after the first few patient experiences, I reached out to Paul. Our first conversation ran for hours, and we became close colleagues quickly. He told me he had by then received more than a thousand emails from emergency and ICU physicians around the world describing the same dramatic recoveries.

Two things from that call have stayed with me ever since. He said his ICU length of stay for septic patients had plummeted to a little more than a day, “Just like my bone marrow transplant patient,” I shouted, probably too loudly. Then he said, more cynically, that he sensed the hospital’s nephrologists were getting annoyed because his unit had largely stopped calling them for dialysis. Unsurprisingly, dialysis begun in hospital is billed by the nephrologist for every day the patient stays on it, and a patient discharged still dialyzing becomes an outpatient on dialysis, which is a revenue stream that does not end. In the sickest cohort of patients, such as those included in Paul’s study, the data showed exactly why. Among treated patients with acute kidney injury, ten percent needed dialysis. In the control group, thirty-seven percent did.

He then told me that a random data contractor from the Centers for Medicare & Medicaid Services (CMS), managing one of the largest health datasets in the country, had, out of nowhere and unprompted, sent his hospital’s CEO the below data chart, showing a sudden, progressive, and eventually massive reduction in his hospital’s sepsis mortality, beginning right after his ICU team began using it systematically around February of 2016.

Sepsis mortality at Sentara Norfolk General Hospital, Q4 2015–Q1 2017. Redrawn from a chart prepared by Truven Health Analytics. Shaded band: the U.S. benchmark range for the period, from 14.4 percent (claims-based, in-hospital deaths only) to 21.2 percent (clinical criteria, counting hospice discharges).

To this day, the stories still find me. A few years ago, my dear friend and colleague, A Midwestern Doctor, called me about a loved one who had been admitted with sepsis. "I never realized sepsis was so serious," they said. "In the hospital where I worked, the intensivists always gave IV vitamin C, and no one ever got that sick." Sit with that: a physician who had worked in a hospital where the protocol was routine had never seen how deadly sepsis usually is, because where they worked, it wasn't.

Paul and I quickly became phone pals, and I started to learn even more fascinating details, like the fact that, somewhere back in our ancestry, humans developed a mutation in the gene for the enzyme that makes vitamin C, a trait shared only with guinea pigs and fruit bats. Which makes calling it a vitamin an accident of our own biology — for almost every other mammal it is something the liver produces on demand, and studies show that all other mammals produce large amounts of it under stress or illness. Paul made that argument in print, in a paper titled “Vitamin C: an essential ‘stress hormone’ during sepsis.”

Then I learned that ICU patients, particularly septic ones, typically enter the ICU disturbingly deficient in vitamin C due to their bodies consuming it (and not being able to make it anew) while battling whatever is ailing them. In one 2017 study, they found that 88% of patients with septic shock had levels below the minimum range, and 38% had levels that met the criteria for scurvy. Worse, all the patients in the study received standard repletion doses, either oral or IV, and their levels didn’t budge at all during their stay, meaning they were consuming vitamin C as fast as they were getting it, so their levels stayed in the basement the entire time they were in the ICU (or until they died).

*If you value the late nights and deep dives into all the “rabbit holes” I write about, your support is greatly appreciated.

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Your Septic Patients Have Scurvy

I am still disturbed that, despite papers showing severe vitamin C deficiency is near universal in severe sepsis, there is no national or international guideline or protocol to restore levels to normal. If potassium or magnesium drops below the lower limit of normal in an ICU, it is immediately repleted by the nurse, authorized by order sets that do not even require them to contact the doctor before infusing. They do this immediately and routinely. Yet, to this day, the entire field of critical care lets patients languish in severe vitamin C deficiency without a second thought.

Paul did what he could by publishing a paper whose title was not subtle: “Doctor — your septic patients have scurvy!”

