Summary of Guidance for Minimizing the Impact of Brainworms on Individual Persons, Communities, and Health Care Systems — United States

Patient readers, what follows was thrown over the transom, doubtless from an ally in the Atlanta area. I don’t know who, and that’s probably a good thing. –lambert

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Morbidity and Mortality Weekly Report / September 31, 2023 / 43(7);37124-19.

On September 24, 2023, this report was posted online as an MMWR Satirical Release.

Bud Abbott, PhD1; Louis Costello, MD1; Jacques Tati, MD1; Desiree Armfeldt, PhD1; Fredrik Egerman, MPH1; Emmett Kelly, DVM1; William Kempe, PhD1; Mikhail Nikolayevich Rumyantsev, PhD1; Oliver Hardy, DPT1; Stan Laurel, MD1; John W. Gacy, PhD1; Violent J, MD (VIEW AUTHOR AFFILIATIONS)


What is already known about this topic?

Some diseases attach the pysche and cannot be traced to any physical agent (Herbert, et al.) Among these are brainworms.

What is added by this report?

To prevent epistemologically significant brainworm infestations, persons must understand their risk, take steps to protect themselves and others with careful media consumption and critical thinking, and media fast for ≥5 days if infested.

What are the implications for public health practice?

Epistemologically significant brainworm infestations must be minimized to protect persons at high risk for severe illness. Importantly, it is not only others who may be infested, but one’s self.

A brainworm has been defined as “a persistent delusion or obsession; a deeply-ingrained or unquestioned idea”; brainworms have been compared to earworms (songs or melodies that keep playing inside one’s mind). Each are cases of involuntary cognition; brainworms, however, also affect speech and often behavior (e.g., frequent handwashing, sometimes continuing for a quarter of an hour, while unmasked). The term may have originated in the lyrics of Pink Floyd’s Hey You.

Understanding Risk. Brainworms can be detected in others through behavior (see above) but more importantly through linguistic cues. In a hospital settings, phrases like “it’s just a cold,” “learn to live with it,” “mild,” “endemic,” “follow the science,” “herd immunity,” “we’re all in this together,” “let me see your smile,” and “evidence-based medicine” are all signs of brainworms, especially when cumulative and occurring regularly. Any or all of these phrases, if repeated, can lead to infestation.

Self-Protection. If in a risky environment, you may choose passive measures, either spatially (leave the area) or attentionally (earbuds). You may also address the infestation by expressing critical thinking, but that carries its own risks (ostracism). Finally, you may wish to observe the media consumed by the infested subject, and avoid it.

If Infested. Cure can be difficult. A media fast, at a minimum, is indicated, for at least a working week. If a relapse occurs, consider excercising critical thinking skills in a group setting.


Brainworms Prevention Strategies

We have discussed preventing brainworm infestation in individual persons above, at “Self Protection.” Preventing brainworm infestation at the community level can be more challenging, since superspreading index patients are most likely to occur at the top of social and institutional heirarchies, and not below. It may be individuals protecting each other is the way forward here (“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has”). More research is needed. As for health care systems, remedies can only come externally by alterting incentives, as with regulation, legislation (and in some cases, prosecution).



The social determinants of brainworms are unknown, but are thought to include the accumulation of social and symbolic capital through excessive deference to authority figures in professional settings. More research is needed here as well. Further, one must take great care to ensure that one is not one’s self undergoing an infestation, especially if one is challenging others (in the vulgate: “high on my own supply”). The exercise of critical thinking, ideally in a group setting, is indicated here, along with regular doses of humility.

Brain Worms Emergency Response Team.


1 All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. vao

    Upon reading the title of the post, I immediately thought that the kind of infestation described here was becoming so common that guidelines “for individual persons, communities, and healthcare systems” were already required.

    Somehow, I do not feel as relieved as I wished; in addition, that aforementioned article helpfully notes that “The worm, Ophidascaris robertsi, is not the only type of worm that can infect human brains” — so whichever sort of brainworm is at play, we are beleaguered.

    1. JBird4049

      Just so long as we do not start getting zombied by Ophiocordyceps unilateralis, I will stay more worried about mind, not brain, worms.

  2. clarky90

    Attention animal lovers/peaceniks/all humans of good will. Israel intends to resume regular, ritual blood sacrifice- cutting the throats and spilling the blood of thousands of animals, on the sacrificial altar; an alter in the Temple with a ramp large enough to lead cattle up and onto it. Apparently, this ancient Old Testament, practice will please god and purify humanity. The unfolding plan (right now) may result in a war that kills billions of us. (you, me, kids, grand-kids, friends, neighbors…….)

    But What If I Don’t Want the Sacrifices of the Temple to Return?

    (The Temple refers to the proposed, Third Jewish Temple on the Temple Mount. It’s construction will require the bulldozing of The Al Aqsa Mosque, which is sacred to both Shia AND Sunni Muslims)

    “My stomach always got queasy thinking about the sight and sounds of the animals being slaughtered, and the blood being slathered all over the alter.

    I am also extremely sensitive to odors, so imagining the smells of blood and slaughtered animals and burning flesh only added to my nausea. It was beyond me to imagine all of that being “a pleasing smell to the Lord.”

    ….What if… what you saw wasn’t intestines and blood but the living Presence of God hovering over the alter……..”

    The Temple Institute

    “Remember: Helping to make HaShem’s dream of a Sanctuary in which His Presence can dwell amongst us, is the work of the Temple Institute! Join us in our efforts!”

    1. VT Digger

      Ph’nglui mglw’nafh Cthulhu Jerusalem wgah’nagl fhtagn

      (“In his house at Jerusalem, dread Cthulhu waits dreaming”).

  3. Mikel

    Whew…when I saw the headline I thought it might be actual an actual worm infestation going around.
    It’s the times…

    1. albrt

      There are probably lots of worm infestations going around. I mean, the Biden administration’s official public health policy on everything is “if we don’t do any testing then we will have very few cases.”

      I wonder where they got that line?

        1. Lambert Strether Post author

          > an inflammatory response

          Perhaps literally. Since I believe our consciousness is so constructed as to make understanding consciousness impossible (given that the world is not a “laboratory setting”), and yet at the same time am a materialist (nothing supernatural) the level of abstraction to approach constructions such as this one is a puzzlement!

  4. Michael Fiorillo

    Stormy Daniels will save the Republic, and Michael Avenatti is returning for a The Walls Are Closing In nostalgia tour: worm on, baby!

    1. Lambert Strether Post author

      > Stormy Daniels will save the Republic

      In all heterosexual scandals involving professional services, the (female) service provider is always the only level-headed and insightful source to be found.

  5. Iseeyoudock

    Uh, Toxoplasm Ghondii anyone?

    There is more to crazy cat ladies than meets the eye.

    The association with schizophrenia is especially interesting.

    Seriously though, it’s all just another putative explanation (really nothing new here, except perhaps a catchy new name) for propagandistic mechanisms which surround us in all manner of circumstances, especially in the advertising industry, to keep it at the amygldya or below.

    Van Der Kolk sums it up some of the mechanisms nicely.

    Mesmer. Houdini. Bernays. Chompsky. Satir. Even maybe Chopra or Winfree.

    Same thing, different packaging.

    Just turn on your local news station for 10 min to get the same effect. Watch a truck commercial. A beer commercial. A tropical resort commercial.

    Repetition. Intonation. Pacing. Alliteration. Just watch some old speeches from Jesse Jackson or MLK to see the rhetorical skill set to create the trance. Those guys were masters of it.

    Are attitudes and moods infectious? Different question yet elated to topic

    I remember once at a movie several years ago, I think it was the first Austin Powers movie, I sat in a packed house on opening night in the center of the theater. Something struck me as hysterically funny, and I had a protracted laughing paroxysm for about 45 seconds.

    A few people besides me chuckled.

    It was rather embarrassing, in that I was trying very hard to suppress my own laughter, but it kept leaking out at about 30 second intervals.

    Waves of subsequent laughter broke out, at first around the few people in front and to the sides, then further down the row, like larger pebbles in a pond, every 30 seconds or so.

    After about 8 min, the entire theater was laughing, after my inciting laugh, in a wave like manner.