Unsurprisingly, advanced scurvy and septic shock present near identically, at least in terms of the collapse of vascular tone. Which makes perfect sense, since the main catecholamines that maintain vascular tone all require vitamin C in order to do so. I remember being shocked when I first realized that I had spent twenty years treating scurvy… without treating scurvy.

A Stupid Electron Deficiency

I understand now what that collapse of vascular tone actually is, and it follows directly from the chemistry I have focused on in this book. A body holds its own blood pressure by making catecholamines — above all norepinephrine, the very vasopressor the ICU spends its nights infusing by the bagful. And it builds that norepinephrine from dopamine, with an enzyme called dopamine β-hydroxylase. That enzyme cannot take a single step without vitamin C.

The reason is redox, the same transferring and accepting of electrons that I followed through soil and water and minerals. The critical enzyme for making norepinephrine has a copper atom at its center which does its work by giving up an electron; the instant it does, it is left oxidized, spent, unable to fire again until something restores what it lost. Vitamin C is that electron donor, the reducing agent that hands the copper back its electron and resets the enzyme for the next cycle of production. Vitamin C is simply the source of electrons that lets a human being manufacture the very drug we pour into them when they can no longer make it themselves.

So a septic patient who has burned through his vitamin C has run out of the reducing power to make his own norepinephrine, and his pressure falls for the same reason a scorbutic sailor’s did three hundred years ago. When I pushed ascorbate into that patient, I was not giving a vitamin; I was just giving him some electrons because he was suffering from a stupid electron deficiency. I did not think in those terms then. I do now, and I have come to see redox, the arithmetic of electrons lost and regained, as one of the quiet governing laws of the living world, the body no exception.

The Ambush in Belfast

Those were the most satisfying and inspiring years of my career. Until they ended when I finally met Paul in person, at a major critical care conference in Belfast right before Covid hit the US in January 2020, where investigators from Australia presented the highly anticipated results of the VITAMINS trial, the world’s first in a series of large, expensive RCTs of IV vitamin C in severe sepsis that were done to confirm Paul’s ground-shaking study.

The trial found no significant improvement in time alive and free of vasopressor support when IV vitamin C and thiamine were added to hydrocortisone; mortality also did not differ significantly between the groups. Though we did not know it yet, that trial was the opening salvo in what would become a years-long war on IV vitamin C in sepsis.

Both of us had come expecting a celebration: a validation of our research and advocacy. Instead, Paul was set up. He had been invited to “moderate” the very session in which the trial would be presented, and was not told its results until we were already on our way to Ireland. He was already at the airport; I was still packing at home, and I will never, ever forget that phone call and the next two days leading up to the session, where we put together a defense of his work and results. We used my recent data to mount a damning critique of the trial, but he was professionally humiliated all the same. On a world stage, in front of an entire field that he had been one of the most widely respected leaders of.

Six Hours

My study easily exposed the flaw in the trial, and it was shockingly simple: timing. My team had analyzed the sepsis outcomes on my own ICU service, a seventeen-member unit I was chief of, from the day “some of us” began using Paul’s protocol. I recall only about four of my seventeen colleagues were moved enough by my lectures and advocacy to change their practice, one of whom was my wife at the time, so let’s say three.

In our published analysis, after adjustment for severity of illness, we found a large and statistically significant reduction in overall ICU mortality between docs who used the protocol and those who didn’t, from 26.0 percent to 11.4 percent. But to Paul and me, that wasn’t the real story. In patients who received iHAT within six hours of arrival to the Emergency Room, not a single person died in the ICU. The benefit then faded the longer treatment was delayed, and although we still saw improved survival up to 12 hours, the “statistically significant difference” was isolated to those who were treated within six. Another striking observation is that we saw no mortality benefit among patients transferred from other hospitals, who were already far along in their illness. I had finally figured out why some of my patients responded little, while others bounced back like springs.

The way I have come to explain it is this. A patient in early sepsis is Humpty Dumpty on the wall, wobbling. Give him vitamin C in that hour, and he rights himself and stays up there. Once he has gone over the edge and broken — once the organ failure is established — you can bring everything you have, and it will not matter. All the king’s horses and all the king’s men. That is what an intensive care unit is.