    Totally embarrassing, but what great fun.

    1. Lambert Strether Post author

      > Repetition. Intonation. Pacing. Alliteration. Just watch some old speeches from Jesse Jackson or MLK to see the rhetorical skill set to create the trance. Those guys were masters of it.

      Yes, you see the point!

      I am not familiar with all the names that you mention. However, the extraordinary quantity and layering of bullshit from, say, the War on Terror onward convinces me that we need a genuine account of these
      “trance”-producing mechanisms. That was the subtext of my “Do I Sleep or Wake” post — we rarely ask ourselves whether we are really awake (or even conscious). And we should.

      When I say “genuine account” I mean something on the order of one of those aerosol transmission epidemiological studies with a seating chart and a diagram or the airflow.* (I don’t think works like Hate, Inc. do that. I won’t say they’re lazy, but I don’t think they come to grips with the problem. There’s no mechanism.)

      The extraordinary and successful effort to suppress the truth that #CovidIsAirborne, and to make the most obvious, cheapest, and clearly proven non-pharmaceutical intervention an object of ridicule and scorn leads me to conclude that people, very much including me, have far less freedom of action than we think. (And when we get freedom, we don’t know what to do with it, having so little experience with it.)

      Hard to practice or even watch politics in such a degraded environment. Bourdieu says that sociology is one of the martial arts. If so, we can use it to train people to protect themselves, because they sure need it.

      NOTE * I don’t mean nonsenses like “woke mind virus” or “mass formation.” These are memes or slogans attempting to occupy the space that a “genuine account” would occupy. To be fair, those slogans are from the conservatives. On the left, “ideology” and “culture” are more serious, but they still fail — demonstrably have failed — to bring the left’s project, control of the means of production by the working class, forward.

    2. Samuel Conner

      > After about 8 min, the entire theater was laughing, after my inciting laugh, in a wave like manner.

      The first time I saw The Gods Must Be Crazy, decades ago, it was in a small theater, probably an art film theater, with maybe 100 other viewers. Starting not long after the opening, the entire room was laughing, IIRC almost continuously, for practically the entire rest of the film. It was a delightful experience.

      Years later, viewing the film in a home setting, I found it pleasantly amusing but not nearly as hilarious as it had seemed in the group setting.

      I suppose that one of the advantages of a multi-polar world is that it facilitates criticism, from outside one’s largest-scale group, of one’s group-think.

    3. Quentin

      Jesse Jackson and MLK? What about our more recent master of the trade of mesmerising the public by means of cadence, intonation, modulation, etc.—-our one and only latest rhetorical wonder: OB. Obama’s ‘style’ always struck me as a caricature of blustering white and black ‘preacher men’, however much their content—OB’s blustering had content?–may vary. The power of the pulpit on the American psyche, you might call it.

  6. iseeyoudock

    I shouldn’t be so dismissive of it. I think recent events have led me to become too skeptical of the literature.

    I have great respect for some of the authors, their skills and contributions, and should read what they say more carefully. They may have a point.

      1. DJG, Reality Czar

        It occurs to me that an important “voice” in this field is missing among the list of distinguished authors: The esteemed Dr. Mae West.

        She gives the cure:
        “Those who are easily shocked should be shocked more often.”

  7. Dr. Tom

    Satire needs to be in the title or “for amusement purposes only”. This article could have an interesting trajectory as it makes the rounds, knowing that there are literalist amongst us, combined with the fact that there are parasitic worms that get into the brain…. now that I write this, we could only hope that might be the reason, for then it could be treated.

    I prefer the dogmatic, closed minded, and delusional (& likely others) in describing my obstreperous political opposites. Not that they would consider my label valid, but as a means to see them as human. Be aware, we’re all vulnerable to these qualities/behaviors.

    1. Lambert Strether Post author

      > Satire needs to be in the title or “for amusement purposes only”.

      That would be true, were our current situation not beyond satire. In any case, read the post: “…posted online as an MMWR Satirical Release.”

  8. Jorge

    No potential conflicts of interest were disclosed.

    This is precisely what I would disclose if I were a brainworm.

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