Which relates to a piece of this that never gets mentioned, and that I have come to think is the most important part of the whole story. Nearly all of Paul’s patients were started on his protocol soon after arrival to the Emergency Room because of how his hospital was organized. A patient who arrived there in septic shock was assigned to an ICU service almost immediately, which meant the intensive care team came down and wrote the treatment orders themselves, while the patient was still in the ER.

Almost nowhere else works that way. In most hospitals, emergency physicians assess the patient, stabilize them, begin treatment, and then call the ICU for evaluation. The ICU service then comes down to evaluate and decide whether the patient is sick enough to be given one of its beds. Learning to make that call was one of the core skills I had to develop, and I made it thousands of times, because intensive care beds are in short supply and someone has to triage them. It is a defensible system. It is also slow at every step. The US median length of stay in an ER prior to ICU admission
(a figure which varies widely by hospital, day of week, time of day, and ER volume) is approximately 4.6 hours, and since length of stay data tend to be right skewed with a long tail of very long waits, the mean is always higher than the median, so say… about 6 hours.

What separated Paul’s patients from everyone else’s was not only what he gave them. It was that his hospital, without intending to, had removed the delay. Every trial that followed set out to test what he gave. Not a single one of them came close to reproducing when he was able to give it.

Which is why Paul and I were enraged in Belfast. In the Australian trial, patients were not treated with vitamin C until 29 hours after admission to the ICU so it is anyone’s guess what the actual delay was, given the ER stay before transfer to the ICU. Just on its own, that delay should be considered malpractice: withholding a potentially life-saving therapy for over a day in a life-threatening medical emergency? Either way, treatment was started long past the window in which it could have saved a life.

The trials that followed all shared the same flaw and added new ones, such as including patients with surgical sepsis or those transferred from other hospitals. Every one of them enrolled patients who had already fallen. Ultimately, the critical care journals and professional societies settled into a consensus: Paul’s protocol was ineffective in severe sepsis, one of the leading causes of death in the world.

The World’s First Randomized Controlled Trial Was a Vitamin C Trial

There is an irony here so complete it feels staged. The modern randomized controlled trial, the very instrument raised over Paul's head to pronounce vitamin C useless, began its life as a vitamin C trial.

In 1747, aboard HMS Salisbury, a Scottish naval surgeon named James Lind ran what is still called the first controlled clinical trial in the history of medicine. He took twelve sailors dying of scurvy, matched them by severity, split them into six pairs, and gave each pair a different remedy—cider, vinegar, seawater, sulfuric acid, a spiced paste, and, to the last two, two oranges and a lemon a day. The citrus pair all but rose from the dead: one fit for duty within six days, the other recovered enough to nurse the rest. The method we built to find cures like that one was then used, three centuries later, to bury the cure that gave rise to it.

And consider what that cure was worth. Scurvy was the greatest killer of sailors in that era. By the historian Stephen Bown’s estimate, more than two million sailors between Columbus and the coming of steam died of scurvy, more than storms, shipwreck, combat, and every other disease combined. On Commodore George Anson’s voyage around the world, of the roughly twelve hundred men aboard his three ships only three hundred thirty-five came home; almost all the rest were buried at sea with scurvy, while exactly three died in battle. A ship could sail with hundreds and return with a handful, the difference rotting away from a want of citrus no one yet understood.

Here is the part that is as familiar to me as the day is long. Lind proved his cure in 1747. The Royal Navy did not adopt it as standard practice in stocking its ships until 1795, (forty-eight years later!), when Gilbert Blane finally convinced the Admiralty to issue lemon juice to the fleet. And when they did, scurvy all but disappeared from British ships, and healthy crews could hold a blockade of the French coast for years.

Historians draw a straight line from that to the naval supremacy that built the British Empire, which means you can make a serious case that the reason so much of the world speaks English today can be traced back to a bag of lemons and a controlled trial that the establishment ignored for half a century. They buried Lind’s cure for forty-eight years, and it still redrew the map of the world. Paul’s has only been buried for a handful. Imagine the reckoning when that account comes due.

The attacks on Paul did not end in Belfast. A couple of years later, an Australian researcher filed a formal fraud complaint against Paul and demanded that Chest, the prominent journal where he had published his study, retract it. The complaint was investigated, no wrongdoing was found, and the paper still stands. Yet today, if you or someone you love is admitted to a hospital, in the United States or nearly anywhere else, and you ask that they receive Paul's protocol—those missing electrons—you will be denied.

The End of the War

We would have fought every step of that war. But Covid intervened soon after Belfast, and our subsequent and very public dissent from U.S. public health policy during that time ended our academic careers. My initial exit from academics was voluntary; I resigned from the University of Wisconsin within two months of our first COVID patient's arrival, in protest of the institution's initial “supportive care only” approach.

Paul’s was uglier, more traumatic, and more public. He woke up one day to go round in the ICU to find an email that had just been sent to the entire Sentara Norfolk General hospital staff, written by a hospital administrator, announcing a new hospital policy targeting Paul: the memo announced that from that day forward, the hospital formulary would no longer fill any orders for any of the repurposed medicines on our FLCCC protocol for Covid (including IV vitamin C).

In one of the many heartbreaking scenes from the Covid war, many of us will never forget watching Paul break while testifying about that episode in one of Senator Ron Johnson’s Covid roundtables, sobbing, “I had to stand by idly, watching people die!” We all need to remember the history of what was done to Paul, and to all of us. Sen. Johnson’s 4.5 hour roundtable is here, Paul’s must-watch testimony begins at 4:18:55.

Children’s Health Defense provided the funds and legal support for Paul to sue his hospital for “practicing medicine without a license” (at the risk of stating the obvious, a hospital is not a doctor). Sadly, and unsurprisingly in the clown world we now live in, he lost, was terminated, and his clinical career ended. He created a new one by becoming what, to me, is the world’s leading expert in the metabolic theory of cancer and the use of repurposed drugs to treat it. Please support his Substack as his income has been markedly diminished (understatement), or buy his book, Cancer Care for you or any loved one who might benefit.

Ultimately, Paul and I were added to the pile of “discredited, controversial, fringe, quack” doctors. At least we don’t have to plead the 5th when someone asks us what color tie we are wearing.

I now look back on the vitamin C fight as our first rodeo against the establishment. Covid was the last.

Pauling's Ghost

Only later did I realize how closely that pattern echoed what had happened to Linus Pauling, the only two-time individual Nobel Prize winner in history. The clinical work was actually done by Ewan Cameron, a Scottish surgeon at Vale of Leven Hospital; Pauling was his collaborator and his megaphone. Their protocol began with ten grams of vitamin C a day given intravenously for ten days, and only then continued by mouth. They reported that patients with advanced cancer survived several times longer than matched controls.

The Mayo Clinic tested the claim twice, in 1979 and again in 1985, and found nothing. Problem: neither trial gave a single dose of intravenous vitamin C. They gave 10 grams a day, but by mouth.

The dose was not the problem. The route was. Vitamin C swallowed runs into absorption limits that hold blood levels below roughly 300 micromolar no matter how much you take. Infused, it reaches twenty millimolar, more than sixtyfold higher, and at those concentrations it is a pro-oxidant. Low-dose oral vitamin C is an antioxidant. They are not the same intervention, and only one of them was ever formally tested.

The negative results were enough. The consensus hardened into “vitamin C is ineffective in cancer,” and it has held for forty years.

What "Controlled" Really Means

My experience with Paul, and what I later learned about Pauling’s work, changed how I interpret clinical trial reports. It made me hostile to the worship of trial design divorced from biological plausibility, clinical timing, dose, pharmacology, and institutional incentive. When I hear the public told that “high-quality evidence” has spoken, I ask who funded it, how the dose and timing were chosen, and which patients were studied.

Learning those lessons changed me permanently. I can no longer read the word “controlled” in a trial report at face value, because I have watched too many studies in which the only thing truly controlled was the outcome. It became the line Paul Marik and I now use whenever the subject comes up: the only thing controlled about a multimillion-dollar randomized controlled trial is… the result.

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Although it pains me to watch it now, I will leave you with one of the almost half dozen TV newscasts of “Paul’s “discovery” in 2017, about 2 minutes long:

Note to readers:

One discovery consumed my last year: a volcanic mineral extract made by the Japanese scientist Shimanishi fifty years ago — the "Golden Elixir" of the old traditions, made real. It led me to write two books, retire from my patient panel (but not from our Leading Edge Clinic), and start a company with one mission: to carry this forgotten chemistry off the page. Aurmina for the water we drink, and Primora Bio for soil, crops, and animals.

From Research to Practice - Links Below Image

Aurmina – The Mineral Extract For Naturally Vitalized Drinking Water

Primora Bio - Bringing Life Back To Soil

Leading Edge Clinic - Tele-Medicine Clinic Caring For Patients in All 50 States

The War on Ivermectin- The Medicine That Could have Ended the Pandemic

The Blueprint of Life - The Hidden Architecture That Powers Life and Health

The Silent Aquifer - Humanity’s Unfolding Food and Water Crisis

The War on Chlorine Dioxide - The Medicine That Could End Medicine

Medical Musings - A View From the Inside Of Modern Medicine

Me, Lisa, and Lazlo (“Latzee”) awaiting his arrival.

Tomorrow is Independence Day, and this year it carries more meaning for me than any Fourth of July I can remember.

Our nation turns 250, our son is due, Aurmina is having a holiday sale, and after eleven months of constant writing, rewriting, editing, and researching — with more than a few moments when I wondered whether I could finish at all — both books that came out of this work are now done. And as a small thank-you to everyone who has followed along, this post closes with the final chapter of The Blueprint of Life — the last piece of the story, shared here first.

On the birth front, nothing is happening yet except for a few odd cramps, but I inflated the birth tub, the midwife and doula are on call, and I have finally cracked open the “Hypnobirthing: Creating Positive Birth Experiences” manual I was supposed to have read months ago (don’t tell Lisa). Independent of my previously described post-Covid nosocomophobia (fear of hospitals), Lisa would never in a million years give birth in one, so it's all happening at home.

On the book front, the first, The Blueprint of Life: Earths Hidden Architecture That Powers Life and Health, has been published and is shipping. Many of you have traveled this road with me from the very beginning. You’ve read early chapters, challenged my thinking, strengthened my arguments, caught mistakes, and encouraged me when the project felt impossibly large. In many ways this community helped write the book alongside me, and I’m deeply grateful.

It began with an unusual mineral extract developed in Japan, and what I first understood as a simple study of minerals. But that research kept widening — into geology, water chemistry, agriculture, soil biology, biochemistry, and ancient wisdom — until it opened onto something far larger: whether the organizing architecture that appears everywhere in nature is best understood as accident, necessity, or evidence of a Creator. Part scientific investigation, part intellectual journey, and part personal memoir, The Blueprint of Life is, above all, an invitation to follow evidence wherever it leads — even when it leads somewhere completely unexpected.

The companion volume has also found its final identity. The book many of you have known as From Volcanoes to Vitality will now be published as The Silent Aquifer: The Unfolding Global Crisis in Food and Water — and the Mineral Solution. At sixty-two chapters and 130,000 words, it is the most comprehensive exploration I know of into water and the minerals it carries — into water’s importance to the Earth, all the waters of the Earth themselves, and how the slow alteration of their mineral chemistry underlies the crisis now unfolding across the world’s agriculture. The manuscript is entering its final production stages and should begin shipping later this month, a couple of weeks behind its companion.